4.2 Strengths and Limitations
This study is inherently subject to several limitations. First, despite
the rather extensive recruitment efforts, the obtained sample size of
women with SCI who became mothers after the SCI event (n=72) was
relatively small. One reason for this might be that there is no national
registry for people with SCI. The SwiSCI cohort study, which collected
data from four Swiss rehabilitation centres, may not represent the whole
national SCI cohort and might thus underrepresent women with SCI, the
elderly and those with very low lesions (L1-S5)
(17). In addition, this survey includes
no further information about conceiving and pregnancy outcomes. SwiSCI
does not gather data on miscarriages, pregnancy outcomes (e.g. premature
or term births, caesarean deliveries). Further, SwiSCI does not identify
first-time pregnancies, whether women have difficulty conceiving, or
whether they used assisted reproductive services to become pregnant.
Finally, although some relevant variables (e.g. educational status, SCI
aetiology) were considered for analysis, information on other potential
predictors of the likelihood of motherhood (e.g. marital status, work
status, finances, satisfaction with health and quality of life) were
only available for the 3-month-period prior to the survey but not for
the time of the delivery or SCI event. Despite these shortcomings, this
study offers insight not only into fertile women but also in the entire
cohort of women with SCI, allowing the formulation of recommendations
for policy and service provision.