Fertility Rates Among Women With Intellectual and Developmental Disability Enrolled in Medicaid and/or Medicare,...

Area of Science:

• Reproductive Health
• Disability Studies
• Public Health

Background:

• Historically, women with intellectual and developmental disabilities (IDD) faced reproductive rights limitations through sterilization and institutionalization.
• While legal protections have advanced, societal stigma surrounding IDD and reproductive health persists.

Purpose of the Study:

• To analyze fertility rates among women with identified IDD (intellectual disability or autism) using over a decade of Medicaid and Medicare data.
• To describe trends in general fertility rate (GFR), age-specific fertility rate (ASFR), and total fertility rate (TFR) for women with IDD.

Main Methods:

• A cohort of women aged 18-45 with IDD enrolled in Medicaid/Medicare from 2011-2022 was identified.
• International Classification of Diseases (ICD) codes were used to determine IDD diagnoses and pregnancies.
• GFR, ASFR, and TFR were calculated annually with 95% confidence intervals.

Main Results:

• Over 50,000 livebirths were recorded among 33,000+ women with IDD between 2011 and 2022.
• General fertility rates remained stable, ranging from 9.3 to 9.9 per 1000 women.
• Fertility rates peaked for women aged 21-25, with slightly higher total fertility rates for autism-only compared to intellectual disability-only.

Conclusions:

• Fertility trends among women with IDD showed consistency over the study period.
• A modest increase in fertility rates was noted specifically for women with autism.
• Further investigation into healthcare access, quality, and continuity is crucial for women with IDD.