Literature Review on Provision of Appropriate and Accessible ...
Literature Review on Provision of Appropriate and Accessible ...
Literature Review on Provision of Appropriate and Accessible ...
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PAGE 39<br />
is placed <strong>on</strong> their health <strong>and</strong> future fertility than <strong>on</strong> other women’s<br />
(McCarthy, 1999: 224).<br />
Another reas<strong>on</strong> proposed for prescribing c<strong>on</strong>tracepti<strong>on</strong> to women<br />
with intellectual disability is that such women, particularly those with<br />
severe intellectual disabilities, would be unable to practically manage<br />
their periods <strong>and</strong>/or that they would be very distressed by the sight<br />
<strong>of</strong> blood (Taylor & Carls<strong>on</strong>, 1993). McCarthy c<strong>on</strong>tends that there is<br />
actually very little evidence to support this point (1998). To protect a<br />
woman with intellectual disability from the sexually active men around<br />
her has also been used as a justificati<strong>on</strong> for prescribing c<strong>on</strong>tracepti<strong>on</strong>.<br />
Taylor <strong>and</strong> Carls<strong>on</strong> (1993) point out that prescribing c<strong>on</strong>tracepti<strong>on</strong> to a<br />
woman with learning disabilities thought to be at risk <strong>of</strong> sexual abuse<br />
in fact increases her vulnerability to abuse. As research has shown that<br />
perpetrators <strong>of</strong> abuse are more likely to be known to a woman with<br />
intellectual disability, the knowledge that a woman is using c<strong>on</strong>tracepti<strong>on</strong><br />
provides protecti<strong>on</strong> in itself for a potential abuser, as he will know that<br />
pregnancy will not occur <strong>and</strong> therefore that there are fewer chances <strong>of</strong><br />
his being caught <strong>and</strong> identified.<br />
Support to People with an Intellectual Disability who are<br />
<strong>Accessible</strong><br />
<strong>and</strong> <strong>Appropriate</strong> <strong>of</strong> Provisi<strong>on</strong> <strong>on</strong> <str<strong>on</strong>g>Review</str<strong>on</strong>g> <str<strong>on</strong>g>Literature</str<strong>on</strong>g><br />
Experiencing Crisis Pregnancy<br />
2.3 Research <strong>on</strong> use <strong>of</strong> c<strong>on</strong>tracepti<strong>on</strong><br />
Most research c<strong>on</strong>cerning the c<strong>on</strong>tracepti<strong>on</strong> <strong>of</strong> intellectually disabled<br />
women refers to the populati<strong>on</strong> attending a particular gynaecologist<br />
(Grover, 2002) or a clinic (Elkins, Gafford, Wilks, Muram <strong>and</strong> Golden,<br />
1986; Chamberlain, Rauh <strong>and</strong> Passer, 1984). Mail surveys have also<br />
been c<strong>on</strong>ducted where directors in instituti<strong>on</strong>s have been asked to<br />
estimate how <strong>of</strong>ten the different c<strong>on</strong>traceptive methods are used in their<br />
instituti<strong>on</strong>s (Gust et al., 2003).<br />
2.3.1 Type <strong>of</strong> c<strong>on</strong>tracepti<strong>on</strong> used<br />
The pattern <strong>of</strong> c<strong>on</strong>traceptive use am<strong>on</strong>gst women with<br />
intellectual disability differs widely from that <strong>of</strong> the n<strong>on</strong>-disabled<br />
populati<strong>on</strong>. L<strong>on</strong>gst<strong>and</strong>ing research c<strong>on</strong>firms that the Pill, Depot<br />
Medroxyprogester<strong>on</strong>e Acetate <strong>and</strong> IUDs are the <strong>on</strong>ly methods used<br />
by most women with learning disabilities, with barrier methods being<br />
reported as unheard <strong>of</strong> (Chamberlain et al., 1984: 449; McCarthy, 1998;<br />
Van der Merwe & Roux, 1987; Shet & Malpani, 1991). More recently,