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Stages of Pregnancy

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First Trimester

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Congratulations! You are pregnant...now what? Here are some tips for your first few months of pregnancy.

Prenatal Vitamins and Nutrition
Continue this discussion with your doctor, especially if you have concerns or are experiencing issues eating or taking your vitamins due to morning sickness.

Planning for Labor and Delivery
Begin discussing labor and delivery plans with your doctor. See Labor and Delivery section below for more information.

Contractions
Signs of contractions may be different for women with mobility impairments, especially those who do not have sensation. You will need to be familiar with these signs early in pregnancy in order to know if you go into early labor.

Planning for an Amniocentesis
An amniocentesis is a test done early in pregnancy where a small amount of fluid is drawn from the sac surrounding the fetus to test for certain genetic abnormalities and fetal infections. This test is optional and you will want to discuss the risks and benefits of the test with your doctor. For some women with mobility impairments, there are different risks and benefits to discuss.

What to Expect as the Baby Grows
This is important for all mothers-to-be but for women with mobility impairments, knowing what to expect can help you plan ahead in terms of transfers, positioning, and bowel and bladder management.

Weight Control
It is important to maintain a healthy weight throughout pregnancy. You want to be sure the baby is getting good nutrition to grow but you do not want to gain extra weight.

Urinary Tract Infections
Know the signs and symptoms of UTIs as you are at an increased risk during pregnancy.

Bowel and Bladder Changes
Pay attention to bowel and bladder changes and discuss them regularly with your doctor.

Seating and Positioning
Check for skin breakdown regularly and discuss necessary changes with your mobility provider.

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Second Trimester

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You are right in the middle of pregnancy and starting to prepare for the baby's arrival! Here are some tips to help you through this time.

Transfers
Transfers may become more difficult and you may want to discuss temporary options to make transfers easier while pregnant.

Mobility
Your mobility needs may change as the baby grows. You may need to temporarily use a wheelchair if you do not use one already. If you have a manual chair, you may need extra assistance with pushing the chair or you may want to look into a temporary power chair or scooter.

Swelling
Swelling is normal in pregnant women with or without mobility impairments. However, women with mobility impairments are at a higher risk for blood clots while pregnant. Speak to your doctor about the warning signs of a blood clot and how you can prevent them.

Continuing Concerns
Urinary Tract Infections: Know the signs and symptoms of UTIs as you are at an increased risk during pregnancy.

Bowel and Bladder Changes: Pay attention to bowel and bladder changes and discuss them regularly with your doctor.

Seating and Positioning: Check for skin breakdown regularly and discuss necessary changes with your mobility provider.

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Third Trimester

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Here are some items to consider as you near the end of pregnancy and prepare to take your baby home!

Finalize Birth Plans
Determine where you plan to deliver, who you want in the delivery room, and make plans in case your regular doctor is not available when you go into labor.

Anesthesia
If you would like to, or need to, use an epidural or other pain medication during delivery, you may want to meet with the anesthesiologist, the doctor who will give you the medication, before delivery. He or she will need to be aware of your mobility impairment and special needs for administering the medication ahead of time. Women with SCI may require an epidural to reduce the risk of autonomic dysreflexia. Any woman who has had a spinal fusion or has scoliosis should speak to the anesthesiologist before having an epidural placed.

Hospital Accessibility
You may need to arrange for an accessible hospital room and the addition of any extra equipment you may need (such as lifts, shower chairs, etc.) ahead of time. Also discuss if you will need extra assistance for showering, transfers, or other personal care.

Prepare to Bring the Baby Home
Have a plan in place for any extra support you may need when you get home. This includes personal care for you to allow you time to rest and heal from delivery - something every woman should allow herself time to do.

Continuing Concerns
Urinary Tract Infections: Know the signs and symptoms of UTIs as you are at an increased risk during pregnancy.

Bowel and Bladder Changes: Pay attention to bowel and bladder changes and discuss them regularly with your doctor.

Seating and Positioning: Check for skin breakdown regularly and discuss necessary changes with your mobility provider.

Transfers: Transfers may become more difficult and you may want to discuss temporary options to make transfers easier while pregnant.

Mobility: Your mobility needs may change in pregnancy. You may need to temporarily use a wheelchair if you do not use one already. If you have a manual chair, you may need assistance pushing or you may want to consider a temporary power chair or scooter.

Swelling: Swelling is normal in all pregnant women. However, women with mobility impairments are at a higher risk for blood clots while pregnant. Speak to your doctor about the warning signs of a blood clot and how you can prevent them.

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Labor and Delivery

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Labor and delivery should have been discussed with all your medical providers during pregnancy and a detailed birth plan should be in place. Here are a few more tips, along with some things to consider when you go home.

Vaginal Birth versus C-Section
C-sections are becoming more common in all births, not just those to mothers with mobility impairments. Many doctors may think a woman with a mobility impairment will need a C-section. This is not always true so discuss your options in detail with your doctor before delivery.

Contractions
Signs of contractions may be different for women with mobility impairments, especially those who do not have sensation. You will need to be familiar with these signs to know when labor is beginning.

Breastfeeding
Let your doctor and the hospital staff know if you would like to breastfeed before delivery. Some women with mobility impairments may need special assistance and support to breastfeed. Still others need to watch for symptoms related to a relapse of their disability (such as MS and rheumatoid arthritis) and women with SCI should watch for symptoms of autonomic dysreflexia when breastfeeding. Also discuss your medications again with your doctor to be sure they are safe to take while breastfeeding.

Going Home
All new mothers need support when going home with a new baby. Women with mobility impairments may need extra time to heal and gain back strength and should have a strong support team in place the first few months after having a baby.

Postpartum Depression
This is also known as “baby blues” and is common in women who have recently had a baby. If you have been treated for depression in the past, you are more likely to have postpartum depression so you and your friends and family should know the signs and symptoms. Click the link for more information.