How to Advocate for Your Pregnancy Care

If you’re an expectant mother living with medical challenges such as a physical or limiting disability, the thought of carrying a pregnancy to term may be scary. The key to overcoming this discomfort is gaining knowledge on how to manage your disability in pregnancy, making accommodations or adaptations, and having a plan for when things don’t go as they should. All of these steps should help you feel empowered during pregnancy decision-making.

Before Pregnancy

It’s best to consult with your pregnancy care provider before getting pregnant, particularly if you have a disability that can complicate pregnancy, labor, or birth. You will likely need to find a care provider who is open-minded, supportive, respectful, and has the capacity to learn about your specific disability.

Ensure your healthcare provider’s office/facility can accommodate your accessibility needs and support your care.

Make a list and arrange a time to ask a nurse or another care provider on staff about how the office is set up to support your needs, such as wheelchair-accessible parking, scales for taking accurate weight in a wheelchair, bathrooms with space to move around with your equipment, and patient rooms with electronic exam tables that are easily lowered and elevated for care. These simple things can reduce the stress of receiving care.

There are additional ways to reduce stress before your first appointment. Create a list of questions or concerns you’ve been thinking about. Ask your provider to order specific blood or genetic tests related to your condition so you’re informed of any risks to your baby as early as possible. Find out if your provider collaborates through a multi-level healthcare system that offers social services and can provide in-home resources before your baby arrives.

Consider starting care with a behavioral health counselor to discuss any anxieties related to getting pregnant. This relationship can become one of support during your pregnancy and throughout your postpartum recovery.

Gain knowledge on how to manage your disability during pregnancy, make adaptations, and have a plan for when things don’t go as they should.

Finally, gather information early, particularly for mothers with visual, hearing, or intellectual impairments. Create a customized plan with your pregnancy care provider that centers around challenges of the disability in pregnancy, labor, birth, and during postpartum recovery including medications.

During Pregnancy

Once pregnant, your medications may be altered due to the safety of your unborn baby. Antispastic, anti-depressant, and anti-seizure medications are examples that need to be discussed because certain medications in these categories can be harmful to the growth and development of your baby.

Long-term, chronic pain control medications for certain conditions like cerebral palsy may also need to be changed completely due to any potential risks to your unborn baby. If your medication has to be adjusted during pregnancy to ensure your growing baby’s health, you can seek out non-drug pain options.

Alternatives include massage and water therapy, heat, ice, acupuncture, meditation, and relaxation techniques. These are just a few treatments that can help you cope with the pain you may be enduring from your medical condition. Schedule an appointment with an occupational therapist, physical therapist, and/or pelvic floor therapist. These professionals will customize therapies to help prepare your body for the changes and possible pain or discomfort you may experience during pregnancy, in labor, and or while giving birth.

If you need a larger wheelchair to accommodate the weight of your growing baby, call your insurance carrier to discuss the options that are available. In the meantime, add a few cushions to your chair; this may help with pain and annoying pressure points.

Near the end of your pregnancy, ask your provider if you should be referred to the anesthesia team early to discuss pain options during labor. It is important to know if certain anesthesia medication used during labor and birth has caused spinal cord abnormalities. Depending on your condition, one procedure may be better than another to prevent complications of the spinal cord., Finally,  for anyone with lower limb contractures, consult with both your healthcare and anesthesia providers about the best form of pain relief and your options for a safe birth experience.

After Pregnancy

Setting up a newborn nursery can be fun and exciting but make sure you read reviews and test equipment before buying to ensure items fit your family’s specific needs. A person that uses a wheelchair may need to purchase a crib that opens on the side. Other options are bassinets that connect to the parent’s bed and allow for easy reach to your baby, these can be fantastic. A baby changing table that allows for easy height adjustments from standing to a person who is sitting can be helpful too.

Conclusion

The number of women with disabilities has increased over the years and many of these women have successfully become parents. With adequate knowledge and the needed resources, women can advocate for their own health care and experience an amazing pregnancy journey.

Having a team who supports you throughout your journey can make pregnancy enjoyable and healthy and support a safe birth for mom and baby.

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Author

ShaBrittaney Condol BSN, RNC-OB is a labor and delivery nurse at Baton Rouge General Medical Center in Baton Rouge, LA.

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