Anne Valentine

This study extends the growing literature on adolescent and young adult females with disabilities’ sexual experiences by using nationally representative survey data. We analyzed the 2011–2019 National Survey of Family Growth to examine disability’s association with sexual experiences among females aged 15–25 (n = 7884). Chi-square and modified Poisson regression analysis compared sexual experiences, debut, and number of partners of females with and without disability by status and type. After adjustment, females with any, cognitive, or physical/sensory disability were more likely than those without disability to have had an opposite-sex sexual debut before age 15 and 10 or more opposite-sex sex partners. Those with any or cognitive disability were more likely than those without disability to have given oral sex to a male, receive oral sex from a male, had anal sex with a male, had any sexual experience with a female, and had 10 or more same-sex partners. Our analyses provide detailed population-level data on disabled adolescent and young adult females’ sexual experiences, debut, and partners and demonstrate that young disabled females have active sexual lives, highlighting the need for comprehensive sexual education and health care addressing relationships with all genders, STI testing and prevention, and sexual rights and consent.

Introduction: To examine severe maternal morbidity (SMM) at the intersection of race and physical disability status using nationally representative data.
Methods: This study conducted a pooled cross-sectional analysis of delivery hospitalizations in 2025 using 2004-2022 Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS) data. Delivery hospitalizations and physical disabilities were identified using validated ICD-9/10-based algorithms. The primary outcome was SMM excluding blood transfusion-only cases. Secondary outcomes included SMM severity measured by number of SMM indicators (≥2 or ≥3); and specific SMM categories. Risk ratios were calculated using modified Poisson regression and evaluated additive interaction using the Relative Excess Risk due to Interaction (RERI) and Attributable Proportion (AP).
Results: Among 8,584,800 delivery hospitalizations, 88,389 (1.0%) were to women with physical disabilities. Black disabled women with 528 per 10,000 deliveries (528.0; 95%CI:492.8-565.5) had the highest rates of SMM, followed by White women with physical disabilities (213.9; 203.6-224.7), and Black women without physical disabilities (107.7; 95%CI:105.3-110.1). White women without physical disabilities with 61 per 10,000 deliveries (60.7; 95%CI:59.4-62.1) had the lowest rate of SMM. After adjustment, Black women with physical disabilities had 6.92 times the risk of SMM (95%CI:6.45-7.44) compared to White women without disabilities. The adjusted RERI for SMM was 2.07 (95%CI:1.67-2.47) and the AP due to interaction was 0.38 (95%CI:0.33-0.43), suggesting that 38% of excess risk among Black women with physical disabilities was attributable to the interaction between race and physical disability.
Conclusions: Black women with physical disabilities experience compounded risks of SMM that exceed the sum of risks associated with race or physical disability alone. These findings underscore the need for intersectional approach to develop effective interventions to improve maternal care quality and outcomes in this high-risk population.

People with disabilities experience substantial disparities in perinatal health and outcomes that may be impacted by inequities in health care.
This study assesses how receipt and content of perinatal care varies by extent of disability.
We analyzed 2019–2021 PRAMS data from 22 sites that included the Washington Group Short Set of Questions (n=43,567). We examined association of extent of disability (none, some, a lot) with pre-pregnancy, prenatal, and postpartum health care using multivariable Poisson regression to calculate state-adjusted prevalence ratios (PRs) and sociodemographic-adjusted prevalence ratios (aPRs). Among individuals who received each care type, we calculated PRs and aPRs for content of care, including topics pertaining to maternal health, pregnancy prevention, and preparing for a healthy pregnancy.
Compared to those with no difficulty, respondents with some difficulty were less likely to receive pre-pregnancy care from an OB/GYN (PR=0.93; 95%CI 0.6, 0.98) or a postpartum checkup (PR=0.98; 95%CI 0.98, 0.99); respondents with a lot of difficulty were less likely to receive pre-pregnancy care from an OB/GYN (PR = 0.86; 95%CI 0.74, 1.00), adequate prenatal care (PR=0.92; 95%CI 0.90, 0.95), or a postpartum checkup (PR=0.94; 95%CI 0.90, 0.95). Respondents with any level of difficulty were at least as likely as those with no difficulty to receive education on maternal health topics and pregnancy prevention but less likely to receive care addressing desire for children or preparing for a healthy pregnancy.
Disabled women, particularly those with a lot of difficulty, receive differential perinatal health care. Our findings highlight the need for comprehensive and equitable care.

