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Pregnancy and Women with Spinal Cord Injury

  • A spinal cord injury (SCI), however, does not limit your ability to become pregnant, have a baby naturally, or carry it out. Your decision to have children will be made the same as any other person. Consider the challenges and demands of parenting, and how you might handle them. These are some other factors to consider when you decide whether or not to have children.
    • All levels of injury have seen women have children. If you want to, you should be able.
    • Parents often find the positive aspects of parenting more rewarding than the challenges.
    • www.lookingglass.org and www.disabledparents.net are good online resources for women with SCI who are pregnant or want to get pregnant.

    What should I do if my baby is or wants to become a child?

    This is a list of things you can do to plan for a healthy baby.

    • Complete a GYN exam. This will enable you to receive pre-conception counseling and Pap smear testing. It also allows for family history assessment, immunization testing, and screening for genetic testing.
    • Talk to a rehabilitation physician who is familiar with women’s health following SCI. A physiatrist, also known as fizz-eea-trist, can help you talk about your injury and explain the implications for your pregnancy, labor and delivery. A physiatrist may also be able to help you locate an obstetrician (pronounced Ob-site Trish-in), or any other medical specialists that you might need during your pregnancy.
    • Get your medicines checked. If you are pregnant, or are planning to become pregnant, many prescription and over-the counter medicines should not be taken. All of your medications should be brought with you to the obstetrician. To keep your baby healthy, you may need to change your medications.
    • A urology exam is recommended. Your bladder will be put under pressure by the growing baby. It is crucial to have a full check-up of your bladder, kidneys, and ureters before you become pregnant. Your obstetrician and you will use the results of your test to plan and prepare for pregnancy.
      • Do not tell your doctor if pregnant or suspect you may be pregnant. You may be harmed by certain tests such as xrays.

    What happens during pregnancy?

    Your baby will not be affected by your injury. Your baby will grow as all babies do. Your obstetrician will advise you on how to care for your baby. Other women may experience the same discomforts during pregnancy as you.

    These include:

    • Headaches
    • Pains and aches
    • Tingling or Nullness
    • Fatigue
    • Nausea and vomiting
    • Dizziness
    • Urinate frequently
    • Indigestion and heartburn
    • Sore feet and ankles
    • Hemorrhoids
    • Breathing problems
    • Bleeding gums
    • Nose bleeds or congestion.
    • Constipation

    As you get older, your chances of developing secondary conditions due to SCI can increase. However, this does not mean you should avoid getting pregnant. This simply means you should work with your obstetrician in order to avoid secondary conditions and to manage any problems that may develop.

    • Your obstetrician and you may need to consult other specialists during pregnancy. You might need to consult a urologist or respiratory therapist as well as an occupational therapist.
    • Your baby may not grow fully if you have experienced a curvature of your spine, broken pelvis or dislocated hip.

    It is difficult to predict when and if secondary conditions may develop during pregnancy. These conditions may develop early in pregnancy, but they will usually disappear over time. Some may be an issue throughout pregnancy and birth. Below is a breakdown of the possible outcomes for each trimester.

    The first trimester is Weeks 1-13. This is where you will notice many changes in your body

    • Autonomic dysreflexia, also known as AD. While nausea and headaches are common in pregnancy, pounding headaches and nausea could also be signs of AD. If your injury level is above T6, you are at high risk of developing AD. Your obstetrician and you should have a plan to deal with AD if it occurs.
    • Urinary Tract Infection (UTI). UTIs can occur at any time. An antibiotic may be prescribed by your obstetrician to prevent infection in the course of pregnancy. If you have a UTI, it is important to get treatment immediately. This can prevent your baby from going into labor early.
    • Bowel Management. Your obstetrician will usually recommend iron and hormone supplements. One of these medications could have an impact on your bowel program.
      • Constipation: If you feel constipated, your doctor may recommend that you drink more water, eat foods rich in insoluble fiber or take a stool softener.
    • Diarrhea: If you experience diarrhea, your doctor may recommend that you drink more water, consume more soluble fiber foods, adjust your laxative or stool softener dose until you feel comfortable with your stool, and increase the frequency of your bowel movements if you have accidents.
      • An impaction (blockage of the stool) can also cause diarrhea. If you have had a hardened stool, or if your last bowel movement was narrow, this could be a possibility. You should eat a healthy diet and drink plenty of fluids.

    Second Trimester: Weeks 14-26 are a time for weight gain, as your baby grows quickly

    • Daily activities It is more difficult to do the same things you did before becoming pregnant because of weight gain. Transferring or pushing your wheelchair might be more difficult. You may get tired more quickly. Talk to an occupational or physical therapist about new ways to accomplish everyday tasks. These are just a few ideas.
      • Use a sliding board or other aid to make fewer transfers.
      • Rent or purchase a power chair.
    • Management of your bladder. Your bladder can be put under pressure by a growing baby. Your bladder may not be able to hold as much urine and can spasm.
      • Intermittent catheterization is a method that women who are pregnant will need to use more frequently or change to an intravenous catheter (Foley).
    • Skincare. Pregnancy is a time when pressure ulcers can be a problem. Your posture and center gravity can be altered by weight gain, making it more difficult to lift your body without ripping your skin. Your boney areas can be put under more pressure if you sit or lie down. Talk to an occupational or physical therapist about new ways to accomplish everyday tasks. These are just a few ideas.
      • You should be checking your skin more often. Prenatal exams can include skin inspections by your obstetrician.
      • Use pressure relief more often.
      • Refer to the fact sheet “Skin Care and Pressure Wounds in Spinal Cord Injury.”
    • Muscle spasms. You may experience changes in your muscles spasms. These may become worse if they are not a regular occurrence.
      • Refer to the fact sheet “Spasticity & Spinal Cord Injury.”

    Third Trimester: Weeks 27-40 are when your baby continues to grow

    • Breathing. Your diaphragm is pushed by your growing baby. It can make it more difficult to breathe. You might need to take deep, shallow breaths and even cough. Talk to a respiratory therapist about ways to improve your breath. These are just a few ideas.
      • Breathing exercises may be suggested by your obstetrician. Your obstetrician might recommend breathing exercises if your injury is severe.
    • Blood flow. The pressure of a growing baby can cause blood to stop flowing to your feet and legs, which in turn can cause swelling.
      • Discuss with your doctor the possibility of medicine to prevent clots from developing if you have ever had blood clots.
      • Discuss with a physical or occupational therapist if you think range-of motion exercises or adjustments in positioning could improve blood flow.
      • Get up high as you can.
      • Wear compression support hose.
      • Get extra rest.

    What happens during labor or delivery?

    SCI women need to plan for labor, delivery and childbirth in the same way that other women.

    • Attend childbirth classes
    • Prepare your nursery for baby.
    • What to do when you get hired
    • Learn how to install a car seat.
    • Bring your hospital bag
    • After the birth Help
    • Stock up diapers, wipes and other essentials
    • Stock up your pantry and fridge with groceries

     

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