Rheumatoid Arthritis and Pregnancy
Rheumatoid arthritis (RA) is an autoimmune disease. The body’s immune system, which normally triggers inflammation as a way to fight off disease, attacks the body’s tissues instead.
RA is chronic, and out-of-control inflammation can cause pain, swelling, stiffness and impaired function of the body’s joints. Many joints may be affected, such as the hands, wrists, fingers, knees, shoulders, hips, neck, feet or ankles. People with RA whose disease activity is not well managed by treatments can experience damage to their joints that causes permanent disability. Inflammation may also affect organs like the eyes, heart, lungs or kidneys in some people with RA.
RA’s pain and fatigue may make women worry how bad they’ll feel when they’re pregnant. However, many women (about half) with RA actually experience lowered disease activity during pregnancy. There is evidence that this varies depending on the patient, but symptoms like pain or fatigue may noticeably improve starting in the first trimester all the way through their delivery. Some pregnant women with RA even see their disease go into remission during this time. Why? During pregnancy, fetal DNA cells circulate through the mother’s system also. These fetal DNA cells increase throughout the pregnancy, and as they do, RA disease activity often goes down. As a result, some moms with RA feel better while they’re pregnant.
After delivery, however, RA disease activity most often comes back. New mothers often experience disease flares. Symptoms like pain and fatigue can return after you have your baby.
Please note that many people share the false information that women go into remission during pregnancy. The expectations of both patient and physician that RA will go into remission during pregnancy may lead to undertreatment based on unfounded optimism.
As a result, you may have debilitating symptoms just as your newborn baby needs a lot of care. Talk to your rheumatologist about treatment options and getting back on medications BEFORE your RA flares. You may be able to start taking RA medications just a few weeks after your delivery to get your disease activity under control. Many medications for RA are safe with breastfeeding, so your rheumatologist can prescribe treatments that are safe to use as you nurse your baby.
Please note that all people are different and because some women experienced a reduction in symptoms doesn’t mean that you will too.