ArticleObstetrics and gynecology2018
Provision of Moderately and Highly Effective Reversible Contraception to Insured Women With Intellectual and Developmental Disabilities.
Article in Obstetrics and gynecology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Right to Sexuality, Reproductive Health, and Found a Family for People with Intellectual Disability: A Systematic Review.International journal of environmental research and public health · 2023Pooled it
- Use of hormonal intrauterine device and quarterly injection for contraception in adolescents with mental disorders.Journal of the Turkish German Gynecological Association · 2026Article
- Barriers and facilitators impacting access to sexual and reproductive health services for women with intellectual disability.Frontiers in psychiatry · 2026Article
- Injectable contraceptive use in women with intellectual disability: narrative review and service evaluation.BJPsych open · 2025Article
- Pregnancy Intendedness Among Racial and Ethnically Minoritized Women with Disabilities.Journal of women's health (2002) · 2024Article
- Clinician perspectives on the need for training on caring for pregnant women with intellectual and developmental disabilities.Disability and health journal · 2022Article
- Birth intentions among US fathers with disabilities.Disability and health journal · 2021Article
- Contraceptive use at first sexual intercourse among adolescent and young adult women with disabilities: The role of formal sex education.Contraception · 2021Article
- Role of family caregivers regarding sexual and reproductive health for women and girls with intellectual disability: A scoping review.Journal of intellectual disability research : JIDR · 2020Article
- Contraceptive Practices and Reproductive Health Considerations for Adolescent and Adult Women with Intellectual and Developmental Disabilities: A Review of the Literature.Sexuality and disability · 2019Article
- Differences in Contraceptive Method Discontinuation and Contraceptive Method Preferences by Disability Status.Women's health issues : official publication of the Jacobs Institute of Women's HealthObservational
- Centering disability visibility in reproductive health care: Dismantling barriers to achieve reproductive equity.Women's health (London, England)Review
- Differences in Telemedicine Use Between People With and Without an Intellectual or Other Developmental Disability During the COVID-19 Pandemic.Inquiry : a journal of medical care organization, provision and financingArticle
- Gynecologic Care for Women With Physical Disabilities: A Qualitative Study of Patients and Providers.Women's health issues : official publication of the Jacobs Institute of Women's HealthArticle
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Authors and funding
5 authors.
Funding
Abstract
objectiveTo estimate provision of moderately and highly effective reversible contraceptives to women with intellectual and developmental disabilities.
methodsWe used data from the Massachusetts All-Payer Claims Database to identify women aged 15-44 years with and without intellectual and developmental disabilities who were continuously enrolled in a private commercial insurance plan, Medicaid, or Medicare in 2012. We calculated the percentage of women aged 15-44 years who were not medically or surgically sterile and were provided 1) highly effective, long-acting reversible contraception (LARC, the intrauterine device or subdermal implant); or 2) prescriptions for moderately effective methods (pill, patch, ring, shot, or diaphragm). Logistic regression models estimated the odds of LARC and moderately effective method provision by disability status, adjusted for age, income, and Medicaid receipt.
resultsAmong 915,561 women who were not medically or surgically sterile, 13,059 women (1.4%) had at least one intellectual and developmental disability. Women with intellectual and developmental disabilities were less likely to be provided LARC (2.1% vs 4.2%, P<.001, adjusted odds ratio [OR] 0.43, 95% CI 0.38-0.48, P<.001) and moderately effective methods (21.1% vs 29.9%, P<.001, adjusted OR 0.68, 95% CI 0.65-0.71, P<.001) than women without intellectual and developmental disabilities. The one exception was the progestin shot, which was provided more often to women with intellectual and developmental disabilities than women without these disabilities (14.7% vs 4.3%, P<.001). Among a subset of women who only received moderately effective methods or LARC (n=310,344), women with intellectual and developmental disability had lower odds of receiving LARC than moderately effective methods (adjusted OR 0.59, 95% CI 0.52-0.67).
conclusionThe study findings raise concerns that the provision of LARC and moderately effective methods differs based on the presence of intellectual and developmental disabilities. Greater understanding is needed regarding factors that underlie lower provision of LARC in comparison with moderately effective methods, especially the progestin shot, among women with intellectual and developmental disabilities.
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