Women with Cognitive Impairment and Unplanned or Unwanted Pregnancy: A 2-Year Audit of Women Contacting the Pregnancy Advisory Service

Little is known about the experience of women with cognitive impairments (intellectual disability and acquired brain injury) in relation to unplanned or unwanted pregnancies. Records of the Pregnancy Advisory Service (PAS) at the Royal Women's Hospital across a 2-year period were examined. Details of 20 women with cognitive impairments, who had contacted PAS for support with an unplanned or unwanted pregnancy, were found. Many of these women had faced significant barriers to reproductive choices. The majority of the women had needed someone to facilitate their first contact with PAS; one quarter had contacted PAS too late for the option of the abortion they were seeking; one quarter were in significant conflict with their support people over the pregnancy; almost half of the women contacted PAS significantly late in their pregnancy; and one quarter (more than half of those who already had children) were currently involved with child protection services. The audit suggests that women with cognitive impairments need more accessible information on sexual and reproductive health, and assistance to access pregnancy information and services. It is important that social workers and other professionals who work with women with cognitive impairments be aware of their greater vulnerability and often complex social situations, and adopt a proactive as well as supportive approach when working with these women.