Communication with the woman's obstetrician is essential. The patient should be provided with a packet of information to share with the obstetrician. This should be followed with a phone call from the SCI physician to the obstetrician. Episiotomy is usually not needed since the pelvic floor is relaxed. In addition, there is an increased incidence of dehiscence since SCI women should be mobilized early and need to transfer in and out of a wheelchair.
Blood pressure needs to be taken during the peak of contraction.
This needs to be compared to prenatal blood pressures. No one has any great experience with this situation and most articles report only a few cases. Even the report by Goller and Paeslack4 dealt with 175 cases from 42 centers in 24 countries. Our spinal cord injury staff were pleased when we had two tetraplegic patients who were pregnant. It helped confirm our belief that life and its functions continue after paralysis.