What If You Get Pregnant?

By editor | December 25, 2007

If you have rheumatoid arthritis or another inflammatory disease such as lupus, you’ll want to carefully think through the decision to have a child and plan thoroughly before the birth. Besides the strain of pregnancy, you’ll also need to consider the physical demands of taking care of an infant and then a young child.

Medication for lupus presents a serious barrier. Although internal inflammation is rarely an issue in rheumatoid arthritis, if you do have inflammation in an internal organ or are required to take more than 10 milligrams of prednisone daily, your doctor will likely ask you to delay pregnancy until these problems abate. Unfortunately, although most women with rheumatoid arthritis actually feel better during pregnancy, the bottom line is that because of the risk of birth defects, if you are on medication it is best to avoid pregnancy unless your doctor has given you the go-ahead.

If you do conceive, you will likely work with a rheumatologist and an obstetrician-gynecologist and possibly a maternal fetal specialist. Although pregnancy has its discomforts for every woman, you may need to also prepare for other changes:

Ask about your medications. Your doctor may shift you to less toxic medicines during your pregnancy or decrease the doses. Generally, aspirin and prednisone can be used cautiously during pregnancy. The drugs penicillamine, methotrexate, cyclophosphamide (Cytoxan), and azathioprine (Imuran) must be avoided because of the chance of birth defects. Do not, however, change any medications on your own. You should also discuss with your doctor any other medications you are taking, including over-the-counter preparations.

Consider your milk. Medicines you take may be passed to the baby via breast milk. It will help to take your medicines after your baby has eaten in the morning, so she won’t be taking in as much. Talk to your doctors. You may choose to alternate breast feeding with formula to limit the amount of medication your baby receives.

Reconsider exercise. Exercise is recommended for pregnant women, but if you have an inflammatory disease, you may be considered high risk, especially if you have an accompanying condition such as heart complications, inflammation of the veins, or high blood pressure. So it’s crucial to discuss your exercise program with your doctor. He may ask you to switch to a different type of exercise or give you guidelines on limiting your activity. (It’s a good idea to get into shape before getting pregnant so that you have strong quadriceps muscles, the large ones above your knees. These provide better support for your joints.)

Watch your weight gain. Generally, women should gain between 20 and 30 pounds during pregnancy. Too much, and you’ll overtax your joints. Too little, and the baby may not get enough nutrients. Ask your doctor what the best overall weight gain is for you specifically and how much you should gain each month.


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Topics: Arthritis |

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