THE SEXUAL NEEDS OF PEOPLE WITH DISABILITIES – CONTRACEPTIVE NEEDS (INTRODUCTION)
If contraception is required then again the biggest problem can be the doctor’s assumptions about what method is suitable for an individual. When advising on contraception, the skill lies in matching the method to the patient’s needs, preferences and lifestyle, within the limits set by certain medical considerations such as absolute contraindications. Where a disability exists, the type of doctor/patient relationship which may develop and the attitudes to the disability may encourage a more authoritarian style, and the doctor needs to recognize this so that the choice remains with the patient. The prescriber will be assessing the usual indications and contraindications for the methods, weighing up the advantages and disadvantages with the patient, but it is useful to ask oneself in addition, ‘What skill is required to use this method?’ Is it a question of having a good memory, manual dexterity or mobility? It is vital to establish good communication with the patient so that understanding is ensured, especially if there is blindness, deafness or mental handicap. To find a way through a complex set of problems the following maxim is useful: ‘How does the disability affect the contraception, and how does the contraception affect the disability? When both of these sides of the equation are satisfactorily answered, one has a possible choice of method.
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