Contraceptive use by disability status: new national estimates from the National Survey of Family Growth

Objective: The objective was to determine population-based estimates of use of contraception among women 15-44 years of age in the United States by disability status. Study design: We examined the relationship between disability status and use of contraception among 7505 women at risk of unintended pregnancy using data from the 2011-2015 National Survey of Family Growth. Results: After examining the full distribution of contraceptive method use by disability status, we found that disability status was significantly associated with differences in three categories of use: female sterilization, the oral contraceptive pill and nonuse of contraception. Multivariate analysis shows that use of female sterilization was higher among women with cognitive disabilities (aOR=1.54, 95% CI=1.12-2.12) and physical disabilities (aOR=1.59, CI =1.08-2.35) than for those without disabilities after controlling for age, parity, race, insurance coverage and experience of unintended births. Use of the pill was less common among women with physical disabilities than for those without disabilities (aOR=0.57, CI= 0.40-0.82). Finally, not using a method was more common among women with cognitive disabilities (aOR=1.90, CI=1.36-2.66). Conclusions: Self-reported cognitive disabilities (serious difficulty concentrating, remembering or making decisions), as well as physical disabilities, are significant predictors of contraceptive choices after controlling for several known predictors of use. Implications: The patterns found here suggest that screening for self-reported cognitive and physical disabilities may allow health care providers to tailor counseling and sex education to help women with disabilities prevent unintended pregnancy and reach their family size goals. (C) 2018 Elsevier Inc. All rights reserved.