Pregnancy Intendedness by Maternal Disability Status and Type in the United States

CONTEXT: Societal views about sexuality and parenting among people with disabilities may limit these individuals’ access to sex education and the full range of reproductive health services, and put them at increased risk for ­unintended pregnancies. To date, however, no national population-based studies have examined pregnancy ­intendedness among U.S. women with disabilities. METHODS: Cross-sectional analyses of data from the 2011–2013 and 2013–2015 waves of the National Survey of Family Growth were conducted; the sample included 5,861 pregnancies reported by 3,089 women. The proportion of pregnancies described as unintended was calculated for women with any type of disability, women with each of five types of disabilities and women with no disabilities. Multivariate logistic regression analyses were conducted to examine the relationship of disability status and type with pregnancy intendedness while adjusting for covariates. RESULTS: A higher proportion of pregnancies were unintended among women with disabilities than among women without disabilities (53% vs. 36%). Women with independent living disability had the highest proportion of unintended pregnancies (62%). In regression analyses, the odds that a pregnancy was unintended were greater among women with any type of disability than among women without disabilities (odds ratio, 1.4), and were also elevated among women with hearing disability, cognitive disability or independent living disability (1.5–1.9). CONCLUSIONS: Further research is needed to understand differences in unintended pregnancy by type and extent of disability. People with disabilities should be fully included in sex education, and their routine care should incorporate discussion of reproductive planning.