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Pregnancy and Inflammatory Arthritis

Planning for a baby and getting pregnant with inflammatory arthritis

When you're living with inflammatory arthritis it is important to plan your pregnancy so that you and your doctor can decide on the best treatment approach. Your doctor will also review if your medication is clinically needed and ensure that it is compatible with pregnancy.

Thinking ahead

Around half of pregnancies are unplanned
The effectiveness of birth control depends on the method and its correct use.

So even when you are not considering having a baby this information might still be important for you.

Top Tip – discuss your family planning options with your healthcare team (e.g. your GP, nurse, rheumatologist, obstetrician and gynaecologist, midwife and pharmacist) early on.

Having inflammatory arthritis doesn't mean you can’t get pregnant, but it may take longer than usual to conceive. This can be due to many different reasons, including disease activity or medications you may be taking.

Controlling your symptoms before pregnancy is essential to help ensure you and your baby have the best health and outcomes possible.

There is a need to continue to control your disease before, during and after pregnancy. However, not all drugs are compatible with pregnancy, so your rheumatologist will be able to explain if your treatment needs to be adapted. Speak to your healthcare team about the most suitable options for you.

Once you decide to try for a pregnancy, you should continue or start taking vitamin and mineral supplements suggested by your healthcare team. Consult your healthcare team if you are taking medications including for the treatment of your inflammatory arthritis.

During your pregnancy

Pregnancy often lasts for 40 weeks that is split into three stages, the first, second and third trimesters, each of which is three months.

Pregnancy triggers short term changes in your immune system. As a result, some women with axial spondyloarthritis (axSpA), psoriatic arthritis (PsA) or rheumatoid arthritis (RA) experience their symptoms improving or disappearing during pregnancy especially in the second and third trimester. In some women symptoms do not change or may even worsen.

It is important to plan for the possibility of flares during pregnancy and after birth by enquiring about suitable medication, making lifestyle adjustments if necessary and discussing any support you might need with your partner and social network.

Several treatment options are available that are compatible with pregnancy and breastfeeding.

Not all vaccinations can be given during pregnancy or when taking certain treatments. Consult your healthcare team about any vaccinations you may need.

Birth and after

Women living with inflammatory arthritis should discuss a delivery plan with their healthcare team. Arthritis in your back or hips might make labour more difficult, but different labour positions can make it easier. Epidural anaesthesia or caesarean sections can also be considered. You should discuss all these options with your healthcare team during pregnancy to plan the best delivery for you.

Looking after a newborn baby can be hard when you are living with inflammatory arthritis. Your symptoms may change during pregnancy, and even if your symptoms get better during pregnancy, they may return after delivery. By planning ahead early you can prepare for any changes you experience.

Try to plan ahead and speak to your healthcare team to develop a treatment plan that will suit you best. Having your disease under control can help you manage this special but challenging time. Additionally, ask your partner, family, friends and support networks for help whilst you get used to life with your newborn. This will give you more time to rest if you need to.

Make sure you ask for guidance from your healthcare team and for extra support from health visitors, physiotherapists or occupational therapists who can give you advice to make holding, dressing, washing and feeding your baby easier. Your healthcare team may also be able to provide information about specifically designed products which could assist you in taking care of your baby.

Please talk to your healthcare team before the birth to discuss a delivery plan.

Breastfeeding

Many women with axSpA, PsA or RA are able to breastfeed successfully, if they choose. Whether you decide to breastfeed or not depends on several factors, including your personal choice, your treatment and your level of disease control.

Breastfeeding is beneficial for both you and your baby, however not all drugs can be used when breastfeeding as some may pass into breast milk. Stopping treatment in order to breastfeed may worsen symptoms and impact your ability to care for your baby.

Although breastfeeding is recommended, for a variety of reasons some mothers may choose not to, or may be unable to breast feed. When breastfeeding is not an option, formula is an acceptable alternative.

It is very important that you talk to your healthcare team before making any decisions about your treatment plan.

By discussing treatment options ahead of time, you can adapt your treatment if necessary.

Will I pass my inflammatory arthritis on to my baby?

You may be worried about passing on your disease. There is a possibility it can be inherited, but in many cases the condition is not passed on. The way your disease is inherited is complex. The risk of passing on the disease varies on your specific condition. For RA, this is between 1 in 30 to 1 in 100. For PsA it is about 1 in 30 and for AS/axSpA it is between 1 in 6 to 1 in 10.

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