Hesperian Health Guides

Planning your pregnancy and birth

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HealthWiki > A Health Handbook for Women with Disabilities > Chapter 10: Pregnancy > Planning your pregnancy and birth


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Around the world, most women give birth at home with the help of a local midwife. These births can be safe and healthy for both the mother and the baby, especially if the midwife is experienced. For women with disabilities, care during pregnancy and birth with a midwife is also usually safe and healthy. But even if the midwife is skilled, there are times when women and babies need hospital care.

Some women with disabilities who have a greater risk of complications need medical care that is usually only provided in a hospital. For example, if you:

  • have a disability that prevents you from opening your legs wide such as cerebral palsy, rheumatoid arthritis, or severe muscle spasms. During the birth, you will need to keep your legs open wide for 2 to 3 hours, either by yourself, or with someone’s help, or you may need to deliver the baby through an operation.
  • are a woman of short stature (dwarf). The bones in your pelvis may not be wide enough for the baby to come out safely without an operation. Also, because you have less blood in your body, you may need a blood transfusion, depending on how much you bleed during childbirth.
  • have a high spinal cord injury (T6 and above) you are at risk for getting dysreflexia, a deadly high blood pressure.
illustration of the below: a variety of foods including grains, fruits, vegetables, milk, and meat.


While you are trying
to get pregnant

To make sure you and your baby will be as healthy as possible, eat regularly and try to eat a variety of healthy food, especially the foods that can help prevent birth defects. Healthy habits like eating good foods, not smoking, and avoiding drugs and alcohol are important because many problems start early in pregnancy—before you even realize you are pregnant.

Make a birth plan

Even though it can be difficult for women with disabilities to get the medical treatment they need, every pregnant woman should make a birth plan. You should begin having prenatal (also called antenatal) checkups as soon as you think you are pregnant. If possible, try to find a midwife, doctor, or other health worker you trust, and take a friend or family member with you when you go for your first checkup. Together you can talk about any possible problems that may happen, what can be done about them, and where you can get the best advice. You can use this information to help make your birth plan. For example:

  • Which will be the safest place for you to have your baby: at home, a birthing clinic, or a hospital?
  • Will you have transport to a hospital or clinic if you need it?
  • If you take medicines regularly, will they have any effect on your developing baby? You may need to change some of the medicines you take to others that are safer in pregnancy. This is especially true for anti-seizure medicines.
a woman speaking to a disabled woman.
I will help you while you are pregnant to make sure you get what you need.
  • Will your disability affect your health while you are pregnant, or the health or development of your baby?
  • Is your disability likely to cause problems during labor or delivery?
  • Can complications be prevented or treated safely?
  • Do you know how to stay healthy during your pregnancy (eating well and exercising)?