Patient Story: Rheumatoid Arthritis and Pregnancy
Manage Your Rheumatoid Arthritis Before, During, and After Pregnancy
By Karina Lichtenstein
Reviewed by William C. Shiel Jr., MD, FACP, FACR
Susan is 34 years old, married, and has a young son. She and her husband, Paul, would like to have another baby, but there's just one problem: Susan has rheumatoid arthritis. She's taking methotrexate to control her condition and she has a lot of questions. Was it safe to take medication before or during pregnancy? How would her disease be during pregnancy? She made an appointment with her rheumatologist (rheumatologists are experts in managing arthritis) to discuss her concerns.
Susan's doctor assessed her symptoms and gave her the go ahead to discontinue the methotrexate. Since the medication has the potential to cause serious birth defects, Susan's doctor advised her that she had to wait at least three months before trying to conceive. After that, it was an ideal time for her to become pregnant as her disease was in remission.
The doctor assured her that there were medications that could be used during pregnancy should her arthritis become active again. Moreover, he explained that rheumatoid arthritis, more often than not, is less active during pregnancy, perhaps a result of the hormonal effects of pregnancy. Susan was pleased to have this discussion with her doctor.
Just six months later, Susan was pregnant! She felt great and her symptoms – the joint pain, tenderness, and swelling – were all diminished. (The fact is that a vast majority of women who have rheumatoid arthritis experience an improvement in their symptoms during pregnancy.) Susan's rheumatologist assured her that if she did have a flare-up, he could safely treat the joint symptoms with low-dose prednisone.
Months later, little Jayden was born. He was a happy, healthy baby. Unfortunately, as is often the case in women who have rheumatoid arthritis, Susan's joint symptoms in her hands and feet returned eight weeks after giving birth. She headed back to her rheumatologist to discuss treatment options. It was necessary to avoid certain rheumatoid arthritis medications while breastfeeding, the doctor explained. Susan decided to wean baby Jayden and restart the methotrexate that had worked so well for her previously. Within five weeks her arthritis was back under control and her biggest challenge was working around the schedule of the new owner of the household, Jayden!
Susan and Paul were thrilled with the new addition to their family. And they were happy that rheumatoid arthritis did not stand in the way of their growing family. Read more about managing rheumatoid arthritis in this article.
Last Editorial Review: 1/26/2012