Facilitating the gynecologic examination of disabled women

Make modifications in office layout and equipment and train staff to meet the physical and informational needs of disabled patients. In particular, the office should be accessible; communication should be possible despite cognitive or sensory impairment; and staff should be trained in safe techniques for transfer of the patient to the examining table.

Ask if the woman feels her disability affects her reproductive functions. Address all gynecologic issues, as appropriate: sexual activity, contraception, menstrual cycles, cancer screening, preconceptional issues, menopause, and osteoporosis.

Understand the medical issues of patients with disabilities.

Allow extra time for the appointment and have extra staff available, if needed.

Inquire about a history of physical or sexual abuse as these women are at increased risk.

A frog-legged or lateral position may be easier to achieve than the lithotomy position for examination. If examination is still not possible, use of ultrasonography, sedation, or anesthesia are options.

Adapted from American College of Obstetricians and Gynecologists. Women with Disabilities. In: Guidelines for Women's Health Care. 2nd edition, Washington, DC, 2002.

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Facilitating the gynecologic examination of disabled women