Childbirth is possible for a woman with spinal cord injury at any level. Healthy babies have even been born to women who were injured during their pregnancy. If you are emotionally ready to have a child and have considered the physical aspects of parenting, being pregnant and becoming a mother should be an exciting and fulfilling experience.You need to consider several potential complications of pregnancy, however, if you have a spinal cord injury. Pressure sores may occur more often during pregnancy because of increased body weight or anemia, and you need to do more frequent weight shifting or pressure releases. Urinary tract infection is more likely during pregnancy, but can generally be managed with antibiotic treatment. An increased risk of autonomic dysreflexia occurs as the pregnancy progresses. This can be caused by sexual activity, and it may be advisable to avoid sexual intercourse after the seventh month to reduce the risk of complications.The risk of autonomic dysreflexia increases during labor and requires close medical supervision. Other complications include the possibility of early delivery or the inability to feel contractions that indicate the start of labor. These problems can be managed by frequent medical checkups after the thirty-second week of pregnancy. Once dilation has begun, hospitalization and bed rest are usually advisable so the course of the labor can be closely monitored. Delivery may be vaginal or by cesarean section, depending on the individual needs of mother and baby. Episiotomy (surgical incision of the vulva to assist with delivery) may or may not be necessary. Finding an obstetrician, who has some experience with spinal cord injury, or coordinating care between your obstetrician and physiatrist, is the best way to ensure a healthy pregnancy and delivery.Breast-feeding your newborn may be possible, perhaps with some help in positioning. Consult with your doctor or a nurse lactation specialist if you want to breast-feed your baby. Keep in mind, too, that breast-feeding is not essential for the well-being of your child, and you and your infant can form a strong emotional bond through bottle-feeding, snuggling, and other forms of nurturing and closeness.
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Kate was diagnosed with Graves’ disease, a common cause of hyperthyroidism, a decade ago, but often didn’t take the medication prescribed to control it because she generally felt fine. When she made an appointment to see my good friend and colleague Martin Barandes, an endocrinologist specializing in thyroid disease, he sent her for a bone density scan, even though she was only in her mid-30s, as part of the workup. The results showed she had osteopenia, and Kate was alarmed at the fact that her bones were 15 percent lower in density than expected for her age—at a time when her bones should have been at their peak!The most important thing for Kate, besides eating well and getting exercise, was to have her thyroid medication adjusted properly—and then take it regularly. Having been caught off guard by the proven bone loss, she was motivated to stick with the pills now, and to maintain the lifestyle changes she made in the interest of her bones. Her bone loss soon slowed to a stop.*22\228\2*