Having a spinal cord injury (SCI) does not affect a woman’s chance to naturally become pregnant, carry and deliver a healthy baby. However, complications can arise during and after, so preparation is key to a successful and healthy pregnancy.
When you begin planning to get pregnant, think through the challenges and demands of parenting, and how you and your partner will manage them to raise a healthy child. Most women with a SCI find the joys and positive aspects of parenting outweigh the challenges experienced.
Before you become pregnant, find an Obstetrician who is comfortable, and has experience, caring for a patient with a SCI. While it is possible to have a healthy pregnancy - should complications arise during labor and delivery with a SCI, you’ll want your clinician to have experience managing and delivering a positive outcome for you and your baby. Most women with a SCI are considered to have high risk pregnancies to ensure they receive the appropriate extra care and attention necessary. Many are also followed by a Perinatologist, a clinical specialist concerned with the care of the fetus and complicated, high risk pregnancies.
As you plan for pregnancy with a SCI, there are several things you should take into consideration.:
- You may experience increased difficulty with activities of daily living due to weight gain. Weight gain is common with all pregnancies.
- For a women with a SCI, weight gain impacts all your ability to perform your daily routines as easily as before pregnancy. Most specifically, weight gain may make transfers more difficult. Don’t get discouraged, and make sure to plan for assistance - especially during your third trimester. To keep weight gain in a healthy range - as guided by your clinician - following a healthy diet is important.
- Women with injuries at the T10 level and higher are at greater risk for experiencing symptoms of autonomic dysreflexia, which is triggered by pain below the level of injury. Uterine track infections (UTI), constipation, skin irritation and childbirth can all trigger autonomic dysreflexia. Pay close attention to any severe headaches, tachycardia, sweating, respiratory distress or spikes in blood pressure as autonomic dysreflexia can be life threatening if it goes without treatment. Your obstetrician and anesthesiologist will monitor you closely when you are in labor to prevent autonomic dysreflexia.
- Women with a SCI who become pregnant double their risk for recurrent urinary tract infections because of neurogenic bladder and the need for intermittent catheterization. The hormone progesterone relaxes the muscles of the ureters, which cause urine to flow more slowly from the kidney to the bladder. The pressure from the expanding uterus also puts more pressure on the bladder and makes it difficult to completely empty. Staying hydrated during pregnancy is important to your health and your baby’s health and can prevent pre-term contractions. If you perform intermittent catheterization you will need to increase your frequency. This may require asking your doctor to increase the number of catheters you receive monthly. Your doctor may consider doing more frequent urine cultures to catch an infection early.
- As the baby grows, you will have increased pressure on your bladder that may cause bladder incontinence.
- You may need to increase the number of times you are catheterizing per day, so let your medical supply company know that you need to increase the amount of catheters you receive each month. Also, bladder accidents are inevitable. Put layers of blue pads in your chair and on your bed. This will save you hours in the laundry room.
- Be sure you review all medication you take with your Obstetrician to make sure they are safe to take during pregnancy. It might be possible to change or stop medication prior to becoming pregnant.
- Women with mobility disabilities are already at a higher risk of developing a pressure ulcer than
those without mobility issues. Weight gain during pregnancy may increase your risk of pressure ulcers. It is important to increase the frequency of pressure reliefs to every five minutes. Transferring back to the bed several times during the day to lay on your side can also help to prevent skin breakdown from happening. Drinking lots of water each day along with
meals high in protein also helps to prevent pressure ulcers.
- A growing fetus can impact the diaphragm movement for women with spinal cord injury. This can predispose you to pneumonia, especially those with tetraplegia. Your doctor will monitor you closely toward the third trimester of pregnancy.
Planning for pregnancy and bringing new life into the world is so exciting. Have a plan in place with your family
and your medical team and enjoy every moment of being pregnant and planning for parenthood.