Having chronic arthritis complicates the choice of motherhood
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?
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:
Will My Arthritis Go Away?
Rheumatoid Arthritis
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.
Lupus
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.
Scleroderma
Research on scleroderma and other types of arthritis is not as definitive. Some studies indicate that scleroderma flares, and other studies report that it improves with pregnancy.
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.
