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Sexuality, Pregnancy, and Parenting

By Kelly McKee

SCI, Sexuality, and Pregnancy

Let’s talk about sex!  Scary subject, right?  It shouldn’t be, as American society has sexualized about every possible scenario.  I can’t even let my kids turn cable channels freely during the day (but that is an entirely different article)!  Here I want to talk about spinal cord injury and sex and pregnancy, which can be awkward or scary subjects for individuals with a spinal cord injury.  For men and women sexuality and pregnancy are inextricably linked to our perceptions of masculinity and femininity.  After a traumatic injury, those perceptions can be tested as we may struggle with the physical challenges of living life differently due to our injury.     So conquering these topics is important whether an individual is in a relationship, considering exploring opportunities for a relationship, or for simple matters of self-esteem.

Each spinal cord injury is unique and levels of functioning vary.  However, sex and intimacy are very natural experiences that having a spinal cord injury should not prohibit individuals from enjoying, no matter what the level of injury.  Topics such as body image, physical positioning, sexual self-confidence or performance issues, sensation level, myths and misconceptions about sex, bladder and bowel function, and spontaneity may be concerns for individuals with spinal cord injury.  Body image can be a particularly difficult issue for women because of the emphasis American society places upon attractiveness in relation to self-worth.  Nevertheless, women with spinal cord injury can become comfortable in their new bodies and can work to overcome negative feelings that may be associated with changes in physical appearance.  Keeping fit in any way possible is a great way to feel better, stay healthy, and will increase confidence when engaging in sexual activity.  And, by the way, sex does not always mean intercourse.  Oral sex, kissing, massage, hugging, and touching are all great ways to be intimate with a partner.  Also, these activities can often be spontaneous.  Intercourse however might need to be planned due to personal care scheduling or the need for physical positioning.  However, who nowadays doesn’t need to plan time to fit sex into a busy schedule?

We cannot discuss the topic of sex without talking about birth control and pregnancy.  Unfortunately (in my opinion), having a spinal cord injury does not stop a woman from menstruating.  However, the positive effect of menstruation is the ability to conceive and give birth.  For women with spinal cord injury, birth control can be tricky because many common forms of birth control are not recommended due to the danger of blood clots.  Today, Levonorgestrol implants placed in the upper arm are a long-term contraceptive method that is safe and effective.  For women with spinal cord injury hoping or actively trying to become pregnant, your injury should not hold you back.  When planning pregnancy, or when you are joyfully surprised, such as in my case (twins!), simply be aware of the potential complications and take extra care.  The added weight of pregnancy can make transfers and weight shifts more challenging.  In my case, a benefit of pregnancy was the additional hormones that reduced the spasticity in my legs.  In most cases, doctors will monitor the pregnancy closely through ultrasounds and schedule a caesarian section for the birth.  During delivery, utilizing anesthetics such as an epidural reduces the threat of autonomic dysreflexia, during which blood pressure may rise to dangerous levels, leading to stroke if not treated.  Autonomic dysreflexia or hyperdsyreflexia occurs primarily because of an imbalance in the body systems which control the blood pressure and the stress on the body when giving birth can provoke an incident.  Monitoring birth and the use of pain medication reduces the possible complication of hyperdsyreflexia, so such a threat need not dissuade a woman from considering the idea of pregnancy.      

Often, the topics of sexuality and pregnancy are not addressed in rehabilitation.  As a woman with spinal cord injury, I would encourage other men and women with spinal cord injury to seek out trusted, professionals for advice, seek out information available on the Internet, and talk to other individuals with spinal cord injury about sex and pregnancy.  Of course, a good sense of humor always helps.  We cannot take ourselves too seriously, and we must realize that very few individuals experience storybook romances and the types of sexual escapades depicted on television.  I will gladly answer any questions regarding the topics of sex, relationships, pregnancy, and parenting with spinal cord injury at tfm099@aol.com.