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Female Fertility after Spinal Cord Injury

| Source: facingdisability.com

Diane M. Rowles, MS, NP Nurse Practitioner, Shirley Ryan AbilityLab (Formally the Rehabilitation Institute of Chicago) https://facingdisability.com/expert/diane-m-rowles-ms-np

I always want to tell people that the likelihood of getting pregnant is the same as it was before your injury. So obviously, if a women has had a hysterectomy, or if there’s some other reason she couldn’t get pregnant before her injury, her injury does not change that. But they can still get pregnant, just as easily as they did before, so if you need to practice safe sex, do that.

When a woman does get pregnant, then you definitely want to be to the OB-GYN early, because many OB-GYNs, just because it’s a lack of experience with women with disabilities, whether it’s a spinal cord injury or some disability, sometimes they’re going to consider you more high risk—just because of the disability and their lack of knowledge of that. If you can find an OB-GYN that’s used to women with spinal cord injury, that’s a wonderful thing. Sometimes it takes the OB-GYN who specializes in the pregnancy, and a spinal cord injury provider who specializes in spinal cord injury, and the two of them working together, and that happens a lot.

The thing to remember is that the woman with the disability knows her body as well as anybody else, so the OB-GYNs a lot of the time really listen to her. Once she gets pregnant, she can carry the baby to normal term; that’s not an issue.

The issues of pregnancy are, statistics show that women with spinal cord injury do have a tendency towards small birth weight, at the birth of the baby. So the baby tends to be a little bit smaller. I’m not saying it’s going to be, I’m saying the risk of that is higher. Also the risk of c-section is higher. In the general population is about 30 percent, so it’s going to be a little bit higher in a person with a spinal cord injury. Is that due to spinal cord injury?—Or is that due to provider-comfort?—we don’t know. But I know people with paraplegia, and I know people with tetraplegia who have normal vaginal deliveries. I also know people with paraplegia and with tetraplegia who’ve had c-sections. And the things that they need to be aware of are that they’re going to have the same risks in going through pregnancy that a woman without a spinal cord injury has—the risk of anemia, the risk of more frequent urinary tract infections.

The things that are going to be a little unique to their spinal cord injury is the fact that they may get urinary tract infections easier or more often because they do, due to their catheter, anyway.

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About Diane M. Rowles, MS, NP
Nurse Practitioner, Spinal Cord Injury Rehabilitation Program, Rehabilitation Institute of Chicago

Diane Rowles has been part of the Spinal Cord Injury Rehabilitation Program at the Rehabilitation Institute of Chicago since 1985. She is also Assistant Professor in Physical Medicine and Rehabilitation at the Northwestern University Feinberg School of Medicine.

Rowles performs one-on-one teaching with patients and families in all areas of spinal cord injury and health management. She also lectures and writes scholarly articles on topics ranging from sexuality after a spinal cord injury, to fertility issues that arise from physical disability.

To learn more about Rowles: http://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=11441

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