Women with residuals of poliomyelitis can usually carry a pregnancy to term. However, in some cases, pregnancy can be complicated by the consequences of having had polio. Basic problems include immobility from paralysis, limited strength and increased muscle fatigue, breathing difficulties, and increased nutritional requirements.
All pregnant polio survivors should be on supplemental iron, as well as regular recommended supplements, throughout pregnancy and the immediate postpartum period to maintain hemoglobin and tissue oxygenation at normal levels.
Immobility and lesser muscle mass may make pregnancy uncomfortable for paralyzed women. Careful positioning and frequent changes in body position should be carried out; the head down body position should be avoided. A physical therapist can stretch out the hip musculature, especially the adductors, so the position of delivery will not be painful.
Women with significant respiratory problems (see Anesthesia) constitute a high-risk group. Early in the pregnancy, the family physician or obstetrician should refer them to a high-risk, maternal-perinatal center. At least four weeks prior to the anticipated date of delivery, the obstetrical team (obstetrician, anesthesiologist, and nurse) should evaluate the woman to plan for a normal, uncomplicated delivery, forceps vaginal delivery, cesarean section, or emergency cesarean section.