What’s on this page?
- Planning for a baby
- Pregnancy and rheumatoid arthritis
- Delivery and rheumatoid arthritis
- Medication after child birth
It is very important that you speak to your doctor or specialist nurse before you try for a baby as some of the drugs you’re likely to be taking for your rheumatoid arthritis may need to be stopped before you get pregnant or father a child, as they can harm the unborn baby. This means it’s very important to plan to get pregnant at times when your condition is under control and to stop taking certain drugs in advance. Methotrexate, leflunomide and biological treatments, should not be taken by men or women while they are trying for a baby.
You shouldn’t stop taking prescribed drugs without talking to your doctor first. Your doctor will prescribe the safest combination of drugs at the lowest reasonable dose to reduce the risk of them causing problems with your pregnancy and still help to keep your arthritis under control.
It is recommended that all women who want to have a baby should take a folic acid tablet (0.4 mg) every day from 3 months before the time of conception until 12 weeks into the pregnancy. This supplement is particularly important if you’ve been given methotrexate for your arthritis as this drug can affect your body’s supply of folic acid. Folic acid will reduce the risk of your baby having a defect in the spinal canal (spina bifida). It is important that you consult with your doctor before taking any supplements.
Although several members of the same family can be affected by rheumatoid arthritis, the tendency to pass it on from parent to child isn’t very strong. Current research indicates that the risk of a child inheriting rheumatoid arthritis from a parent is between 1 in 100 to 1 in 30 (about 1–3%)
For more information from Arthritis Research UK on planning for a baby, please click on the button below:
Most women regardless of whether they RA or not get aches and pains, particularly backache, during pregnancy, especially during the later stages. Most women with rheumatoid arthritis will be free of flare-ups during pregnancy, although they’ll probably return after the baby is born. Up to 75% of women find that the pain and swelling associated with RA is much improved during pregnancy, usually in the second trimester (14-27 weeks). This is probably due to the normal hormonal changes in pregnancy.
Rheumatoid arthritis doesn’t harm the baby or increase the risk of problems during pregnancy. It is very important that you are aware of the possible effects of the drugs you take while you’re pregnant, as they can sometimes affect the pregnancy.
For a good explanation see the Arthritis Research UK website:
But remember the best person to talk to if you have queries is your doctor, specialist nurses or specialist rheumatology pharmacist.
It’s important to keep exercising for as long as possible during the pregnancy. As your pregnancy advances and you gain weight you may find it easier to exercise in a swimming pool, where the water will help to support your weight.
Your arthritis shouldn’t usually affect the delivery. However, if your arthritis afffects your hips or your mobility it’s important you discuss this with your midwife or consultant before the birth. Different positions can be used in childbirth which should allow you to give birth naturally, even if you’ve had hip replacements.
Many women find that their RA returns or flares up six weeks after delivery. This is because the changes in hormone levels caused by pregnancy ends and levels go back to normal pre-pregnancy levels. Coping with a newborn baby is tiring for all mothers and this may be more so for women with RA because of the additional worries of RA flaring up. It is important to have sufficient support and help during this period. Before the birth it may be a good idea to arrange for extra help from family and friends once the baby is born. If necessary, other extra help can be arranged – discuss this with your doctor or with Social Services. You may also want advice from a physiotherapist or occupational therapist on holding, washing, dressing and feeding your baby if stiffness is making this difficult.
Some top tips for caring for a baby when you have RA can been found here:
If your drugs for arthritis were stopped before or during the pregnancy most doctors recommend going straight back on them, except where the drugs would stop you breastfeeding. Because of the benefits of breastfeeding, some women prefer to wait until the arthritis flares up again before returning to their medication. Ask your doctor or rheumatology nurse specialist for advice on this.
Breastfeeding is best for your baby. Even if you only breastfeed for a few weeks it will still be beneficial to your child. Some drugs can pass through into breast milk so it’s very important that you speak to your doctors who will be able to advice you on what drugs are safe to use when you are breastfeeding.
For more information on breastfeeding see the NRAS website:
Arthritis Research UK produce a very helpful guide to pregnancy and arthritis which can be downloaded or ordered for free:
Read some tips from mums on caring for baby:
National Childbirth Trust Cornwall branch:
Main branch contact:
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