Labor and birth 239
To midwives and other health workers caring for women
with spinal-cord injury during pregnancy, labor, and birth:
Dysreflexia is a medical emergency. For more
information, see pages 117 to 119. The high blood
pressure can cause seizures or deadly bleeding
inside the brain. Because of this, during the last
2 months of her pregnancy, make sure to check
her blood pressure every day. Also, before her
labor starts, it is best for a pregnant woman with a
spinal cord injury to go to a hospital or clinic that
can take care of the medical problems she may
have during labor and birth.
To prevent dysreflexia during labor, she must have anesthesia injected in
her spine (an epidural). Also, it is important to:
• make sure she is not left alone.
• make sure she is not lying down flat, and that her head and shoulders
are supported and her knees bent.
• measure her blood pressure frequently, at least once every 10 minutes.
• If she needs to pass stool, be very careful if you remove the stool with
a finger, or give her an enema to remove stool. Removing the stool can
start dysreflexia. Apply lidocaine gel (2% to 4%) to the rectum first.
• keep her bladder empty. If necessary, put in a catheter to drain the urine
(see pages 103 to 104). Apply lidocaine gel to the urine hole before
putting in the catheter.
A Health Handbook for Women with Disabilities 2007