Pregnancy with a disability: What you need to know

What does that mean?

About 12% of women of childbearing age have a disability, that is, any impairment that results in a restricted ability to perform social functions or access necessary services. Still, little is known about the sexual, contraceptive, and perinatal needs of women with disabilities, and not much data is available to help clinicians provide care for a disability during pregnancy. Medical care (and available medical records and research) for these women tends to focus on disability rather than pregnancy. Still, new data indicates that women with and without disabilities have an equal chance of having a healthy and live birth.

A disability is often physical, mental, sensory, or learning-related. It can be a life-long condition or a recent change in health status; it may be stable and require minimal support, or it may require ongoing care and attention. When considering pregnancy, disabilities should be viewed as part of a woman's overall health and well-being and in relation to her coping ability and family support. At Disability Maternity Care, we publishes some of the stories and guide books to help you get through this situation and find out how you can get more help.

What will change?

In general, women with disabilities are as likely as women without disabilities to become pregnant. Having a disability does not immediately mean that you will have a high-risk pregnancy, but it can be prone to certain complications. For example, women with spinal cord injuries are more likely to experience urinary tract infections and breathing problems during pregnancy. Weight changes can affect your balance and the way you walk or move, so if a disability already affects these activities, pregnancy can make them even more challenging.

During labor and delivery, spinal cord injuries and other neurological conditions or musculoskeletal problems can affect the use of anesthesia. If possible, meet with your anesthesia team prior to labor and delivery (such as in the last weeks of your pregnancy) so they can be prepared for any special considerations associated with spinal or epidural anesthesia.

Women who take medications related to their disabilities during pregnancy should talk to their doctor or pharmacist about the safety of the medications. Some medicines aren't safe once you are trying to conceive or during pregnancy. Your doctor or pharmacist will help you decide which medications to continue and which to change.

What to expect?

One of the most important barriers faced by women with disabilities is the attitudes of other people. Social prejudices and assumptions about the wishes, needs and capacities of people with disabilities are widespread. Many women with disabilities have even reported that healthcare providers assumed they would never want to get pregnant, and when they did, healthcare providers questioned their ability to care for a child.

What you can you do?

Women with disabilities have reported that planning ahead is the most important step in ensuring a healthy pregnancy. Finding doctors with expertise in her specific disability also led to better labor and delivery experiences. Fortunately, many obstetric practices and hospital systems are developing programs with specialized care for many types of disabilities.

Women with disabilities are increasingly sharing their stories and experiences through social media platforms, support groups, and even structured and formal clinical research to help healthcare providers care for other women during pregnancy and offer advice and support for your peers who are pregnant.

What does it all mean?

In general, healthcare providers, especially obstetricians and gynecologists, should focus more on a woman's abilities than her disabilities. And care and communication must empower, not discourage, women. Fortunately, there are an increasing number of resources available to support women with disabilities (and their doctors) who are pregnant and transitioning to parenthood. Finding these resources and advocating for your own care is great preparation for parenthood!

Having a disability will likely pose additional challenges during your pregnancy, but with the right support and care, you have as much of a chance as any woman for a happy and healthy baby. Get in touch with Disability Maternity Care today!