Pushin' On: UAB Spinal Cord Injury Model System Digital Newsletter Volume 34 | Number 2 | Page 3

negative attitude about helping
women transfer to and from the table.
Some doctors may prefer not to take
women with disabilities as patients
in the first place. Some doctors
assume women with disabilities
aren’t sexually active, so they fail to
discuss important issues related to
sexual and reproductive health. They
may not discuss sexually-transmitted
diseases with women or screen for
diseases, and may not advise women
about birth control. Doctors may
assume that women with disabilities
have no interest in having children
and they may not educate them on
preconception health and healthy
pregnancies.
Another problem is that some
doctors simply don’t know about
the possible complications that exist
for care during pregnancies. For
example, many doctors don’t know
that pregnant women with spinal
injury (SCI) may have issues related
to autonomic dysreflexia, respiratory
management, skin care, bladder
management and increased risks for
urinary tract infections and spasticity.
Women with other disabilities may
have potential problems, too.
Here is the simple fact. It is your
responsibility as a woman to manage
your health needs and get regular
mammograms and gynecological
screenings.
The law requires healthcare
providers to offer you full and equal

access to the healthcare services
that all women have. The last issue
of Pushin’ On features an article, The
Law and Accessible Healthcare, that
outlines steps you can take to work
with healthcare providers to meet
your needs. So what are some other
suggestions women can use in the
meantime?
1. Try to find healthcare providers
that are open to working with
you. A good provider puts your
healthcare needs first. If you have
a problem with access, a good
provider will offer options to solve
those problems.
2. Talk to your doctor about getting
mammograms and Pap tests and
your risk factors for developing
cancer. The American Cancer
Society has current guidelines
that you can consider. It’s
suggested that women begin
annual mammogram screening
at age 45. Women who have
higher risk factors for cancer may
need to begin at age 40. Women
age 55 might get mammograms
at least every two years. Some
women with family history of
breast cancer or other risk
factors may need MRI screening
in addition to a mammogram.
For cervical cancer screening,
the American Cancer Society
suggests women begin Pap tests
at age 21 and have them every
three years after that. At age 30,

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they may continue having them
every three years or have them
every five years in combination
with a human papillomavirus
(HPV) test. Women over 65 years
of age who have had regular
screening in the previous 10
years may be able to stop getting
cervical cancer screenings as
long as they haven’t had any
serious pre-cancers found in the
last 20 years.
If you are having a problem with
access to a mammogram, ask
your doctor if an ultrasound is an
option.
For Pap tests, you might request
a different exam table in a more
accessible room, if possible.
Women with disabilities should
never live in fear of voicing their
questions and concerns. Speak
up for yourself because all
women deserve access to proper
healthcare.

Author Note: Dr. Emily Perkins
is a guest author and consumer
with tetraplegia. She is a former
Coordinator/Consultant for the Online
Writing Center at the University of
Alabama. Information found in this
article is not meant to replace the
advice from a medical professional.
You should consult your health care
provider regarding specific medical
concerns or treatment. References
are available upon request.

Questions and Answers: Women’s Health after SCI
Do my gynecological needs change after SCI?
No. Women with spinal cord injury (SCI) have the same
gynecological needs that all women have. This means
you need to see a gynecologist for regular gynecological
(sometimes called pelvic) examinations of your female
organs. These organs include your vagina, cervix, uterus,
ovaries and fallopian tubes. The exam may also include
a Pap test (sometimes called a Pap smear). A Pap test is
used to screen for cancer. Most cancers can be spotted
early with a Pap tests. Spotting cancers early allows for
the early treatment needed to help reduce deaths related
to cancer.
Do I need a mammogram?
Yes. A mammogram (sometimes called a
mammography) is an x-ray exam of the breast used to

screen for breast cancer. This exam helps spot breast
cancer early and allow for early treatment needed to help
reduce deaths related to breast cancer. Women should
talk with their doctors about when to start getting regular
mammograms.
Can I do breast self-exam instead of a mammogram?
Yes and no. Beast self-exams do have value. Women
who have good movement and sensation in their hands
can do a breast self-exam to notice changes in the way
their breasts look and feel. Most changes are not a sign
of cancer, but it is still a good idea to talk with your doctor
as soon as possible to find out if a change is a serious
concern. That said, breast self-exams are not an effective
way to spot breast cancer. The best way to spot breast
cancer is by getting regular mammograms.
UAB Spinal Cord Injury Model System

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