Coping with a physical disability and pregnancy

If you are expecting a baby and have a physical disability, you might be worried about how it will affect things. But with the right care and support, you can have a healthy pregnancy and baby.

Will my pregnancy be high-risk?

Just because you have a disability while pregnant, it doesn’t necessarily mean that your pregnancy will be high risk. In fact, many women with disabilities are not considered high risk when pregnant, so the care you receive might not differ dramatically from that of women without disabilities.

However, this depends on the disability you have. Some disabilities can increase certain risks so your midwife will factor these in and you may be referred to a hospital obstetrician (a doctor who specialises in pregnancy and birth) to help with your care. It’s important that you go to all your antenatal appointments so you can get the right help.

One example is if you have a disability that limits your mobility and you use a wheelchair. The pressure of your growing baby can affect your blood flow and increase your risk a clot in your leg veins deep vein thrombosis (DVT).  Also, skin problems may increase as the pregnancy progresses. Pre-existing bowel problems tend to worsen, especially constipation. If you have a condition such as spina bifida or multiple sclerosis, these disabilities can increase your risk of getting a urinary tract infection (UTI), which, if untreated can increase the risk of a kidney infection and pre-term birth.

Managing pregnancy with a physical disability

There are ways to manage any risks to your health from carrying a baby. For example, with an increased risk of DVT, your midwife can take extra care to assess your legs and you can wear compression stockings and elevate your legs, particularly when you are late on in your pregnancy, to promote the flow of blood back to your heart from your legs. And if you have a risk of getting a UTI, your midwife will check for these regularly and, encourage you to drink plenty of fluids to reduce that risk. Extra vigilance will be needed for skin problems and assessment by occupational therapy may be needed to makes sure that a wheelchair or mobility aid is suitable for you during pregnancy.

Ideally, if you are taking regular medications for disability – related health conditions you will have discussed with your specialist prior to getting pregnant whether they are suitable to take during pregnancy. If you find out you are pregnant and are taking such medicines, e.g. for rheumatoid arthritis or for seizures, you must speak to your doctor at once.

Some medicines may be harmful for your baby so you might need to take a different dose or stop taking altogether. However, don’t stop taking your medicines unless your doctor tells you to do so: it will depend on your condition and what treatment is needed to keep you healthy and your pregnancy safe.

As for women without a disability, it’s just as important to make sure you’re healthy as possible throughout your pregnancy. Make sure you eat well, avoid excessive weight gain and continue with any exercise you’re able to do.

Will my disability affect child birth?

All women worry about giving birth, but you might have more concerns because of your disability and how this will affect your choices of how you deliver your baby. While for some disabilities it might be necessary to have a caesarean, this might not necessarily be the case for you.

Most women with disabilities are also able to have the same pain medicines during labour as other women, although there may be some risk if you have a spinal cord injury. Your medical team will take this into account and the important thing is to talk to your doctor so you can put a plan together in advance.

Depending on your disability, you may be advised to deliver your baby at a different hospital to your local one. Some hospitals are better equipped to deal with complex disabilities and may have other specialists on hand which may not be available in all hospitals, particularly smaller units. Your doctor will let you know if they recommend delivery at a different unit, but the choice is always yours.

Are there any additional risks to my baby?

This will depend on your individual disability and you should speak to your doctor about what risks may be increased in your personal circumstances. However, research also shows that potential complications are readily managed with the right care and support.

What should I expect after the baby is born if I am physically disabled?

After your baby is born you might need a little more time to recover if you have a physical disability, which will probably mean a longer hospital stay. You might need to see a physiotherapist to create an exercise program to help you return your mobility to the level you had before your pregnancy.

You can breastfeed your baby but if you have disability that affects your arms, you might need some extra help at first to find the best position for you. You can be creative with pillows to support you if you’re in a wheelchair, or attach a handle to a bottle if you have a weak grip. Other practical equipment such as cots that have adjustable sides, low baby changing tables, or even a side car that you can attach to a wheelchair will make life much easier. Lightweight pushchairs and buggies that are easy to push, have adjustable handle heights and can be attached to a wheelchair are also available. An occupational therapist can help you with all of this.

You also need to take care of your health needs after you give birth. Some health conditions such as rheumatoid arthritis and multiple sclerosis tend to be better during pregnancy and then flare up after you give birth. If you stopped taking medicines while you were pregnant, your doctor might need to get you back on these soon after you give birth to prevent your symptoms and disability getting worse. These medicines can enter breast milk but your doctor will explain everything to you so you can make an informed decisions about feeding.

Am I entitled to additional benefits?

As well as the child benefit that all parents can apply for, if you already receive working tax credit due to a disability, you may be eligible to the Sure Start Maternity Grant. This is a one-off payment to help towards the costs of having a child. Ask your local Citizens Advice for more information.

Where can I get additional support?

As well as the support your midwife and doctor can provide, you might find it helpful to talk to other parents to get tips and advice. Consider joining a support group to connect with other people with your particular disability to see how they managed. There’s also an online community on the Disability, Pregnancy & Parenthood website.