Having or not having children is a big decision. And if you are a woman who has an autoimmune disorder (AD), this decision can seem even more complex.
Will I have trouble conceiving because of my AD? Will I have to stop certain medications? How will it affect the baby? Could pregnancy make my AD worse?
Autoimmune disorders, such as lupus, Graves’ disease, and rheumatoid arthritis, are more prevalent in women than men and typically occur during a woman’s reproductive years. Inflammatory disorders can affect pregnancy, from conception to following birth, but having an AD doesn’t mean you can’t or shouldn’t have a baby.
“Having an AD does not mean that a woman should not consider pregnancy,” said Lindsay Allen, MD, an OBGYN at Banner Health in Arizona. “The majority of women with an AD can have a very safe and healthy pregnancy."
If you are considering having children, here are six tips to ensure a healthy pregnancy.
Before Pregnancy
1. Schedule Preconception Counseling
The key to a healthy pregnancy is scheduling a pre-pregnancy consultation with your rheumatologist and OBGYN well ahead of conceiving so you are prepared. The reason for this is that your treating physicians may require adjustments to your medications and other modifications to ensure you’re healthy enough for pregnancy.
2. Know the Risks – For You and Baby
While every AD is different and can vary in severity from woman to woman, some ADs carry higher risk for mom, baby or both.
For example, systemic lupus erythematosus is one of the higher risk conditions. It can lead to complications, such as preeclampsia, nephritis or kidney injury and frequent flare-ups of lupus symptoms. For the baby, lupus can pose a risk of congenital heart block, which is an irregular heartbeat for baby, or the baby can be born with lupus rash.
Another high-risk condition is antiphospholipid syndrome, which can put mom at high risk for a blood clot or pulmonary embolism during pregnancy.
“As part of your pre-pregnancy planning, discuss any potential risks to you or the baby with your doctor,” Dr. Allen said. “It is important to have these discussions ahead of time as it may require extra preparation.”
During Pregnancy
3. Stay on Top of Regular OB Appointments
Because you may have a higher risk pregnancy, you may need more frequent prenatal visits to monitor your baby’s growth and your condition, identify any abnormalities and offer you reassurance and encouragement. You may also need blood and urine tests to watch for specific changes in your body and the health of the baby.
4. Watch for Flare-Ups, Changes and Improvements
During pregnancy, you may notice your AD symptoms taper off, or you may experience flare-ups.
“For example, for some women with rheumatoid arthritis, they may actually see improvement of joint pain during the pregnancy period,” Dr. Allen said. “They should be ready for and watch for potential flare-ups after delivery, however, as this can be common.”
If you experience any flare-up of the usual symptoms or any new concerning symptoms during pregnancy, make sure you are evaluated by your physician right away. And because some ADs are more highly associated with risk of preeclampsia or blood clotting, you should also watch for any new symptoms such as headaches, visual disturbances, upper abdominal pain or lower leg swelling.
5. Ask if Breastfeeding is Possible
You may be concerned about whether you’ll be able to breastfeed your baby or not, because of the risks some medications pose through breast milk. Share with your doctor your intentions to breastfeed and discuss what medications can be safely used during breastfeeding after giving birth.
6. Prepare for a Resurgence After Delivery
If pregnancy quieted your AD, be prepared for flare-ups just after delivery. Being a new parent is exhausting, but it can be especially exhausting for those with an AD. Take your medications, eat healthy, get plenty of rest (as much as you can with a newborn) and ask for help if you need it.
Having an AD can add another level of fear and anxiety in your life. But with the right doctor and knowledge on your side, you can have a safe and healthy pregnancy.
For more helpful pregnancy tips, visit bannerhealth.com.