Purpose: This study reports rates of sexual and reproductive health (SRH) care receipt among female adolescents and young adults (AYA), comparing results for those with and without disability, stratified by age and disability type. We examined five SRH service areas: (1) sexual health risk assessment, (2) physical examination; (3) sexually transmitted infections prevention, testing, and treatment; (4) contraceptive counseling; and (5) prescription contraceptives. Methods: We analyzed publicly available data from the National Survey of Family Growth, combining data for women aged 15–25 years (n = 8,242) across four waves (2011–2019). We compared any disability stratified by two age groupings (15–20; 21–25 years) and disability type groups (sensory/physical disability, cognitive disability) to those without disability using Chi-square statistic and modified Poisson regression. Results: Among sexually active respondents, less than 56% received a sexual health risk assessment from their medical provider, and less than half received sexually transmitted infections testing, regardless of disability status. Compared to nondisabled female AYA, those with disability were less likely to receive human papillomna virus vaccination. The results for prescription contraceptive use varied among age and disability subgroups. Discussion: Overall low rates of sexual health risk assessment suggest a need for more comprehensive SRH care for female AYA. Differences in the receipt of vaccinations and use of contraceptives may lead to increased risk of negative health outcomes for disabled AYA. These findings add to our understanding of SRH receipt for female AYA with disability, underscoring the need for more research to better grasp their reproductive health care needs and service receipt.

The purpose of this study was to qualitatively examine preconception health and counseling experiences of people with mobility disabilities through evaluation of personal lived and professional experiences.
From March 2023 to July 2023, we conducted a descriptive qualitative study of free-text responses collected as part of a larger Delphi study involving a convened panel of experts, including physicians, researchers, and individuals with lived experience of mobility disability, in preconception care and education for individuals with mobility disabilities. Participants were identified by a systematic review of published and gray literature and purposive sampling. Free -text responses were collected from waves of the Delphi study survey questions and analyzed using constant comparison analysis to develop thematic results from the raw data through comparison of experiences, beliefs, and concepts noted within and between respondents.
The participants (n = 17) in this study were a group of experts on preconception health and disability, including individuals living with mobility disabilities (n = 7) as well as physicians and researchers in fields related to pregnancy and disability (n = 10). Four major themes were identified: strong patient interest in preconception counseling, ableist perceptions strongly affect the presence and quality of preconception counseling, implicit barriers to preconception counseling and pregnancy planning, and expectations and concerns about a multidisciplinary approach to preconception counseling.
Personalized preconception health is of great interest to women with disabilities, and there are clear knowledge and communication barriers to optimal evaluations of preconception risk and interventions to improve health before and during pregnancy.
Preconception education should be personalized to the specific medical needs and social challenges present for people with mobility disabilities considering pregnancy.

Most research on sexual and reproductive health (SRH) care has focused on women with disabilities, leaving gaps in understanding SRH care among male adolescents and young adults. This study examines the associations of disability status and type with SRH service receipt among young males in the United States
We analyzed 2011–2019 data from the National Survey of Family Growth, focusing on males aged 15–25 years (n = 7,479). We used Chi-square tests and modified Poisson regression to explore SRH care receipt by disability among sexually active males, adjusting for sociodemographic characteristics.
We found that, overall, young males with disabilities were more likely than those without disabilities to say their doctor had asked them about sexual orientation and number of sexual partners. However, those with sensory or physical disabilities were less likely to have been asked about condom use (adjusted prevalence ratio [aPR] 0.85; 95% confidence interval [CI]: 0.84–0.85). Receipt of HIV testing differed by age group; disabled young adults ages 22–25 were more likely than nondisabled peers to have been tested (aPR 1.31; 95% CI: 1.30–1.31), while disabled youth in other age categories were less likely to have received testing than nondisabled youth in the same age group (age 15–18 aPR 0.95; 95% CI: 0.94–0.97; age 19–21 aPR 0.96; 95% CI: 0.95–0.96).
Young men with disabilities experience different patterns of SRH care than those without disabilities. Our findings suggest that, while some aspects of SRH dialog are more likely to occur for young men with disabilities, barriers remain in accessing comprehensive SRH services.

