June 14, 2022
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I expected my RA to go into remission during pregnancy. When this wasn’t the case, it affected my physical and mental health.
Before I was pregnant with my daughter, I heard many speculations about what happened to rheumatoid arthritis (RA) during pregnancy.
It can take a lot of preparation to have a baby when you have RA. Depending on what medications you take, you might have to stop taking them several months before getting pregnant. Despite any preparations you make, you aren’t always ready for what happens during and after pregnancy.
I didn’t know anyone who had personally been through pregnancy with RA, and I wasn’t able to find real accounts online. It was all just statistics I heard from my doctor.
All the information I had been told beforehand suggested that autoimmune diseases, like RA, go into remission during pregnancy due to hormonal changes. I even read articles and blog posts that said women felt so great during pregnancy, they ended up having multiple pregnancies close together.
This meant that I had unrealistic expectations about going into remission during pregnancy. But I didn’t. In fact, I was in for a shock with how I ended up feeling during most of the nine months. At times, this had dangerous effects on me, ignoring any potential symptoms because I didn’t expect to have my RA as usual.
Hearing real stories from people who have been through pregnancy would have helped me immensely. While everyone has a different experience, I hope sharing my experience might help you have a better idea of what to expect so you feel less alone.
In August 2017, I found out I was expecting my first child.
I was very happy, and I was most excited about being RA symptom-free. I thought about how active I would get to be, and how great it would feel to be without pain for nine months.
Things started fine, but I soon got morning sickness that could last all day. The morning sickness intensified until about week 16 or 17, so much so, that I didn’t notice I was having joint pain in my elbow and knee — what I would usually refer to as my RA problem joints.
I was so sick during that first trimester, I rested most of the time. Those first 17 weeks were a blur, so I was oblivious to how other parts of my body were feeling.
When the sickness finally passed, I realized how swollen my elbow was. My knee was also very swollen, and I was having trouble walking. Prior to pregnancy, I was managing symptoms pretty well, so it had been years since I had gone through a flare like this.
I started seeing a new doctor right around this time. I told her how disappointed I was to not be in remission. In fact, I had started to feel quite alone, as if I was doing something wrong. But she explained that not everyone goes into remission. Some do, and some do not. This was the first time I heard a doctor say this, and it helped me immensely.
She told me I could take a small dose of prednisone to keep the flares down, but only a small dose of steroids was considered safe according to my OB-GYN. There was not good communication between my rheumatologist and OB-GYN, so this was all the information I had on medication options. Unfortunately, a small dose like this didn’t help, so I ended up not taking any medication at all.
During this time, I kept up with pain management by using heating pads, massaging, and resting my joints. I would take short walks and stretch each day to stay active. This was about all I could do with the swelling I experienced.
Around week 30, the swelling started to go down in my joints. It didn’t go away, but it became more manageable at this time. By week 35, I was feeling much better.
Right before my daughter was born, my body suddenly felt like it was going into remission. I felt pretty good, and I was able to be a little more active, just in time for the baby to come.
My daughter was born at 39 weeks, and I can say I was completely symptom-free by this date. A part of me was disappointed it took almost the entire pregnancy to feel better. At the same time, I was grateful to feel good in time for the birth.
I had a cesarean delivery scheduled weeks in advance because my daughter was breech. This made the delivery a little less stressful because I had the specific date, and I did not go into labor.
The cesarean delivery was not due to having RA, and I was not asked about RA at all at this point in the pregnancy and delivery. Since I was symptom-free by the time she was born, it was not a concern for anyone.
During the recovery after my cesarean delivery, I continued to be in remission. I didn’t experience any arthritic pain or swelling during those six weeks after surgery. I was thankful for this — lack of sleep and having surgery can be very stressful on the body, and I knew it would make RA symptoms worse if I started having them.
After you have a cesarean delivery, they recommend you wait at least six weeks before doing any physical activity. Once my doctor gave me the go-ahead to start exercise, I went right into some light Pilates and daily walking. I took all of the physical activity slow just to ease my joints back into it.
I was exclusively breastfeeding as my rheumatologist had told me that the hormones involved with breastfeeding can be beneficial for both myself and my daughter.
When analyzing a number of different results, studies suggest breastfeeding is associated with a lower risk of RA. I decided to breastfeed because my mom had done it, and it was always something I planned to do.
It’s important to remember that breastfeeding isn’t necessary, and it can be very painful with RA, especially if you experience a flare after birth. So remember to choose what’s right for you.
For eight full months after my daughter was born, I was completely symptom-free. There was no pain or swelling in any of my joints during that time. I had energy and was able to exercise three or four days a week without any problems.
Soon after, I started having some elbow pain. It started off very mild, so I just continued to monitor it. Within a few weeks, I was in a flare with swelling and pain in my problem joints. Both my knee and elbow had intense pain and swelling that quickly got out of control.
I went to my rheumatologist, and we decided it was time to go back on medication. I was not taking anything at the time because I was symptom-free for so long. There are many options available for breastfeeding women, so we went ahead and started on a medication called Cimzia.
It took several months to get the flare under control, but I finally did.
Once I got past that first flare after having a baby, my arthritic symptoms overall seemed more manageable with the medication. I don’t know if this is due to hormonal changes in my body overall, or if having a child has just changed my focus onto someone else.
In the four years since my daughter was born, I’ve kept my symptoms managed with a healthy lifestyle and medication. I’ve gotten more into exercise since my daughter was born, mainly due to needing some time to myself. I chose to get more involved in Pilates and barre classes since those are most enjoyable for me.
Looking back on my postpartum journey, I would have liked to have been more proactive at taking medication before the flare got out of control. The reason I didn’t take any medication was simply because I was feeling so great. I believed I might be in remission for years, but the flare happened quickly.
When I share this story with others, many people say how wonderful it is to hear a real story. It turns out that many people have a rough time with RA during pregnancy. Even though my doctor at the time told me I would most likely go into remission, I did not.
Everyone has a different experience, but if you go into pregnancy not expecting remission, I think it can help you be better prepared for what might happen, just in case you go through what I did.
I’m currently pregnant with my second child, and remembering how everything went with my first has helped me be a little more prepared this time around. Most importantly, I know that if I don’t go into remission, it doesn’t mean I have done something wrong.
Everyone’s experience is different.
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