A pregnancy with rheumatoid arthritis presents few additional risks. The major health complication to be aware of is high blood pressure.
Pregnancy does not often exacerbate symptoms of women with RA. In fact, #RAWarriors often find that pregnancy reduces flares and rheumatoid arthritis symptoms. Medical researchers have theories about this.
One theory suggests, the female body’s immune system becomes weaker during pregnancy to protect the baby—the immune system won’t think the baby is a foreign invader. However, other autoimmune diseases do not validate this theory—other conditions carry complications during pregnancy.
While many #RAWarriors see their symptoms decrease during a pregnancy, some women experience flares. The flares of the joints—which is the common area attacked during these episodes—brings significant discomfort to pregnant #RAWarriors, because there is already added pressure to the lower appendages.
Professionals agree pregnant women can safely take the steroid prednisone during the second and third trimesters and, also, while breastfeeding. The medical community considers Plaquenil (hydroxychloroquine) safe to take while pregnant as well as Enbrel (etanercept)—the latter is not the first choice and strictly administered in the 2nd and 3rd trimesters.
Still, always speak with your RA treatment team about medications and the additional risks/challenges of a pregnancy.
Preeclampsia and Prednisone
Preeclampsia is a condition of pregnant women when their blood pressure is dangerously high, and their kidneys are not functioning properly. Symptoms of preeclampsia include:
- water retention
- blurred vision
- inability to tolerate bright light
- fatigue, nausea/vomiting
- urinating small amounts
- pain in the upper right abdomen
- shortness of breath
- tendency to bruise easily
The most severe forms of preeclampsia can result in seizures and death.
If a medical team detects preeclampsia in the second and third trimester, there should be little concern of it affecting the mother or the baby. However, preeclampsia can develop acutely at the onset of delivery. These cases are considered extremely high-risk.
Medical providers diagnose preeclampsia by determining a high-blood pressure reading, detecting protein in the urine, and seeing swollen hands and feet. Pregnant women often have swollen legs and feet. It’s very important to be aware of sudden differences in the hands.
One of the side effects of prednisone is high blood pressure. Medical providers will be sure to monitor blood pressure in #RAWarriors to treat any sign of preeclampsia. If mild preeclampsia is detected, medical providers will most likely adjust medication and instruct the pregnant woman to:
- Rest, lying on your left side to take the weight of the baby off your major blood vessels
- Increase prenatal checkups
- Consume less salt
- Drink at least 8 glasses of water a day
- Change your diet to include more protein
Gestational Diabetes and Prednisone
Prednisone also has the ability to raise blood sugar. Mothers carrying babies not only need to worry about the effects of high blood sugar on their own bodies but the bodies of their babies. Gestational diabetes happens in the womb and can negatively impact a baby’s health.
As mentioned previously in this article, many women experience their RA going into remission during pregnancy. There are, though, many accounts of having flares after the delivery. The body is exacerbated but mothers are also tired from handling a newborn child.
Flares during this time are particularly troublesome for mothers and their newborns, because most mothers are breastfeeding. Substances can easily pass through the mother to the baby during breastfeeding. Medicine that is beneficial to the mother to treat RA flares might be harmful to baby.
What to Do to Diminish Postpartum Flares
Ask for help. It’s important for #RAWarriors to get their rest and recovery. Medical professionals are unclear if the physical nature of a delivery or the stress of having a newborn causes these profound postpartum flares. Either way, having the help available to avoid a flare or help during a flare is important to the mother’s physical health and overall well-being
Every mother’s journey is different—especially for #RAWarriors. Reach out for help, prioritize your health, and don’t forget there is a community of support out there.