More than a half million women in the United States are estimated to be dealing with spinal cord traumatic injury or disease. Individuals who survive the first year after such an event have an overall life expectancy that is almost normal (90%). Clearly, those women need ongoing reproductive health care that is comprehensive, consistent with the recommendations of the American College of Obstetricians and Gynecologists, and affirms their dignity. Having said that, there are a number of potential barriers and issues that can impair optimal care for this patient population.
The following is a Top 8 list of ways to optimize an outpatient visit for reproductive health care for women with spinal cord injury or disease. The recommendations are based on observations of a patient, Cody Unser, and suggestions from Contemporary OB/GYN Editorial Board Member Sharon T. Phelan, MD. Ms. Unser has been a paraplegic at a T4 level since age 12, when she experienced transverse myelitis. She has been a strong advocate regarding women’s health care issues for wheelchair-dependent women. In this article, Ms. Unser discusses many of the challenges she has had when interfacing with medical offices, especially ob/gyn offices. Dr. Phelan offers her suggestions for how best to accommodate such patients and address some common issues that may arise during their exams.
1. Committee on Health Care for the Underserved Woman. Special Issues in Women’s Health. December 2017. American College of Obstetricians and Gynecologists. Washington DC
2. Abrams GM and Wakasa M. Chronic Complications of Spinal Cord injury and disease. Up-To Date. Last revised August 19, 2019. Accessed on Oct 24, 2019 at https://www.uptodate.com/contents/chronic-complications-of-spinal-cord-injury-and-disease?search=autonomic%20dysreflexia&source=search_result&selectedTitle=1~31&usage_type=default&display_rank=1