1) The information here is not intended to be advice in lieu of professional medication advise, in fact, it is just a primer on things you should be discussing with your physicians.
2) I am not endorsing any particular path, medical treatments, or medications.
One of the reasons I started this blog is because there was a lack of information and knowledge about what it is like to get pregnant and parent with an autoimmune disease. My medical professionals at the time thought the best path was to discontinue all of my therapies, which led to a lot of problems and complications that I am still paying for, four years later. I made it my mission to find good, scientific evidence about pregnancy and autoimmune arthritis.
This post will likely end up being a few parts, and will also continue into a series of what to discuss with your OB-GYN before getting pregnant.
So, let's dive right in to the questions.
1) Am I in a controlled disease state? This is the most important question you need to ask your rheumatologist, because the BEST thing you can do for your pregnancy outcomes is to make sure that you are in a well-controlled disease state before getting pregnant. If you aren't in a controlled disease state, never fear, now you know what your goal is.
2) Are there any medications that I will need to discontinue before considering pregnancy? Will I have to do anything special to get any of my current medications out of my system? This is strait forward, there are simply some meds that can't be taken during pregnancy, and there are some that require a "wash" to remove them from your system.
3) What can I do to replace the medications that I will no longer be able to take? Just because you have to stop taking some meds doesn't mean you have to go off of every medication, and that nothing can be done to help you maintain your health.
4) Are you willing to work with my OB-GYN to make sure I stay healthy during this pregnancy? If not, can you suggest a colleague that you respect? Again, you need to have a good medical team in place.
5) If I experience a flare or irregular symptom, who do you want me to contact first, you or my OB-GYN? How would you like me to contact you? How quickly can I be seen? It's just important to have a plan in place so you don't panic.
6) Will you support my breastfeeding goals? It's important to have a goal and make sure your doctor is on the same page about that goal ahead of time.
7) How soon would you like to see me postpartum? Will your office get me in to see you in that time frame?
8) Do I have positive anti-Ro antibodies? This increases the risk of a congenital heart condition, and need to be managed more carefully.
9) Do I have antiphospholipid antibody syndrome? Again, this is a condition that can lead to problems in an unborn baby, but can be appropriately managed?
10) What will we do if I flare while pregnant? It's important to have a plan in place.
The bottom line is, it's important to have a plan in place for many eventualities. The bottom line is, in many cases, it's entirely possible to continue treating your disease and still have a happy, healthy pregnancy and baby. It just requires some planning.