# Understanding Barriers to Reproductive Health Care among Women with Autism Spectrum Disorder (ASD)

> **NIH NIH R03** · KAISER FOUNDATION RESEARCH INSTITUTE · 2022 · $80,017

## Abstract

ABSTRACT
Early evidence suggests that women with autism spectrum disorder (ASD) experience unique challenges
around reproductive and sexual health. Exacerbating these problems, autistic women face health care
disparities in accessing women’s health services. At Kaiser Permanente Northern California (KPNC), a large
integrated healthcare system, we found that women with ASD utilize gynecological care and cervical cancer
screenings at nearly half the rate of women with ADHD or typical neurodevelopment. Aim 1 examines which
factors, including sociodemographic characteristics, medical and psychiatric conditions, and other types of
healthcare utilization may contribute to autistic women underutilizing different types of gynecologic care. Aim 2
will examine the epidemiology of pregnancy in women with ASD and whether autistic women also experience
gaps in obstetric care, an area that has been largely understudied. We will sample women with and without
autism using a case-control study design. There are currently 2600 adult women in the KPNC autism registry
with 350 pregnancies enumerated among them. This population is growing dramatically as the wave of
children diagnosed with ASD reaches adulthood. We will examine differences in obstetrics/gynecology
utilization, including frequency and counts of visits, procedures, and prescriptions, in the period of January
2016 to December 2020. We will examine pregnancy history extending back to 1995, the year KPNC’s
outpatient databases were established. Using multivariate logistic regression, we will examine whether factors
such as race/ethnicity, age at ASD diagnosis, and mental and physical health status are associated with
utilization of gynecologic care among women with ASD compared with controls. We will also describe the
epidemiology of pregnancy and obstetric care utilization, including ultrasounds and screenings for gestational
diabetes, among autistic women compared to controls. Given the impact of COVID-19 on health care, we will
conduct an analysis focused on care delivery in 2020 to explore how the shift to telemedicine may have be
impacting OB/GYN care disparities between women with and without ASD. Study findings will inform the
development of strategies to improve provider knowledge, care practices, and effective obstetrics/gynecology
health care delivery for adult women with ASD.

## Key facts

- **NIH application ID:** 10366066
- **Project number:** 5R03HD105164-02
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Jennifer Lisa Ames
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $80,017
- **Award type:** 5
- **Project period:** 2021-04-01 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10366066

## Citation

> US National Institutes of Health, RePORTER application 10366066, Understanding Barriers to Reproductive Health Care among Women with Autism Spectrum Disorder (ASD) (5R03HD105164-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10366066. Licensed CC0.

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