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Pregnancy and Arthritis

Is it possible to have arthritis and a baby, too? You bet.

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The decision to have a baby is one of the most important ones any couple will ever make. But when the prospective mother has arthritis, the decision requires additional considerations: Can her body with withstand the stresses of pregnancy and childbirth? Can she safely stop her medications until her child is born? Does she have the stamina – and support – to care for a newborn and toddler? Could her disease have a negative effect on her child?

Arthritis has the potential to affect pregnancy at every stage – from conception to the weeks following birth. And pregnancy can make a difference – either good or bad – on a mother’s arthritis. But predicting the course of pregnancy – much less the course of a variable disease during pregnancy – is impossible.

Despite such uncertainties, doctors who have studied arthritis during pregnancy and pregnancy during arthritis have found some common problems shared by women with certain forms of arthritis and related diseases and at certain stages. (For information about pregnancy and specific types of arthritis, see the list here.)

For example, regardless of the form of arthritis you have, the medications you take for it have the potential to affect your pregnancy and/or your unborn child. Furthermore, if you suffer from morning sickness during your pregnancy, your ability to absorb oral medications may be affected. Speaking to your doctor about your medications before you become pregnant is essential.

If you struggle with fatigue because of your disease, the added stress of pregnancy may make it worse. Likewise, if you have back pain, your growing belly may exacerbate it, and increasing weight will place more stress on weight-bearing joints. And certainly any chronic disease presents challenges to caring for a newborn and growing child.

Doctors have also found some not-so-common problems and problems specific to certain forms of arthritis at certain stages of pregnancy. However, there are also findings that should ease fears and reassure couples who long for a baby – and those who find they are unexpectedly expecting one.

Your Pregnancy Health Care Team

When most women plan a pregnancy or become pregnant, they rely on one doctor – their OB/GYN – for advice and care. If you have arthritis, however, you’ll need to continue seeing your rheumatologist as well. If you have lupus or scleroderma – or if you develop any problems during your pregnancy – your OB/GYN will probably refer you to a high-risk obstetrician. If he doesn’t volunteer, you should bring up the possibility yourself.

If arthritis affects your spine or hips, ask if your obstetrician has experience working with women with disabilities – unfortunately, most doctors don’t, says Michael Lockshin, MD, professor of medicine and OB/GYN at Weill Cornell Medical College and director of the Barbara Volcker Center for Women and Rheumatic Disease at the Hospital for Special Surgery in New York. If possible, find out the same about the anesthesiologist who will be working with you in the delivery room, should you need a C-section or pain medication during vaginal delivery.

Finally, you’ll probably want to stay in touch with your primary care physician. If you are a member of a health maintenance organization, this may be a necessity for medical coverage of your pregnancy.

 The good news is that, armed with knowledge and the help of a knowledgeable health care team, most women with arthritis and related conditions can have successful pregnancies and healthy, happy babies.

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