Return to graphic version of Pregnancy and Women with SCI Infocomic.

Infocomic Main Characters

Nina: An American Indian woman in her early thirties with a spinal cord injury (SCI). She has black hair pulled into a ponytail.

Nina’s husband: An African American man in his early thirties. He has short black hair.

Dr. Smith: A White woman in her mid-forties. She has chin-length blonde hair.

A physiatrist: An Asian man in his mid-forties. He has medium-length, swept back hair and a full beard.

Infocomic Story Description

Nina wants to start a family. But she doesn’t know if it’s OK for women with SCI to start a family. Her husband is on his knee, holding her hand. The groceries are sitting nearby. She and her husband decide to visit her doctor, Dr. Smith.

Dr. Smith tells Nina and her husband that an SCI shouldn’t keep Nina from getting pregnant or having a baby. Dr. Smith tells them, “An SCI usually does not affect getting pregnant.”

Nina imagines the challenges of being a parent. They include:

  • Waking up in the middle of the night to the baby crying
  • Changing the baby’s diapers from a wheelchair
  • Getting frustrated while installing a car seat

Nina also imagines the rewards of being a parent. They include getting to introduce her baby to her whole family.

Women with SCI who want to get pregnant should take these steps before they get pregnant.

Nina is listening to Dr. Smith. She tells Nina to get a complete GYN exam. A GYN exam will give you the chance to talk with your doctor. You can also get a Pap smear and review your vaccine history. Finally, you can discuss your family history and screening for genetic testing.

Nina and Dr. Smith are reading labels on medicine bottles.

Get your medicines checked. There are many medicines that you should not take if you are pregnant or want to get pregnant. Take your medicines with you when you see your obstetrician (OB) or the family doctor who will care for you during pregnancy.

Nina is visiting her physiatrist.

Talk to an SCI clinician such as a physiatrist (also known as a rehab doctor). This doctor will talk to you about your SCI and what it means for your pregnancy, labor, and delivery. Talk to your rehab doctor about any adjustments to your wheelchair or adaptive equipment. As your baby grows, your wheelchair may need adjustments. You may need further adjustments as you start to take care of your child.

Nina is in her power wheelchair heading toward the bathroom.

Get your bladder checked. As your baby grows, they will press on your bladder. It is important to get a complete check-up of your urinary tract before you get pregnant. This includes your kidneys, bladder, and ureters. Tell your doctor if you are pregnant or think you might be pregnant. Some tests, such as x-rays, can harm your baby.

Dr. Smith says that she will observe Nina closely while she is pregnant to address any issues that may come up.

Potential issues during the first trimester include:

  • Autonomic dysreflexia (AD). Nina is wincing and holding her head. Nausea and headaches may be a sign of AD. An SCI at the T6 injury level or above increases the risk of AD. AD is a serious medical condition that your doctor must treat right away!
  • Urinary tract infection (UTI). Nina is shaking pills from a bottle into her hands. Your doctor must treat a UTI right away. You may need medicine.
  • Bowel problems. Nina is pushing away her dinner plate, which still has food on it. Your doctor may give you hormones or iron pills during pregnancy. They may cause constipation or diarrhea.

Potential issues during the second trimester include:

  • Daily activities. Nina is struggling to transfer from her chair to her bed. Weight gain from pregnancy can make it hard to transfer to or from your wheelchair. It can also make it hard to push your wheelchair.
  • Bladder problems. Nina is sitting outside the bathroom and lamenting, “Not Again!” A growing baby puts pressure on your bladder. Also, your bladder can’t hold as much urine as usual.
  • Skin care. Nina is thinking, “My therapist said that a tilting angle of between 25 and 65 degrees can provide pressure relief. Let me try 30 degrees today.” Weight gain from pregnancy can raise the risk of pressure injuries. You must be extra careful to protect your skin.
  • Muscle spasms. Nina is rubbing her calves, which are trembling. Muscle spasms may develop or get worse.

Potential issues during the third trimester include:

  • Breathing. Nina is breathing hard. Her husband says, “Let’s talk to a respiratory therapist.” A growing baby pushes on your diaphragm. This can make it harder to breathe, take deep breaths, and cough. You may talk to a respiratory therapist to find ways to improve your breathing.
  • Blood flow. Nina is lifting weights while her husband exclaims, “Good Job, Nina!” Pressure from a growing baby can slow blood flow to your legs and feet, which can cause swelling. If you have had blood clots before, talk to your OB about medicine to keep clots from forming. See a physical therapist for exercises to improve blood flow.

Nina, her husband, and their new baby are leaving the hospital. There is a bundle of roses in Nina’s lap. Having an SCI does not affect your ability to become pregnant, carry a baby, and deliver a baby. So, you will make your decision to have a child in much the same way as anyone else. Talk to your OB to plan and decide on the type of delivery that is best for you.

Source: The Content of this infocomic has been adapted from the factsheet Pregnancy and Women After Spinal Cord Injury (https://msktc.org/sci/factsheets/Pregnancy), which was developed by Amie B. McLain, M.D., Taylor Massengill, B.A., and Phil Klebine, M.A., in collaboration with the SCI Model Systems Knowledge Translation Center. It was illustrated by Marty Two Bulls Sr. Our health information content is based on research evidence whenever available and represents the consensus of expert opinion of the SCI Model System directors.

Disclaimer: This information is not meant to replace the advice of a medical professional. You should consult your health care provider about specific medical concerns or treatment. The contents of this infocomic were developed under grants from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant numbers 90DP0082 and 90DPKT0009). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this infocomic do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the federal government.

Copyright © 2022 Model Systems Knowledge Translation Center (MSKTC). May be reproduced and distributed freely with appropriate attribution. Prior permission must be obtained for inclusion in fee-based materials.