Whether or not to have a baby is a major decision for any woman. The decision is made even more complicated if the woman has arthritis and must deal daily with physical pain and limitation. Some important questions to be considered include:
- Am I ready to have a baby?
- Will my arthritis go away?
- Will my child inherit arthritis?
- Will arthritis affect my pregnancy?
- Will pregnancy affect my arthritis?
- How can I plan ahead and make it easier?
Am I Ready?
Since arthritis affects physical ability, strength, and endurance, it is imperative to honestly judge whether you would be able to care for a baby. A newborn is wholly dependent on others, so it is valid to question your capabilities. The Self-Test for Strength and Endurance can help assess your potential limitations:
- Can you lift a 10-lb. bag of potatoes from the height of your bed?
- Can you hold a 10-lb. bag of potatoes in one arm while sitting for at least ten minutes?
- Can you go up and down stairs easily while carrying a 10-lb. bag?
- Can you walk around the house carrying the 10-lb. bag for up to 10 minutes?
- Do you get increased pain in the hips, knees, or feet when carrying the 10-lb. bag?
- Can you screw on and off the top of a baby bottle?
- Can you get through an average day without taking a nap?
- Can you bend your neck, chin to chest, to see the baby if you were holding it close?
Will My Arthritis Go Away?
In some cases, the symptoms of rheumatoid arthritis are relieved during pregnancy. This can occur at any time during the pregnancy. In most women, the improvement occurs by the end of the fourth month. Although joint swelling may decrease, joint pain and stiffness can still persist due to existing joint damage. Unfortunately, the improved symptoms do not continue after the pregnancy is over. A flare in the disease can occur approximately two to eight weeks after the baby is born.
During pregnancy, symptoms of lupus may stay the same, improve, or get worse. Ideally, to minimize the chances of a flare, the lupus should be in remission for six months prior to becoming pregnant. The remission should be reflected in both how you feel as well as in normal blood test results.
Abortion / Delivery
Having an abortion does not prevent a flare. Any type of delivery, spontaneous abortion, therapeutic abortion, or stillbirth can result in a flare.
Will My Child Inherit Arthritis?
The cause of most types of arthritis is not known. Scientists have found certain genetic markers which may be indicative of whether people are at higher risk for developing particular types of arthritis. The relationship between these markers and the actual development of arthritis is indistinct. Having these markers does not guarantee passing on the disease to your child. There is no definite way to know if your child will develop arthritis.
Heredity is not regarded as the single factor in developing arthritis. Environment is viewed as a contributor as well. Currently, there are some who believe that a person may be born with a susceptibility to the disease, but that it still requires something to "trigger" the disease.
Will Arthritis Affect My Pregnancy?
In most women, the actual course of pregnancy is not affected by arthritis. However, individuals with rheumatoid arthritis have a statistically greater chance of premature births and neonatal complications. There is a greater chance of miscarriage and a small possibility of congenital abnormalities.
The forms of arthritis which affect internal organs may cause problems during pregnancy. Pregnancy can be life-threatening for women who have lupus, scleroderma, or other rheumatic diseases, especially if the disease has caused kidney problems or high blood pressure.
If the rib joints are affected by arthritis, the pregnancy may be uncomfortable because it is more difficult to breathe abdominally. If the hips have been affected by arthritis, it may complicate normal delivery and a Cesarean section may be needed. If lungs are affected, more shortness of breath may be experienced.