Female Fertility and Pregnancy
What Is It?
Female fertility is essentially a women’s ability to conceive a child through fertilization of an egg with sperm. This process can be broken into four different “perinatal” phases:
Pre-pregnancy: This is the planning stage – it might involve getting familiar with your body’s menstrual cycles, speaking to your doctor about your plans and/or no longer using contraception. Typically women may start taking pre-natal vitamins at this stage.
Pregnancy: A full term pregnancy generally lasts 40 weeks, known as the gestation period. As the baby grows, your body goes through several changes. Depending on your situation, you may undergo tests and procedures and your health may be routinely monitored by a team of medical professionals.
Labour and delivery: Known as childbirth, this stage can lasts minutes or days. Many women make a birth plan during the earlier stages of their pregnancy that includes your plans and desires for where and how your baby will be delivered.
Postpartum: The first six weeks after childbirth is a time of great adjustment; You, your family, and your new baby are adjusting to life together. In the hours, days and weeks following delivery your body will experience multiple physical and emotional changes.
We are working to ensure this resource is inclusive of all who experience pregnancy with SCI and similar disabilities. We recognize that the language we use can add to the barriers experienced by LGBTQ+ people with disabilities in accessing healthcare. This page will be updated to use language is inclusive of trans and non-binary pregnancy journeys. Share your input with us by emailing firstname.lastname@example.org.
My spinal cord injury means pregnancy isn’t a good idea.
SCI does not affect a woman’s fertility!
What’s Different Now?
In general, unless there has been pelvic trauma, a woman’s reproductive system is unchanged because of spinal cord injury. Typically right after injury (while the spinal cord is in shock), your period stops for about 6 to 8 months and during this time, pregnancy is unlikely. But once your period returns, your chances of becoming pregnant remain the same as before your injury.
You may find that looking after some of your regular reproductive healthcare is a little different after spinal cord injury. For example, getting onto examination tables for a Pap test or vaginal exam might be more difficult, or you may have trouble holding your legs in stirrups, especially if you have spasticity. If you are in the greater Vancouver area, you can be referred to the Access Clinic at BC Women’s Hospital for breast and cervical cancer screenings, vaginal exams and contraceptive services.
For more information regarding common changes to all of the phases listed above, check out our Pregnancy and Spinal Cord Injury Guide.
What Can I Do About It?
Pregnancy with a spinal cord injury comes with some unique considerations. It is important to make connections to health care providers such as physiatrists, maternal fetal medicine specialists, occupational therapists, physiotherapists, and other rehab clinicians early in the pregnancy, even in the planning stages when you are trying to get pregnant. In some communities, there may be an established clinic where women with disabilities can get access to all of those specialized services. In Vancouver, it’s the Maternal Fetal Medicine Team at BC Women’s Hospital. In Toronto, there’s the Accessible Care Pregnancy Clinic. If you’re unsure where to find these resources or whether you need them, start with your family doctor and physiatrist (rehabilitation physician) and ask for referrals. A regional SCI rehab centre may also be a good place to ask for suggestions.
Reach out to peer groups and SCI organizations to learn about pregnancy experiences and tips from other people with SCI.
- Check out the feature article on the experiences and tips of five moms with SCI in The Spin Magazine (Spinal Cord Injury BC).
- Jump down to the Resources list at the bottom of this page for links to other stories about pregnancy and motherhood with disabilities.
- Check out the clinical guidance on pregnancy, childbirth and spinal cord injury in the Resources section below.
Also check out our Peer Stories Playlist on Pregnancy, Fertility and SCI for great videos by and for moms with disabilities.
What Do I Need to Know?
This Pregnancy and Spinal Cord Injury guide was designed for women with SCI by the team behind this Sexual Health website. It covers all of the areas you’ll need to consider about your fertility, pregnancy, labour, and delivery as a woman with SCI. You can download it, or read it here:
Or check out a shorter overview here.
Be your own advocate. You may come up against negative attitudes and obstacles in the process of starting a family; however, the information in this chapter can be used as a guide for you to access the resources you need for a successful pregnancy and delivery.
Reach out! Think about the help you might need, then reach out and ask for it! You can roughly guess what kind of support you will need by speaking to other women with SCI who’ve been pregnant (see our What Do I Need to Know? section for some great peer stories), your injury level, complications, and the family and support you have around you.
Rest! The most important part of getting pregnant and having a baby is being healthy – take time to look after yourself and get enough rest.
Who Can Help Me?
The Sexual Health Rehabilitation Service can help you assess your fertility, identify potential challenges, and refer you to a variety of clinicians if you need them. Women with complicated pregnancies or SCI complications during pregnancy may be referred to the Maternal Fetal Medicine Clinic at BC Women’s Hospital.
Friends and family, attendant care, mother’s helpers, doulas, housekeepers, and nannies can all be helpful to you and your family in those last weeks of pregnancy and the first weeks or months of childbirth. Plan ahead, and don’t be afraid to ask for help!
Pregnancy after SCI is possible! Being familiar with the resources available and developing a collaborative network of care providers can help you have a healthy birth experience and outcome after SCI.
Fertility and Pregnancy Resources
Maternity Rolls On: Pregnancy, Childbirth and Disability - Heather Kuttai, a memoir.
Wheelchair Accessible Tips and Tricks I Learned as a First-Time Parent - Stephanie Arrache, New Mobility.
We're In This Together - Karen Hodge, Pacific Post Partum Support Society; about struggles with postpartum anxiety.
Pre-conception care for women with spinal cord injury - BC Women's Hospital + Health Centre
Antenatal care for Women with SCI - BC Women's Hospital + Health Centre
Postpartum care for women with spinal cord injury. - BC Women's Hospital + Health Centre
Guideline No. 416: Labour, Delivery, and Postpartum Care for People with Disabilities. Journal of Obstetrics and Gynecology of Canada (JOGC), 2021
The impact of spinal cord injury on pregnancy, labour and delivery: What you need to know. - Government of Queensland, Australia.
SCI Factsheets: Pregnancy and spinal cord injury. - (US) Model Systems Knowledge Translation Centre
Through the Looking Glass - A nonprofit offering support and information to families impacted by disabilities.
The Disabled Woman's Guide to Pregnancy and Birth - A helpful book to have if you're expecting, or planning to start a family.
Sexuality and Reproductive Health in Adults with SCI: What You Should Know - Consortium for Spinal Cord Medicine.
Pregnancy and SCI Webinar with Dr. Anne Berndl - Mobility Clinic/Sunnybrook Health Sciences Centre (Toronto)
Female Fertility and Spinal Cord Injury - Facing Disability.
Reproductive Health for Women with SCI - UAB School of Medicine.
Fertility - Sexuality After SCI.
Check out our Video Playlist for this chapter!
Articles and Other Resources
Male Fertility After Spinal Cord Injury: A Guide for Patients (PDF) - Miami Project to Cure Paralysis.
Spin Doctor Article on male fertility questions with Shea Hocaloski, Sexual Health Clinician, Vancouver Coastal Health.
Things to Consider in Male Fertility After SCI - Facing Disability.
Fertility - Sexuality After SCI
Check out the Video Playlist for this chapter.