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 41<br />
McCarthy (1999: 221), who carried out research with women with<br />
learning disabilities in Engl<strong>and</strong>, notes that the reliance <strong>on</strong> low/no<br />
maintenance methods, such as those described above (Chamberlain et<br />
al., 1984), assumes that women with learning disabilities are incapable<br />
or unreliable when it comes to managing their own fertility. She suggests<br />
that as new forms <strong>of</strong> slow-release, l<strong>on</strong>g-acting c<strong>on</strong>tracepti<strong>on</strong> (such as<br />
implants) come <strong>on</strong>to the market <strong>on</strong>e could expect these to be over-used<br />
as well (McCarthy <strong>and</strong> Thomps<strong>on</strong>, 1998). It has also been argued that<br />
the use <strong>of</strong> l<strong>on</strong>g-lasting c<strong>on</strong>tracepti<strong>on</strong> like Depot Medroxyprogester<strong>on</strong>e<br />
Acetate reveals pressures to discourage the fertility <strong>of</strong> certain groups<br />
<strong>of</strong> women (Williams, 1992). IUDs are not generally the c<strong>on</strong>tracepti<strong>on</strong><br />
<strong>of</strong> choice <strong>of</strong> younger women without learning disabilities, yet they are<br />
frequently used for women with learning disabilities (Chamberlain et al.,<br />
1984; Elkins et al., 1994).<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 />
McCarthy (1999:222) notes that the use <strong>of</strong> c<strong>on</strong>doms is menti<strong>on</strong>ed<br />
widely in the literature but this is almost exclusively in relati<strong>on</strong> to<br />
HIV preventi<strong>on</strong>. Use <strong>of</strong> the diaphragm: is almost entirely overlooked.<br />
McCarthy (1999) acknowledges the possible difficulties for a woman<br />
with learning disabilities in using a diaphragm: learning how to insert<br />
it properly, having to touch her genitals, inserting <strong>and</strong> removing it at<br />
the right times. The hurried nature <strong>of</strong> much <strong>of</strong> the sexual activity the<br />
women in her study reported to her would suggest that diaphragms<br />
would be impractical, as would the female c<strong>on</strong>dom for the same reas<strong>on</strong>s<br />
(McCarthy, 1999: 223).<br />
2.3.2 Factors influencing c<strong>on</strong>tracepti<strong>on</strong> usage<br />
Research has shown that the living envir<strong>on</strong>ment <strong>of</strong> women with<br />
intellectual disability is a determining factor in their use <strong>of</strong> c<strong>on</strong>tracepti<strong>on</strong><br />
<strong>and</strong> the type <strong>of</strong> c<strong>on</strong>tracepti<strong>on</strong> used. Servais et al.’s (2002) populati<strong>on</strong>based<br />
study involved a survey <strong>of</strong> 397 women with intellectual disability<br />
aged between 18 <strong>and</strong> 46 attending government-funded facilities in<br />
Brussels <strong>and</strong> the province <strong>of</strong> Wallo<strong>on</strong> Brabant in Belgium. [13] Of these<br />
women, over 40 per cent did not use any c<strong>on</strong>traceptive method, 22 per<br />
cent were sterilised, 18 per cent used an oral c<strong>on</strong>traceptive agent, <strong>and</strong><br />
13 Findings from the survey indicated that 7% <strong>of</strong> the women were having or<br />
previously had had c<strong>on</strong>senting sexual intercourse; 51% were not sexually active,<br />
<strong>and</strong> this informati<strong>on</strong> was not known for 41% <strong>of</strong> the women.