The Impact of Perceived Health Care Provider Attitudes on Planned versus Unplanned Pregnancies in People with Cerebral Palsy.

OBJECTIVES

For people with cerebral palsy (CP), the transition from adolescence to adulthood can be particularly difficult. There are misperceptions surrounding the sexuality of people with disabilities; CP is no exception. These may affect discussions with health care providers (HCPs).

METHODS

This study is part of an online international survey examining reproductive health outcomes of people with CP, designed according to the principles of person-centred research. Multiple recruitment techniques were used, including partnering with disability organizations to conduct snowball and peer recruitment.

RESULTS

A total of 57 pregnancies were included in this analysis, of which 33 were planned and 24 unplanned. Eight of the 24 (33.3%) participants who reported unplanned pregnancies stated that their HCP acted negatively to or ignored their inquiries about sexual health, as opposed to 2 of 33 (6.1%) participants with planned pregnancies (P = 0.007). Eleven of the 24 (45.8%) participants with unplanned pregnancies reported negative attitudes towards inquiries about pregnancy planning, as opposed to 6 of 33 (18.2%) participants with planned pregnancies (P = 0.02). Those with planned pregnancies reported higher rates of HCPs inquiring whether they were sexually active (32/33 [97.0%] vs. 21/24 [87.5%]) and offering birth control (31/33 [93.9%] vs. 21/24 [87.5%]); however, this difference was not statistically significant. Sexually transmitted infection screening was offered more frequently to participants with unplanned pregnancies than those with planned pregnancies (17/24 [70.8%] vs. 16/33 [48.5%]), although this difference was not statistically significant.

CONCLUSIONS

People with CP appear to have similar risk for unplanned pregnancies as the general population. However, many report negative attitudes from their HCPs towards family planning. Further research is needed to enrich HCP education regarding sexual health in this population.