Forty-one percent of the patients who had sexual intercourse during the preceding year and had not wanted children report that they or their sexual partner had not used contraception at the time of last intercourse. When possible, providers should allow individuals with mental handicaps to manage their sexual lives, including decisions about having children. This can be complicated and time-consuming. Often, providing contraceptive information is not enough. Women who are depressed, anxious or suffering from though disorganization may be unable to use some contraceptive methods reliably, such as OCs or condoms.
Difficulties arise when attempting to provide contraception to homeless, mentally disturbed women.
Such women tend to abuse drugs and be at high risk for sexually transmitted diseases, giving their reproductive health low priority as they struggle to survive on the street. They rarely tend to seek medical attention, may suffer discrimination when they go to a clinic, lack negotiation skills to get their partners to use condoms, and are difficult to serve. However, most people with mild intellectual disabilities are as interested in having sexual relationships as members of the general population. Furthermore, their fertility generally is not compromised. The need to offer contraception to women with mild intellectual disabilities is particularly great because they may be at increased risk for sexual abuse.