Autoimmune Motherhood at a Glance

According to a recent survey, more than 1 in 3 women had concerns serious enough to lead them to delay their plans for pregnancy. Talking to your healthcare professional early on in the family planning process can help ease any worries you may have.¹

1. N. Thyssen, M. Geens, C. Jauquet, E. Van den Eeckhart. “WoCBA Patient Survey Raw Data”. Questionnaire. 16 Nov 2017.

In Canada, 60% of women consulted a doctor before becoming pregnant, but discussing your pregnancy plan with your healthcare team – whether that be your primary care physician, rheumatologist, dermatologist, OB/GYN, midwife, etc. - early on is important to ensure you fully understand all of your options before making any decisions.¹

Only 1 in 2 women with a rheumatic condition felt they had adequate information to make an informed choice about medication and pregnancy.

Some anti-rheumatic medications should not be taken at all during pregnancy, while others are thought to be safer. Talk to your healthcare specialist if you are uncertain about your medication and pregnancy. A healthy pregnancy starts with having good control over your condition, but that control needs to be achieved and maintained safely.

Before you attend your medical appointments, it’s a good idea to make a note of any questions you want to ask your healthcare team. Possible questions may include:

• Is now a good time for me to consider pregnancy?
• Are there any specific screenings or prenatal tests that I need because of my condition?
• Are there any risks to me or my baby if I get pregnant?
• What are the chances of me passing my condition on to my baby?
• Will I be able to carry my baby to full term?
• Will I need to adjust my medication during pregnancy and breastfeeding?
• Will my pregnancy make my condition worse?

It is important to plan for the possibility of flares during pregnancy and after birth by inquiring about options for managing your condition, making lifestyle adjustments if necessary (i.e., making changes to physical activity, eating and sleeping habits, managing stress) and discussing your needs with your healthcare team and your support system.^2,3

2. Ostensen M, et al. Ann Rheum Dis 2006l63:1212-7.
3. van den Brandt S, et al. Arthritis Res Ther 2017;19:64/ doi:10.1186/s/13075-017-1269-1.

You will need the same check-ups as any other pregnant women, but, you may. However, you may need extra depending on your symptoms. It is therefore important to monitor your symptoms during pregnancy and be aware of any changes. Always talk to your doctor about changes in your symptoms.

If you or anyone in your healthcare team feels your symptoms are worsening, do not hesitate to call your doctor right away.

Make sure you and your healthcare team have a plan in place for a safe delivery of your baby. This includes the type of delivery you want to have (i.e., vaginal birth vs. C-section) and where you want to have it (home births may not be an option for higher risk pregnancies). Be sure you have a backup and be prepared for the unexpected. Sometimes things don’t always go as planned during delivery.

Talk to your doctor about breastfeeding whether you can breastfeed while taking your current medication. Together you can decide what's best for both you and your baby.

Looking after a newborn baby can be very demanding, especially if you are living with a chronic inflammatory condition. You may feel tired managing both your symptoms and the demands of your newborn, and there is the possibility that you will experience flares in your symptoms.

Make sure you ask for guidance from your healthcare team and for extra support from social services, physical therapists or occupational therapists who can give you advice to make holding, dressing, washing and feeding your baby easier.

Sometimes people with rheumatic conditions experience a disease flare in the weeks or months following childbirth as hormones return to pre-pregnancy levels. Be sure to keep track of your symptoms and talk to your healthcare professional should you experience any flares.

Make a point to check in regularly with your healthcare team after your baby is born so that you can review medications, symptom control and mental well-being. The post-partum period can be both physically and emotionally challenging. Don’t be afraid to ask for help.

If you were taking a biologic during pregnancy, make sure you talk to your child’s doctor about the potential impact it may have on your child’s immunization schedule, particularly the Rotavirus vaccine.

If you are struggling with infertility, you are not alone. Women with rheumatic conditions have higher rates of infertility and delayed pregnancies. This can be due to a number of factors, including menstrual irregularity, uncontrolled disease activity, reduced levels of anti-Mullerian hormone (an indicator for ovarian reserve), use of prednisolone and/or non-steroidal anti-inflammatory drugs (NSAIDs), ovulatory dysfunction, and endometriosis.

If you are having trouble conceiving, and are thinking of visiting a fertility specialist, be sure to include the rest of your healthcare team in your discussions. They all have very different – yet equally important – roles to play in helping you plan your family.