Skip to main content
SMFM 2026 Pregnancy Meeting Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared outside of the session
Faculty have requested this content not be shared outside of the session
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
Foundation Awardee
Foundation Awardee
Poster Icons
Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 1

Category: Operative Obstetrics

Poster Session 1

(162) Rates and Indications for Cesarean Section in Obstetrical Patients with Spinal Cord Injury

Wednesday, February 11, 2026
10:30 AM - 12:00 PM  

    Submitting Author and Presenting Author(s)

  • Christina Antinora, MD

    Resident
    Department of Obstetrics and Gynecology, University of Toronto
    Department of Obstetrics and Gynecology, University of Toronto, Ontario, Canada

    • Coauthor(s)

  • AH

    Anne Harris, PhD

    Associate Professor
    Dalla Lana School of Public Health, University of Toronto
    Dalla Lana School of Public Health, University of Toronto, Ontario, Canada

  • CM

    Claire J. Mazzia, MSc

    Medical Student
    University of Toronto
    University of Toronto, Ontario, Canada

  • Anne Berndl, BSc, MD, MSc

    Maternal Fetal Medicine Physician
    Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Toronto, Toronto, ON
    Toronto, Ontario, Canada

Objective:
Spinal cord injury (SCI) in young adults is on the rise globally. Little is known about pregnancy in patients with SCI, including optimal mode of delivery. People with SCI are more likely to deliver via cesarean section (CS), however the reason for this remains unclear. People with SCI may require CS for common obstetrical reasons and for SCI-specific indications including prior surgery, concerns with neuraxial analgesia or autonomic dysreflexia, and provider preference. Our study aims to determine rates and indications for CS among pregnant patients with and without SCI.

Study Design:

Data was obtained from a large online cross-sectional observational questionnaire examining reproductive health outcomes of people with SCI between 2019-2021. We compared rates and indications for CS in respondents with SCI (n=259) and without (n=301) SCI using descriptive statistics and chi-square analysis.

Results:

38% of patients with SCI delivered via CS compared to 23% without (p < 0.01). Approximately half of CS occurred in labour in both SCI (46%) and non-SCI patients (55%) (p > 0.05). Indications among SCI patients included safety concerns secondary to SCI (30%), malpresentation (24%), and maternal choice (17%). Among patients without SCI, most common indications were arrest of dilation (25%), cephalopelvic disproportion (22%), and previous CS (19%). 41% of patients with SCI underwent CS under general anesthesia, compared to 19% for those without SCI (p < 0.01). Specific indications for CS which differed significantly (p < 0.01) between patients with and without SCI were maternal choice, cephalopelvic disproportion, and arrest of dilation.

Conclusion:

Rates of CS among SCI patients is significantly higher than those without. Maternal request and perceived risks secondary to SCI were among the most common indications, compared to more traditional obstetrical indications in non-SCI patients. This significantly different pattern suggests the need for tailored guidelines that consider the medical complexity of people with SCI, and shared decision-making to support evidence-based delivery planning in this population.