Rheumatoid Arthritis and Pregnancy: What to Consider
For women that are young and healthy, pregnancy can still be very intimidating. Add rheumatoid arthritis to the picture, and the whole idea can get daunting or even terrifying at times. Pregnancy can prove to be dangerous for both mother and baby if the mother has rheumatoid arthritis.
Though some doctors and patients report that pregnancy can give a woman a break from her rheumatoid flares, there are still many other factors that go into planning for a baby that can make things complicated if an expectant mother suffers from RA.
Many medications used for rheumatoid arthritis are unsafe for a baby
For one, a lot of the medications that are very effective at treating rheumatoid arthritis are actually unsafe for the baby. If you are trying to get pregnant, many of these medications can cause harmful defects or even kill a fetus before it can develop properly.
Methotrexate is an example. This drug is one of the most common medications prescribed to people with rheumatoid arthritis because: 1) it works. And 2) it’s been around for such a long time. We know a lot about methotrexate, and that’s why so many doctors are comfortable prescribing it. Not only do we know it’s side effects very well but we also know most insurance companies will cover this drug. However, methotrexate is also linked to higher rates of birth defects and other complications with pregnancy. It’s so bad for the fetus that it can actually cause abortions.
Aside from methotrexate, most of the other RA medications, such as the biologic therapies and chemotherapy drugs, are also unsafe for mothers. Usually, mothers cannot be pregnant or breastfeeding when taking any of these medications.
Women with RA are at higher risk of infections
Another complication for women with rheumatoid arthritis is that they are often taking medications that lower their inflammatory response. This means that these drugs are suppressing your immune system from attacking your own. By lowering your immune system, you get the flip side where you are also more susceptible to germs and bugs, making it more likely that you can get an infection or illness. This risk makes it harder for women who get pregnant because now they not only have to worry about their own health but also the health of the baby growing inside their bellies.
Taking care of the child
Beyond just having to deal with the complications RA can pose to a pregnancy, women have to think forward and plan for how they can raise their child once they are born. This can be extra hard for women with RA because they may have more trouble with physically taking care of the baby after birth. Simply the act of holding your newborn bundle of joy might prove to be too painful for some women with RA. Planning for a baby requires a lot more support from either childcare services or family when you’re a mother with rheumatoid arthritis.
Babies also don’t sleep the same cycles as adults. Most women with RA also need a lot more sleep than other people. As a new mother, you don’t get very much sleep because babies usually need to be fed every 2 hours. The pain and the lack of sleep might be too much for someone with RA to handle.
Family planning for women with RA
Do you have RA yet yearn to start a family? You’re not alone. There are many women out there who also want to start a family but their disease isn’t quite under control yet. They want to have their baby when their body is in its best shape to handle a pregnancy, and when they are emotionally and financially able to raise their child.
Many women are now freezing their eggs. Having a medical condition such as cancer or autoimmune disease is among the most common reasons for why women choose to do this. It makes sense. Being pregnant while needing chemo becomes a heart-wrenching dilemma of saving the baby versus saving yourself. Why make that choice if you don’t have to? If you save your eggs, you can make sure to take care of your body first so you can be most ready to take care of your child.
It’s no different with rheumatoid arthritis. For people having severe flares, they may be taking potent drugs that can cause harm to the growing fetus. That’s why it’s best to get the disease under control before getting pregnant. If you can freeze your eggs, you can rest easy that when your body is finally ready, you will have the option of starting your family available to you.
Freezing your eggs also protects them from the onslaught of side effects and toxicities that may come from taking drugs like methotrexate. Freezing them will protect them from ever getting exposed to these harmful chemicals.
Unfortunately, freezing eggs is still a very expensive option, and not everyone can afford to do this. Currently, there is no health insurance that will cover the cost of the entire process.
What’s it like to be pregnant with RA?
Trying to get pregnant even when you think you’re at your optimal condition still isn’t easy with rheumatoid arthritis. Some of the medications that are less harmful to your baby can have other side effects such as weight gain or fatigue. Some of them are also not covered by health insurance, making it a very expensive nine months.
Some people with RA also take anti-depressants or mood stabilizers. Unfortunately, with pregnancy, these medications are not safe either. So, women are left paying up the wall for medications with more side effects, working double time to pay for them, and deprived of their happy pill. Talk about a living nightmare!
It’s all worth it in the end, but it’s still not over.
People say there is no better joy than holding your infant in your arms as a new mother. But now that you’ve gone through the hellish nine months of pregnancy, motherhood barges in with a slew of her own problems to deal with. Most women cannot breastfeed if they decide to go back on drugs like methotrexate, as it’s not considered safe for the newborn baby. In addition, working and taking care of a newborn is a reality for many women including those with RA. The combination of working both full-time jobs is exhausting.
In the end, family planning is complex and personal for each individual woman.
In the end, you have to choose what you believe is best for. That best situation is going to be different for everyone. Some women feel they can’t live without children and will do anything to start a family. Some will try to first gain control of their disease before they try to have kids. Lucky women might have the ability to freeze their eggs or pay for in vitro fertilization. Others will decide early on they will never have kids for one reason or another. Some women are even so unfortunate to be infertile because of their medical conditions. Everyone’s situation is different, and what you choose to do will be the right choice for you.
If you’re a hopeful mother with rheumatoid arthritis, there is good news!
It’s almost cruel to think how RA tends to hit women in their most fertile stage - the age range between 20s to mid-30s. For people who really want to have children, it’s not a time to panic or despair. There are many resources out there to help women just like you!
Some of you might think that RA can make you infertile. Rest assured that this isn’t necessarily true! Though women who have rheumatoid arthritis tend to have fewer children on average, there doesn’t seem to actually be a problem with these women getting pregnant.
It’s been known that women with RA tend to also give birth to premature babies. Though this is a valid statistic, most doctors don’t tend to see this as a huge barrier. They actually feel that it’s more problematic that a woman needs to stop her medications to conceive and carry the child. Aside from this, most of the doctors feel that it’s relatively safe for someone with RA to get pregnant.
So what should you do if you have RA and want to get pregnant?
The most important thing to start first is the conversation you need to have with your doctor. We need to make sure you have a safe and feasible plan for your pregnancy should you choose to try and have one.
References
http://www.rheumatologynetwork.com/ivf/elective-egg-freezing-10-thoughts-rei
