The management of pregnancy, labor, and delivery in women with spinal cord injury (SCI) has received increased attention by investigators and clinicians in recent years. Physicians who care for women with SCI need to become familiar with the general principles of care during pregnancy. This article presents a summary of publications identified by a MEDLINE search of the topics spinal cord injury, paraplegia, tetraplegia, and pregnancy, and by reviewing the reference lists of these articles. The current medical literature suggests excellent overall maternal and neonatal outcome. Certain medical complications such as urinary tract infections and autonomic hyperreflexia are predictable and can be managed successfully. Obstetrical management is changed little by SCI but needs to account for the risk of unattended delivery in the patient with a high level of lesion. (C) 1996 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation