Having a physical disability doesn't typically affect your chances of getting pregnant, or of carrying and delivering a baby. But depending on the nature of your disability, you may be more prone to certain complications.
The good news is that many women with physical disabilities have completely healthy pregnancies.
Choosing a prenatal practitioner when you have a physical disability
Having a physical disability doesn't automatically classify your pregnancy as high-risk. Some practitioners, however, will feel more comfortable referring you to an obstetrician or maternal fetal medicine specialist who has experience treating patients who have disabilities.
And these specialists may be easier to find than you’d think. A growing number of hospitals are developing special programs to provide women with disabilities better prenatal and obstetrical care.
Some OB/GYN offices are making their practices more accessible to moms-to-be with physical disabilities too, by adding wheelchair accessible scales, for instance, or exam tables that lower for easier transfers.
If such a program or practitioner isn’t available in your area, you’ll want a doctor who is willing to learn "on the job" and is able to offer you all the support you need.
Managing pregnancy if you have a physical disability
Just which additional measures will be necessary to make your pregnancy successful will depend on your specific condition. Staying as healthy as possible throughout your pregnancy will go a long way in making your pregnancy as comfortable and safe as it can be.
Try to keep your weight gain to within the recommended range, as it will help minimize the stress on your body. Eating the best possible diet will improve your general physical well-being and decrease the likelihood of pregnancy complications.
Having a healthy exercise routine will help ensure that you have maximum strength and mobility when the baby arrives. Both water and physical therapy exercises may be beneficial and safe, so be sure to ask your practitioner for a referral if it makes sense in your case.
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Are there added risks to my pregnancy or baby if I have a physical disability?
It should be reassuring to know that though pregnancy may be more difficult for you than for other pregnant people, it shouldn't be any more stressful for your baby.
There's no evidence of an increase in fetal abnormalities among babies of women with spinal cord injury (or of those with other physical disabilities not related to hereditary or systemic disease).
Moms-to-be with certain physical disabilities may face a greater risk of some added symptoms and complications, however. Pregnant women with spinal cord injuries, for instance, are more susceptible to urinary tract infections (UTIs), kidney infections and bladder difficulties.
There also may be a higher risk of potential respiratory problems (and even pneumonia) as the uterus grows and pushes against the diaphragm, and of autonomic dysreflexia, a sudden onset of excessively high blood pressure.
Other common issues may include anemia (taking an iron supplement can help prevent it, so check with your doctor to see if you should), skin ulcers (if you can, try to minimize these by avoiding staying in one position for too long), increased back pain and discomfort, and a higher risk of varicose veins and even deep vein thrombosis (blood clots in the legs).
Childbirth, too, may pose special challenges, though in most cases a vaginal delivery will be possible. Uterine contractions may be painless for moms with certain spinal cord injuries, so you may be instructed to watch for other signs of impending labor, like bloody show or your water breaking. You may also be asked to feel your uterus periodically to see if contractions have begun.
Additionally, well before your due date, you should come up with a plan for getting to the hospital, including what you'll do if you happen to be alone when you go into labor. For example, you may want to leave for the hospital early to avoid any problems caused by delays en route. You’ll also want to be sure the hospital staff is prepared for your additional needs.
What should I expect after the baby is born?
Parenting is always a challenge, particularly in the early weeks. But planning ahead will help you meet that challenge more successfully.
Here's a checklist of things to do or consider in advance if you can:
- Make the necessary modifications to your home before your baby arrives to accommodate your specific child care needs.
- Enlist some help from a partner, relative, friend or other caregiver — especially in the beginning, when you're just getting started.
- Get your diapers and other baby supplies delivered, which will also save effort and time.
- The changing table should be tailored for you to use from your wheelchair, if you use one.
- The crib should have an accessible side so you can take baby in and out easily.
- The baby tub should be set up in a place and way that's accessible to you if you’ll be doing all or some of the baby bathing. Daily tub baths aren’t a must, so you can sponge your little one on the changing table or on your lap on alternate days.
- Wearing your baby in a carrier or sling may be the most convenient way for you to tote your little bundle around, since it will leave your hands free. Putting it on first thing in the morning will allow you to slide baby in and out as needed.
- Consider joining a support group of parents with disabilities or finding a good online group. They'll likely provide you with some much-needed reassurance, friendship and empathy, and they can be a gold mine of good ideas and advice.
- Try some other resources for those with physical disabilities and their families, including Through the Looking Glass and the National Spinal Cord Injury Association/United Spinal Association.
Though being pregnant with a physical disability can come with extra challenges, you can take heart in knowing that your odds of having a healthy pregnancy are very good with the right medical care and help. And the reward is that beautiful baby gazing at you, who will change your life in all sorts of wonderful ways.
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