Gynecologic and reproductive services for women with developmental disabilities.

A two-phase study using mail-out questionnaires examined the availability and accessibility of gynecologic and reproductive services for women with developmental disabilities. First, 127 women with developmental disabilities responded to queries about the accessibility and type of available services, the providers of necessary care, and satisfaction with the services. The age range of the women was 18-80 years, with a mean age of 40 years. Of the women queried, 40% indicated that they had not received health education regarding gynecologic and reproductive needs, and 27% indicated that they disliked health education about such matters. In the second phase of the study, agencies that provide services to these women were queried about patterns of the providers, available services, and identified barriers, including financial problems, difficulty in finding a provider, family perceptions, and fear of and distaste for examinations. A surprising finding was that more than one-third of the reporting agencies indicated that questions about the identification and treatment of sexual abuse were not applicable to their agencies. The findings are discussed with an emphasis on identified barriers to care, available services, and the implications for nurse practitioner practice.