As many as one in five couples have difficulty conceiving, regardless of any known medical condition. Although some studies show that women with RA have fewer children than otherwise healthy women, that may represent a choice to limit family size rather than a reduced ability to conceive or carry a baby to term.
A study by arthritis and post pregnancy at the University of California, San Francisco, found that women with diagnosed with RA before the birth of their first child had the fewest pregnancies and children. Some can affect an unborn child from the very earliest days of pregnancy and because the effects of certain drugs can remain in the body for a period of time after you stop taking them, ideally, you should work with your doctor to taper off harmful medications — and perhaps switch to less risky medications — for at least a few months before you try conceive.
Before you get pregnant is also the best time to speak to your doctor about prenatal vitamins and supplements of folic acid, which can help reduce the risk of certain birth defects, arthritis and post pregnancy.
Your doctor may also recommend a calcium and vitamin D supplement, but will probably advise that you avoid any over-the-counter herbal remedies. Some drugs, such as leflunomide Aravamethotrexate and cyclophosphamide Cytoxan can cause birth defects can cause birth defects.
The greatest risk of these drugs comes later in arthritis and post pregnancy, when they may interfere with labor, affect amniotic fluid production or cause excessive bleeding during delivery. If you need medications to keep your disease under control, your doctor may put you on a corticosteroid, such as prednisone, that reduces arthritis inflammation but crosses through the placenta only minimally, arthritis and post pregnancy. One of the first symptoms of pregnancy for any woman is fatigue.
For women who already experience fatigue with rheumatoid arthritis, fatigue may worsen. Otherwise, pregnancy should have little effect on arthritis during this trimester; nor should arthritis have any effect on pregnancy.
Approximately 70 percent of women with RA experience an improvement in symptoms beginning in the second trimester and lasting through about the first six weeks after delivery, says J. Bruce Smith, MD, assistant compliance officer for research at Thomas Jefferson University in Philadelphia and a rheumatologist whose research has focused largely on autoimmune disease and pregnancy. Fatigue may improve as well.
There are a number of theories why disease symptoms improve, including increased levels of evil and mental illness cytokines and hormonal changes that occur during pregnancy. Researchers are continuing to study the phenomenon. If your disease was mild to start with or improved during the second trimester, it will likely stay mild through the third trimester.
However, fatigue may become worse as you grow heavier and closer to delivery. Having rheumatoid arthritis may slightly increase your risk of a premature baby, but does not increase your risk of having a baby with low birth weight, according to a study by researchers at the University of Washington, Seattle.
Women with RA are also more likely to have their babies delivered by Cesarean section. A baby is a pretty big package to get through there, arthritis and post pregnancy. If you took corticosteroids for more than two or three weeks during pregnancy, your doctor will likely give you stress doses of corticosteroids during delivery and monitor your baby after delivery to make sure she is producing adequate corticosteroids on her own.
Infection is a possibility after any delivery. If you are taking medications that suppress your immune system, however, arthritis and post pregnancy is more likely. Most infections can be cleared up fairly easily and quickly with available antibiotics. In a study out of the Netherlands, 39 percent of RA patients studied had at least one moderate flare postpartum.
While all new mothers need help from family or friends, you may especially welcome their help as a new mother with RA. You may arthritis and post pregnancy yourself having to deal with a disease flare at the same time you are trying to recuperate from childbirth and adjust to parenthood.
After you deliver, arthritis and post pregnancy, it is important to discuss medication choices with your doctor again, particularly if you plan to breast feed, arthritis and post pregnancy. Certain medications — including methotrexate and leflunomide — should not be taken during breastfeeding because of their potential effects on the baby.
Others — including prednisone, certain NSAIDs and hydroxychloroquine — are probably safe and may be prescribed on a case-by-case basis. Arthritis Friend or Foe?
How Much Is Enough? Glossary Looking for a quick definition of a term? Rheumatoid Arthritis and Pregnancy It helps to know what to expect during your pregnancy. By Mary Anne Dunkin.