Reproductive Issues for Persons with Physical Disabilities.

This book is a compendium of some of the presentations given at a 1991 conference on reproductive issues co-sponsored by a number of national institutes and centers, including the National Institute on Disability and Rehabilitation Research of the US Department of Education and the National Institute of Child Health and Human Development of the National institutes of Health. The purpose of the book is to highlight the major presentations given by researchers, scientists, medical professionals, psychologists, and consumers, all brought together in order to address and present the latest information on reproductive issues for persons with disabilities. The book is a readable mix of scientific information, reviews of literature, and accounts from persons with disabilities about their own reproductive issues or experiences.

In the overview, a coverage of sexuality, disability, and reproduction with general comments and recommendations to help professionals, caregivers, and persons with disabilities consider a variety of issues dealing with reproductive issues is provided. One of the editors presents a chapter on contraceptive choices for men and women, providing an overview of the methods and addressing of the pros, cons, side effects, and potential problems for each. Discussion of risks is pertinent not only to persons with disabilities, but to others as well.

The second section of the book deals with personal issues, and the collection of writings reflects the accounts of the writers' own reproductive-related issues. Included in this section are chapters dealing with attitudes relative to a racially mixed marriage with one partner having a disability; attitudes about persons with disability having children either through birth or adoption; parenting with a disability; learning more about disability from a child's perspective; pregnancy, labor, and delivery for women with disabilities; options of adoption; and experiences of a mother with a disability. For the most part, these chapters are accounts of personal experiences. Two of the chapters cite minimal references to reinforce the text and provide the reader with additional resoures.

Throughout the first and second sections of this book there are short vignettes inter-spersed between chapters depicting graphic accounts of experiences related to reproductive issues and other lifespan developmental issues. These accounts heighten one's awareness of the issues and sensitize the reader to the day-to-day issues encountered by persons with disabilities.

Section 3 delves into the scientific and medical research literature and provides clinical implications of the range of reproductive issues addressed in section 1. Included are chapters dealing with normal female and male reproductive physiology, infertility, congenital factors and reproductive disabilities, spousal relationships and disability, genetic counseling, parenting by fathers with disabilities, orgasmology and its relevance for persons with physical disabilities, current research trends in spinal cord injuries, pregnancy, labor and delivery in women with spinal cord injuries, sexuality issues after traumatic brain injury, and electro-ejaculation and its techniques in males with neurologic impairments. The chapters in this section are more scientifically based and vary in complexity. Although most chapters are research and literature based, some have helpful suggestions for persons with disability relative to the reproductive issues addressed.

The final section of the book has two relatively short chapters addressing policy and future research issues. Although these chapters very poignantly and directly challenge the professional reader to address the need for policy formulation and future research on these topics, they serve primarily to summarize the basic concepts that are presented throughout the book.

The editors of this text have achieved their goal. The variety of chapters addresses the reading needs of the consumer, the researcher, and the health care professional. Sections of this book could be very helpful to persons with disabilities. Although this is not strictly a "how-to" book, it provides some helpful information on topics such as suggestions on pregnancy, labor, and delivery for women with disabilities. The content of most of the chapters challenges health care professionals and researchers to explore the topics further. The approach to the subject matter varies from chapter to chapter, and, as in any compendium, the writing styles vary. The variety of writing styles and interspersing of personal vignettes in the beginning of the book enhance its readability. This book could heighten the physical therapy practitioner's sensitivity to die topics, broaden one's knowledge and understanding of the issues, and provide a resource to aid individuals in their adjustment to disability.