Physician Recommendations Against Pregnancy Among Young Women With Disabilities in the United States

Bibliographic Data

ID9100060
AuthorsIlhom Akobirshoev (0000-0003-0680-5101, Lurie Institute for Disability Policy, Brandeis University, Waltham, MA, corresponding author), Robyn M Powell (0000-0001-7898-2268, Brandeis University, corresponding author), Robyn Powell (Lurie Institute for Disability Policy, Brandeis University, Waltham, MA), Willi Horner-Johnson (Institute on Development and Disability, Oregon Health and Science University, Portland, OR), Ruby Siegel (Lurie Institute for Disability Policy, Brandeis University, Waltham, MA, corresponding author), Justine Wu (0000-0003-4646-8410, Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI), M Mitra (0000-0002-4089-3240, Brandeis University, corresponding author)
Year2026
Volume64
Issue6
Pages368-375
Publication date2026-03-31
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000002316
PMID41914514
OpenAlexW7143736079
LanguageEN
References cited26

BACKGROUND: Women with disabilities face systematic barriers to reproductive autonomy, yet physician bias in pregnancy counseling has not been quantified using nationally representative data. METHODS: We analyzed pooled data from 4 waves of the National Survey of Family Growth (2011-2019), including 8018 US women aged 15-25. Disability status was defined using the American Community Survey's 6-item measure. The primary outcome was self-reported physician recommendation against pregnancy. Among women who received such recommendations (n=122), we examined physician-reported reasons using categories: "dangerous for you," "dangerous for your baby," and "some other reason." Poisson regression was used to estimate adjusted prevalence ratios (aPRs). RESULTS: Disabled women comprised 21.2% of the sample and were significantly more likely to report receiving physician recommendations against pregnancy compared with nondisabled women (2.6% vs. 1.1%; aPR:1.91, 95% CI: 1.10-3.29). The disparity was highest among women with physical disabilities (aPR:5.73, 95% CI: 1.79-18.29), followed by those with hearing (aPR: 4.24, 95% CI: 1.49-12.07) and vision disabilities (aPR:3.99, 95% CI: 1.60-9.99). A substantial proportion of recommendations were attributed to "some other reason" (disabled women: 44%; nondisabled women: 40%). CONCLUSIONS: Young disabled women face systematic bias during reproductive health care counseling, with nearly double the likelihood of receiving recommendations against pregnancy. The high proportion of recommendations under "some other reasons," beyond maternal or fetal health concerns, suggests potential subjective biases may influence clinical recommendations. These findings underscore the need for evidence-based clinical guidelines and monitoring to ensure respectful, individualized, and medically appropriate reproductive health care regardless of disability status

Health care · MEDLINE · National Health Interview Survey · National Survey of Family Growth · Poisson regression · Pregnancy · Reproductive health · Disability Rights and Representation · Down syndrome and intellectual disability research · Spinal Cord Injury Research

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