NEW DELHI: Meenu Arora Mani had a frightful experience after the mammogram at a private hospital could not come to level of her wheelchair and she was shifted to a revolving chair with no arms. As she suffers from cerebral palsy and cannot sit without support, the screening could finally be done only with the help of four women who held her during the test. Mani is just one of the cases which show how sexual and reproductive health checks, tests and even communication with doctors and counsellors on subjects like sexuality, contraception, pregnancy , child birth and menopause remain a challenge for disabled women.Case studies on this find space in a manual for practitioners developed by disability rights activist Abha Khetarpal who leads a voluntary organisation, “Cross the Hurdles”, that focuses on counselling women on such issues. Khetarpal, who is also wheelchair-bound, shows through a detailed need assessment survey of 50 disabled women from Delhi how their sexual and reproductive health continues to remain in the closet.The study of women with average age of 36 years, shows that 72% of them did not go for regular health check-ups. While more than half of them were aware of various screening tests required to maintain sexual and reproductive health, 88% had never gone through any screening like mammogram and PAP smear. Around 58% of them said they faced barriers during check-ups.Among the barriers, 36% of women cited inaccessible examination tables as a major hurdle, around 18% cited the absence of a sign language interpreter; and 14% complained of lack of assistance for balance and positioning during check-up, particularly pelvic examination. Women with visual disabilities faced difficulty over prescriptions. Lack of comprehensive education on sexuality was evident among 66% of them.“This study and manual is my way of opening space for a dialogue and reaching out to practitioners with possible solutions so that the system can be equipped with a response mechanism,” Khetarpal said. She plans to now approach the ministries of women and child development and social justice and empowerment to draw their attention to these concerns.The case of a woman with spinal injury is a telling commentary. In her 35th week of pregnancy, she was faced with uncertainty as there was no anaesthetist to handle her case at the hospital. She went ahead with pregnancy only after a green signal from a neurologist and gynaecologist . Finally, doctors found out a way out and she gave birth to a healthy baby.The manual quotes Reshma Valliappan, director of ‘The Red Door India’, as saying, “Honestly with schizophrenia we don’t get to sexual health. We’re stereotyped at the basic level of comprehension. ”