Saranya (name changed) was diagnosed by doctors at the Christian Medical College (CMC) in Vellore, with a bone cyst in her spine leading to her becoming a paraplegic in 2011. Nine years later, the woman in her 20s, delivered a baby at the same hospital where she learned to become independent in mobility and self-care.
On April 22, in the midst of the COVID-19 lockdown, a pregnant Saranya and her husband made their way from Chennai to CMC, Vellore. A team of doctors from the departments of obstetrics, medicine, rehabilitation medicine, anaesthesia and virology came together to handle the pregnancy. She went into labour by late evening and delivered a baby by caesarean section at about 3 a.m. on April 23. She was discharged without complications, according to doctors.
Women with spinal cord injuries (SCI) do have obstetrical challenges. But with increased awareness and support, they can have maternal experiences similar to their able-bodied counterparts, doctors say.
Saranya had a lack of sensation and ability to move below chest and loss of continence. In 2016 she was referred by a peer group to the rehabilitation institute of CMC. She later got married and conceived in 2019.
“She was getting antenatal checkups in a nursing home in Chennai. Her expected date of delivery was in the last week of April. Due to the lockdown and COVID-19, the nursing home was shut down for a while. When it opened, they said there were no facilities for her to deliver, and it was a risk,” V. Subbulakshmi, a peer trainer with The Spinal Foundation, said.
“We approached another private hospital near Chennai but they were unwilling to take in a new patient,” added Ms. Subbulakshmi, whose husband had sustained a spinal cord injury, following which she has been part of the support group.
S. Vaidyanathan, co-founder and secretary of the foundation made arrangements for an appointment at CMC, and an ambulance was arranged, she added.
“We have documented only three to four spinal cord injury patients having successful pregnancies in the past 25 years,” Henry Prakash M, professor, Department of Physical Medicine and Rehabilitation and deputy medical superintendent, CMC, said.
“Many women who receive spinal cord injuries are in their childbearing years. A survey of women who delivered children after SCI showed that 96% of them had stated that becoming a parent improved the quality of their life,” he said.
They are prone to complications such as urinary tract infections, bed sores, and deep vein thrombosis during the course of pregnancy. During labour, one should watch for a serious complication of autonomic dysreflexia (severe headaches, very high blood pressure, flushing, sweating), he added.
There is a lack of awareness among even the medical community, he noted. “People living with disability are knowledgeable about their condition and listening to their views on management will optimise their care,” he said.