Improving reproductive health care services for women with a physical
disability: Insights from a community survey of women with spinal cord
injury in Switzerland
Abstract
Objective: To describe a cohort of women with a physical disability in
various reproductive life stages to support the development of specific
management targets, especially during the fertile stage. Design:
Community survey. Population / Sample: We analysed data from 440 female
participants with chronic spinal cord injury (SCI) aged over 16 years
from the cross-sectional community survey of the Swiss Spinal Cord
Injury Cohort Study (SwiSCI) in 2017. Methods: The full cohort was
analysed using descriptive analysis. For women in the fertile
reproductive life stage, a regression technique was used to identify the
predictors of becoming a mother after SCI. Results: More than 50% of
the sample were aged over 56, and approximately one fourth were in the
fertile (16-45 years) age group. Motherhood after SCI was most prevalent
in women with low and incomplete lesions and those who sustained an SCI
at a young age. The chances of giving birth significantly decreased when
sustaining an SCI after the age of 35. The mean age at first delivery
after SCI (age 31.2±5 years) was five years higher compared to women
with an SCI who gave birth before sustaining SCI (age 26.2±5 years).
Conclusions: The study provides evidence for the need for tailored and
specific lifespan adjusted obstetric and gynaecological services for
women with SCI and for women with a disability in general. Funding: This
study has been financed through the framework of the Swiss Spinal Cord
Injury Cohort Study supported by the Swiss Paraplegic Foundation.