To develop recommendations for neurologists for reducing reproductive health care inequity among women with physical disabilities with neurological conditions.

Reproductive and sexual health are essential components of overall health and wellbeing. For women with neurological disabilities, barriers in the built environment, stereotypes and biases, and limited disability competency among reproductive providers result in reproductive health inequity. A better understanding of their experiences provides opportunities to reduce reproductive health care disparities in women with physical disabilities and improved health outcomes.

81 women with physical disabilities due to neurological and other disabling conditions participated in 13 semi-structured focus groups (n = 64) and 17 interviews to assess their experiences around reproductive health and contextual factors related to disability. Deductive and inductive qualitative coding was used to identify key themes.

Major themes of communication, knowledge about health condition, health care environments, and self-advocacy around reproductive health may offer guidance for neurologists on how to assist their female patients with reproductive health care. Women often reported feeling expected to share information between different health care providers for insufficient direct communication among providers, discussed reproductive health providers’ lack of knowledge about disability and felt responsibility to educate reproductive health care providers about their condition. Deficits in knowledge significantly compromised the decision-making process of many women and their providers. Stigma often makes patients hesitant to bring up topics of concern, such as pregnancy, sexuality, sexually transmitted infections, birth control, or menstrual suppression.

Neurologists can help women with physical disabilities in reducing reproductive health inequity and improve their overall health outcomes by educating the reproductive health care providers about the patient’s condition, guide patients on how to talk with an reproductive health care providers and by involvement in pregnancy decision making or planning.