Spinal cord injury pregnancy

Spinal Cord Injury and Pregnancy

There is no evidence to suggest that a woman who has a spinal cord injury (SCI) will be unable to conceive. There are, however, some other factors to take into account if an individual with an SCI is considering getting pregnant.

Here we answer some frequently asked questions related to spinal cord injuries and pregnancy whilst also discussing some things that should be considered.

Is Fertility Affected by a Spinal Cord Injury?

The short answer to this is no. The chances of getting pregnant are about the same as they would have been before an injury. Individuals may, however, want to plan their approach and get to understand what challenges may lie ahead by consulting their physician.

How Might a Spinal Cord Injury Affect Pregnancy?

There are several things that should be considered when it comes to pregnancy and spinal cord injuries. As we know, an injury to the spinal cord can affect the the body in a number of different ways, beyond reduced mobility, and these secondary medical complications can potentially impact a pregnancy.

1. Bladder Function

Pregnancy puts pressure on the bladder. For an individual with a spinal cord injury who already experiences issues with bladder function due to their injury, this is something that should be made aware of.

If the individual uses intermittent catheterization, this may have to increase over the term of the pregnancy. If there is a vaginal birth and not a cesarean, there may be challenges with bladder care following delivery that means a plan should be put in place.

2. Bowel Function

Similar to bladder function, bowel problems can also arise following a spinal cord injury. Women often suffer from constipation during pregnancy and making sure there is a clear management process in place is important.

With individuals gaining weight and having trouble with mobility, more assistance in this area might be needed, especially in the later stages of the pregnancy.

3. Respiratory Function

A growing baby not only puts pressure on the lower part of the body, it can also press on the lungs as well. As a result, breathing difficulties that arise as a result of a spinal cord injury may be exacerbated during pregnancy.

Breathing exercises and taking care over positioning during sleep, including raising the upper body on pillows, can certainly help with this particular issue.

4. Circulation

Pregnant lady with spinal cord injury

Circulation problems affect areas like the legs and cause swelling. There is also a potential risk of deep vein thrombosis following a spinal cord injury and the risk can be heightened during pregnancy.

Ways to support this and find relief include raising the feet above the heart when in a prone position, wearing compression stockings and loose shoes and ensuring sufficient water is consumed each day to remain hydrated at all times.

5. Autonomic Dysreflexia

Autonomic dysreflexia (AD) is a common issue associated with spinal cord injuries at the T6 level or above. It’s important to look out for symptoms such as a pounding headache, blotchy skin, chest pain and nausea.

It’s also essential to try and avoid the causes of AD, such as constipation, bladder issues and tight clothing. During labor, an epidural is generally used if the individual is known to suffer from autonomic dysreflexia.

6. Urinary Tract Infections

The risk of getting urinary tract infections (UTIs) is increased during pregnancy. UTIs are also more likely to occur following a spinal cord injury, meaning individuals who are pregnant and paralysed are at particular risk.

It’s important to get treatment for urinary tract infections as quickly as possible. If a UTI is not treated, it can lead to an early or even premature pregnancy.

7. Skincare

Individuals with an SCI are more prone to skin pressure injuries and management may be needed whether they are pregnant or not. Carrying the extra weight of an unborn child, however, can present some additional challenges.

It’s important to check the skin regularly and review things like posture and cushions/mattresses to ensure that the correct support is provided.

8. Spasticity

Spasticity is another issues closely associated with spinal cord injuries and one which can be more likely to occur during pregnancy.

A growing baby can lead to a sudden increase in spasticity and it’s important to talk to a doctor about this. Undertaking exercises such as passive stretching help reduce the problem but the individual should also be sure to avoid activities that often lead to spasticity.

Seek Medical Advice

Medical advice should always be sought when considering pregnancy following a spinal cord injury.

It’s useful to also have support from a qualified midwife who understands the individual’s needs and challenges. Generally speaking, an individual with an SCI should be able to get pregnant as likely as they would have prior to their injury.

However, many secondary complications associated with spinal cord injuries are likely to be exacerbated during the pregnancy.