Pregnancy, Parenthood and Spinal Cord Injury
Despite the myths that perpetuate, pregnancy after spinal cord injury happens regularly. And while nothing’s the same after SCI, pregnancies in injured women typically go as smoothly as they do for non-injured women. Parenthood and growing a family aren’t off the cards for either men or women after SCI - but things work a little differently.
Having sex post-spinal cord injury can be just as fulfilling, intimate and exciting as ever - but there are key differences for men and women. Getting pregnant works just the same as before: women normally return to their menstrual cycle within a year of injury, which doesn’t affect fertility at all. Any issues with fertility are likely to be pre-existing, but talking to a doctor before trying to get pregnant is a good idea for anybody planning a family.
For women with SCI, it’s recommended that you talk to a specialist after physical and emotional rehabilitation. SCI carries a higher risk of urinary tract infections (UTIs) and other complications, which alone can be managed, but can make a difference to how you approach pregnancy, birth and postnatal treatment.
Pregnancy for the most part is the same as in non-injured women. Depending on injury level, reduced sensation can make it harder to know when the baby is moving and kicking. Mobility can affect getting to appointments and scans - but most hospitals cater for accessible scans. Your doctor can help you identify the best facilities nearby.
Antenatal classes for disabled women and partners are also available, to instill confidence and prepare couples (and singles) for the road ahead.
Catheterisation may be required, which can raise UTI risk, and bowel function can be affected by pregnancy independently of SCI. With an adjusted bowel routine and good bladder and urinary care, this can be managed without too much impact.
Even without an injury, pregnancy can be tough - frequent urination, hormone fluctuations, discomfort, morning sickness, night sweats and brain fog are all hallmarks of the process. SCI adds an extra set of challenges but doesn’t necessarily make these normal and natural signs of pregnancy any worse.
Additional adaptive equipment should be considered within the first trimester to make things easier down the road.
Can Men be Fathers after SCI?
The short answer is a resounding yes - but again, it’s a little different. We’ve covered male fertility in more depth in our post titled Love, Sex and Spinal Cord Injury.
Birth and Labour
Contrary to popular belief, natural childbirth is the most common form of delivery - with a Cesarean section reserved for complicated births in SCI women.
Early stage labour pains may not be not experienced in women with complete injuries at T10 or above. This is because pain in the first stage of labour is mediated by T10 to L1 spinal segments. But other cues for labour are present - including water breaking or discharge and a sense of slight discomfort. There are cases where no cues are given at all, so extra vigilance is needed - contact the labour ward as soon as anything arises and try to stay as comfortable and calm as possible.
During labour and childbirth, a doctor will assess the situation before delivery, to make the best decision on how to proceed. Due to lower muscle resistance and reduced pain, birth is often faster for women with SCI. However, this is not the case for injuries below T12 and birth contractions will be experienced the same way as in a non-injured person.
The uterus is fed by independent nerves, so vaginal birth can occur as usual at any level of injury unless bone fusion, spasticity or hip joint contracture prevents it.
Autonomic dysreflexia can be a sign of the onset of labour, so close monitoring and preparedness is essential as the due date approaches.
Autonomic dysreflexia (AD) can be triggered by childbirth and in pregnancy for patients with a T6 or higher level injury. It has similar hallmarks to Preeclampsia - including hypertension. Recommended AD management during birth is in the form of epidural analgesia, to reduce potential AD triggers. Some women with SCI can be concerned about further spinal cord damage from an epidural - but this is extremely rare, with an incidence of <0.02%.
Parenting with a Disability
Disabled parents don’t just “make do” - there’s so much more to parenting than being mobile. In the early years, getting around, feeding and changing can be more difficult with spinal cord injury, but there are some useful tricks to make it work.
SCI Parenting is an amazing resource, full of ideas and techniques for everything from holding your baby to making an adapted pushchair.
Parenting is the biggest thing anyone can do, with or without a disability - and a happy family is one that trusts and loves each other, no matter what happens. As long as there’s love, a solid support network and some ingenuity, parenting with spinal cord injury can be one of your greatest achievements.
Family life takes many different forms - and yours can be any shape you want it to be.
Here for You after Spinal Cord Injury
Aspire Law is a specialist law firm, working for people with SCI. We’re dedicated to providing information and support for everyone affected by spinal cord injury - from advice about having babies, to legal help when you need it.
For information and spinal cord injury legal advice, get in touch: give us a call on 0800 030 20 40.