anonymous on September 12, 2011

My son is marrying a woman paralyzed from the waist down...will they be able to have children?

My son is engaged to a 20-year-old young woman. She was in a car accident and in a coma for 60 days. She’s finally awake and is doing well mentally, but she’s paralyzed from the waist down. They are planning to get married as soon as she gets her strength and health back. She is a darling girl and we are so lucky to still have her with us, but I am wondering about her chances of having children and how her paralysis will affect their sexual relations? My son loves her very dearly and is willing to do whatever it takes to make her happy. I would appreciate it if you could help educate me on some of the things that they might face as a married couple. Thank you so much.

answered by Mitchell Tepper, PhD, MPH on September 12, 2011

Thank you for your thoughtful questions, and for showing such loving concern for your son and his future wife. While I’m very sorry to know of her traumatic accident and injury, she is fortunate to be surrounded by such care, support and acceptance.

Regarding the sexual and reproductive functioning of your future daughter-in-law, I’m pleased to offer you some general information for your consideration. That said, when they’re ready to start a family, I would encourage them to speak with a rehabilitation doctor and an obstetrician who specializes in serving women with spinal cord injury (SCI). They’ll need an expert to answer all their specific questions, and the unique challenges they face.

Now, for the basics…

Can women with a spinal cord injury still have children? Yes, in most cases. An SCI typically doesn’t affect a woman’s reproductive system…so, if she chooses to, she should still be able to have a successful pregnancy and delivery.

Although menstrual periods often stop temporarily after a traumatic injury, menstruation usually returns after the body has a chance to heal and adapt. And when a woman’s periods return, it’s likely that she’s ovulating again, and pregnancy should be possible through sexual intercourse.  

For women with an SCI, it’s a good idea to consult a specialist before becoming pregnant. Why? Well, there are a number of factors to consider before getting pregnant (like the possible affects of medications on a developing baby, and the mother’s skeletal strength and structure in carrying the baby); as well as during pregnancy (for example, how to manage weight gain, bowel and bladder management, and the possibility of pressure sores or muscle spasms). Not all obstetricians are trained in SCI, so it’s best for your future daughter-in-law to find a specialist.

More good news…

Vaginal delivery is often possible for women with an SCI. The uterus is a muscle with its own nerves. So when it’s time to deliver a baby, a pregnant woman with SCI will typically have normal contractions and the uterus will push…even if she’s not aware of it. Of course, if a woman’s injury keeps her from feeling contractions, she and her doctor should talk about ways to recognize premature labor so that eventuality can be promptly addressed.

You also asked about sexual activity...a number of studies have examined women with SCI and their sexual functioning, and it turns out that they are typically capable of experiencing orgasms and sexual pleasure from genital stimulation, or from touch to other parts of the body.

The most commonly reported problem among women with SCI, however, is lubrication…but this can be easily overcome by using extra water-based lubrication during sexual activity.

Thanks again for trusting us with your concern, and I wish your son and his fiancée a happy marriage and future family life.

Related info:

Mitchell Tepper, PhD, MPH

Dr. Tepper directs sexual health education at An AASECT-certified sexuality educator and counselor, his areas of expertise include sexual dysfunctions, sexuality following disability or illness, pleasure and orgasm, relationships, and military and veteran couples' counseling. Dr. Tepper was educated at the University of Pennsylvania and Yale University.

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