Female Fertility and Pregnancy
My spinal cord injury means pregnancy isn’t a good idea.
Female fertility is essentially a women’s ability to conceive a child through fertilization of an egg with sperm. This process can is typically broken into four different “perinatal” phases:
Pre-pregnancy: This is the planning stage – it might involve getting familiar with your body’s menstrual cycles, speaking to your doctor about your plans and/or no longer using contraception. Typically women may start taking pre-natal vitamins at this stage.
Pregnancy: A full term pregnancy generally lasts 40 weeks, known as the gestation period. As the baby grows, your body goes through several changes, and you will undergo tests and procedures and be routinely followed by a team of medical professionals.
Labour and delivery: Known as childbirth, the process can lasts minutes or days. Many women make a birth plan during the earlier stages of their pregnancy that includes your plans and desires for where and how your baby will be delivered.
Postpartum: The first six weeks after childbirth is a time of great adjustment; You, your family and your new baby are adjusting to life together. In the hours, days and weeks following delivery your body will experience multiple physical and emotional changes.
What’s Different Now?
In general, unless there has been pelvic trauma, a woman’s reproductive system is unchanged because of spinal cord injury. Typically right after injury (while the spinal cord is in shock), your period stops for about 6 to 8 months and during this time, pregnancy is unlikely. But once your period returns, your chances of becoming pregnant remain the same as before your injury.
You may find that looking after some of your regular reproductive healthcare is a little different after spinal cord injury. For example, getting on to examination tables for a Pap test or vaginal exam might be more difficult or you may have trouble holding your legs in stirrups, especially if you have spasticity. If you are in the greater Vancouver area, you can be referred to the Access Clinic at BC Women’s Hospital for breast and cervical cancer screenings, vaginal exams and contraceptive services.
For more information regarding the common changes to all of the phases listed above, check out our Pregnancy and Spinal Cord Injury Guide.
What Can I Do About It?
Pregnancy with a spinal cord injury comes with some unique considerations. It is important to make connections to health care providers such as physiatrists, maternal fetal medicine specialists, OT, PT and other rehab clinicians early in the pregnancy, even in the planning stages when you are trying to get pregnant.
Reach out to peer groups and SCI organizations to learn about pregnancy experiences and tips from other women with SCI. For example, Spinal Cord Injury BC’s article in The Spin covers the experiences and tips of five moms with SCI. Download the whole issue here or read below:
Or check out our Peer Stories Playlist on Pregnancy, Fertility and SCI for more.
What do I need to know?
This Pregnancy and Spinal Cord Injury guide was designed for women with SCI by the team behind this Sexual Health website. It covers all of the areas you’ll need to consider about your fertility, pregnancy, labour and delivery as a woman with SCI. You can download it to read it for yourself, or read it here:
Or check out a shorter overview here.
Be your own advocate. You may come up against negative attitudes and obstacles in this process; however, the information on this web-page can be used as a guide for you to access the resources you need for a successful pregnancy and delivery.
Read up! In addition to reading you’re probably going to do about pregnancy, labour and delivery, read about spinal cord injury pregnancies and talk with your team! Don’t forget our SCI and Pregnancy guide and the other resources listed in this chapter and in the Resources section below.
Reach out: Just like you’re preparing your healthcare team for having a baby, think about the help you might need and reach out and ask for it! You can take a guess what kind of support you might need with what by speaking to other women with SCI who’ve been pregnant and had babies (see our What do I need to know? section for some great sources for peer stories about pregnancy and childbirth), based on your injury level, complications and the family and support you have around you.
Rest: The most important part of getting pregnant and having a baby is being healthy – so take time to look after yourself and get enough rest.
Who Can Help Me?
The Sexual Health Rehabilitation Service can help you assess your fertility, identify potential challenges and refer you to a variety of clinicians if you need them. Women with complicated pregnancies or SCI complications during pregnancy may be referred to the Maternal Fetal Medicine Clinic at BC Women’s Hospital.
Friends and family, attendant care, mother’s helpers, doulas, housekeepers and nannies can all be helpful to you and your family in those last weeks of pregnancy and the first weeks or months of childbirth.
Pregnancy after SCI is possible! Being familiar with the resources available and developing a collaborative network of care providers can help you have a healthy birth experience and outcome after SCI.
Life Rolls On: Pregnancy, Childbirth and Disability by Heather Kuttai (memoir)
Our Pregnancy and Spinal Cord Injury Peer Story playlist (video)
Female Fertility and Spinal Cord Injury – Facing Disability (Youtube Video)