This study aimed to describe the risk of unintended pregnancy among women with previous history of sexual violence by disability and race/ethnicity.
The authors conducted a retrospective cohort study using the 2011–2017 National Survey of Family Growth, a U.S. nationally representative survey. The authors classified women aged 18–44 years by combining disability status and racial/ethnic background and selected all pregnancies that occurred after a reported exposure to sexual violence. The authors used unadjusted and adjusted logistic regressions to examine differences in unintended pregnancy. All analyses were conducted in 2024 and 2025 using Stata 18 MP.
Among women with lifetime experience of sexual violence, pregnancies to disabled White (OR=1.35, p<0.05), Black (OR=2.94, p<0.001), or Hispanic (OR=1.81, p<0.01) women were more likely to be unintended than to nondisabled White women. Adjustment for sociodemographic covariates did not attenuate disparities, nor did further adjustment for risky prenatal health behaviors.
Targeted efforts are needed to address the prevalence and consequences of sexual violence, including unintended pregnancy. Existing research finds that unintended pregnancies are associated with adverse health behaviors and outcomes. These findings thus underscore the importance of accessible services for racial/ethnic minority women with disabilities.

To describe risk of unintended pregnancy among women with previous history of sexual violence by disability and race/ethnicity.OBJECTIVETo describe risk of unintended pregnancy among women with previous history of sexual violence by disability and race/ethnicity.We conducted a retrospective cohort study using the 2011-2017 National Survey of Family Growth, a U.S. nationally representative survey. We classified women 18-44 years by combining disability status and racial/ethnic background and selected all pregnancies that occurred after a reported exposure to sexual violence. We used unadjusted and adjusted logistic regressions to examine differences in unintended pregnancy. All analyses were conducted in 2024 and 2025 using Stata 18 MP.METHODSWe conducted a retrospective cohort study using the 2011-2017 National Survey of Family Growth, a U.S. nationally representative survey. We classified women 18-44 years by combining disability status and racial/ethnic background and selected all pregnancies that occurred after a reported exposure to sexual violence. We used unadjusted and adjusted logistic regressions to examine differences in unintended pregnancy. All analyses were conducted in 2024 and 2025 using Stata 18 MP.Amongst women with lifetime experience of sexual violence, pregnancies to disabled White (OR=1.35, p<0.05), Black (OR=2.94, p<0.001), or Hispanic (OR=1.81, p<0.01) women were more likely to be unintended than to nondisabled White women. Adjustment for sociodemographic covariates did not attenuate disparities, nor did further adjustment for risky prenatal health behaviors.RESULTSAmongst women with lifetime experience of sexual violence, pregnancies to disabled White (OR=1.35, p<0.05), Black (OR=2.94, p<0.001), or Hispanic (OR=1.81, p<0.01) women were more likely to be unintended than to nondisabled White women. Adjustment for sociodemographic covariates did not attenuate disparities, nor did further adjustment for risky prenatal health behaviors.Targeted efforts are needed to address the prevalence and consequences of sexual violence, including unintended pregnancy. Existing research finds that unintended pregnancies are associated with adverse health behaviors and outcomes. These findings thus underscore the importance of accessible services for racial/ethnic minority women with disabilities.CONCLUSIONSTargeted efforts are needed to address the prevalence and consequences of sexual violence, including unintended pregnancy. Existing research finds that unintended pregnancies are associated with adverse health behaviors and outcomes. These findings thus underscore the importance of accessible services for racial/ethnic minority women with disabilities.

•We assessed tailored preconception education for people with mobility disabilities.•Tailored preconception education was feasible and acceptable.•The intervention increased preconception health knowledge by 2.7 points (p = 0.025).•This pilot study demonstrates a promising intervention for a vulnerable population. To assess the feasibility and acceptability of our newly designed, tailored preconception educational intervention for people with mobility disabilities. A prospective pre-post pilot study to measure the feasibility and acceptability of an educational intervention for people with mobility disabilities who could become pregnant in the next five years. Before and after general health and preconception knowledge were compared using paired t-tests. 26 participants completed the study from November 2023 − July 2024. The most common diagnoses related to mobility disability were spinal cord injury (n = 9), spina bifida (n = 4), and cerebral palsy (n = 4). The intervention increased general health knowledge by 0.9 points (p = 0.13) and preconception health knowledge by 2.7 points (p = 0.025). A significant increase (1.8 points (95 % CI 0.9–2.6 points), p < 0.001) in preconception health knowledge compared to general health knowledge suggests the intervention successfully improved the targeted knowledge area. This pilot study demonstrated the feasibility and acceptability of a preconception educational intervention tailored to individuals with mobility disabilities. This intervention holds the potential to improve health literacy, increase preconception health knowledge, and ultimately improve pregnancy outcomes among people with mobility disabilities.