Literature Review on Provision of Appropriate and Accessible ...

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Servais, Jacques, Leach et al.(2002) found in their study [12] that
women with intellectual disabilities were more likely to be treated with
sterilisation or Depot Medroxyprogesterone Acetate and less likely to be
prescribed oral <strong>Literature</strong> contraceptives.
<strong>Review</strong> Provision of Appropriate and Accessible
Support to People with an Intellectual Disability who are
Experiencing Crisis Pregnancy
Rodgers’s study (2001) on the experience and management of
menstruation for women with learning disabilities involved qualitative
interviews/focus group with 21 women with mild to moderate learning
disabilities from six locations in the South West of England. Her
findings indicated that 11 of the 21 women had been given a medical
intervention of some kind, including the contraceptive pill, Depot
Medroxyprogesterone Acetate and hysterectomy. The women were
not well informed about the nature of the interventions or possible
side effects. For example, women taking the Pill did not know that it
prevented pregnancy as well as making periods lighter and more regular.
The same study gathered the viewpoints of carers and health
professionals (32 participants in total, comprising 11 family carers, 12
paid carers, four community learning disability nurses, and five general
practitioners), who reported that medical interventions relating to
menstruation appeared to be common, even routine. In one area many
women were taking Norethisterone tablets to prevent menstruation.
It was felt that interventions were not always used with due care for the
woman’s overall well-being or health. Participants spoke of carers who
had attempted to arrange sterilisation as well as hysterectomies for their
daughters. These were perceived by carers as more difficult to arrange
as they believed that gynaecologists might be reluctant to perform them,
due to concerns about consent, the possible side-effects of the operation,
and the woman not being able to comply with her post-operative care.
Interventions were commonly seen as a way of ‘protecting’ women from
unwanted pregnancy.
12 Servais et al.’s (2002) population based study involved a survey of 397 women
with intellectual disability aged between 18 and 46 attending government funded
facilities in Brussels and the province of Walloon Brabant in Belgium.