In 2008 there were an estimated 259,000 people living in the USA with spinal cord injuries (SCI). The majority of these people are in their reproductive years, and over 19% are estimated to be women. Advances in medical management have allowed many women to live successfully with congenital defects or injuries resulting in SCI that even a few years ago would have been fatal. Although many of these women may be classified as ` disabled', fertility is not usually affected in SCI and many of these women desire children of their own. It is important to counsel these women regarding the range of issues related to pregnancy. These include conception issues, parenting with a disability, emotional concerns of the family, nutrition and exercise in pregnancy, risks in pregnancy, labour and delivery, postpartum care, and breastfeeding. For health-care providers it is important to know and understand your patient's disability and be able to provide the best patient-centred quality care, understanding that each patient's circumstance may be unlike any other patient.