It Takes Two to Tango, It Takes Three to Get Pregnant

A typical relationship centers around two people: me and someone else. Simple, right? Not anymore. Now there is a third individual to think about: my rheumatoid arthritis. It is just one part of my identity but it acts as though it is its own person, especially when I consider intimacy or other relationship decisions. In this article, I’ll talk specifically about pregnancy but I will re-visit relationships as a whole later.

Methotrexate use and pregnancy planning

I recently had two doctor appointments that made me realize how prominent my RA would be in any relationship. The first appointment was with my rheumatologist and the second was with my gynecologist.

Concerns about methotrexate from my gynecologist

When I re-started the MTX my gynecologist sat me down and said “DO NOT GET PREGNANT. YOU CANNOT GET PREGNANT.” (Disclaimer: He was not yelling at me. I am using capital letters to highlight how serious he was.) The medications I am on (he was mostly concerned about the methotrexate) put not just a fetus at-risk but myself, as well. He told me no matter my choice, each was high-risk for me.

“You MUST use two forms of birth control at all times.”

Scary.

Warnings from my rheumatologist

As I had restarted the MTX after six weeks of fighting with my new insurance, my rheumatologist also told me, “You cannot get pregnant on methotrexate. Just don’t do it.” (He meant getting pregnant). At this time, I also saw one of his female partners in the practice so we could talk about this more in detail.

Pregnancy with rheumatoid arthritis requires planning

She asked me if I ever wanted to get pregnant. Current me said “NO”. She then asked if I wanted to get pregnant in the future. I still wanted to shout “NO!!”, but the truth is I just didn’t know. I’ve never wanted to carry a child and always wanted to adopt.

I may change my mind about getting pregnant

However, that doesn’t mean I won’t change my mind but I don't have that kind of time. If I want a baby in the future, I better think about it now! In order to carry a healthy baby to term and maintain my own health, I would have to get off some of my medications soon (considering their half-lives), and change some if I became pregnant.

Let’s put a pin in this RA thing for a while. Assuming everything was good and healthy when most couples decide they want to have a baby, they go off their birth control and start going at it.

It’s not that simple for people with chronic illnesses, is it? We can’t simply decide to get pregnant. We have to consider everything the RA entails: our medications, what will happen if we get off them, how long until we can get pregnant, safely? I’m sure I am just barely scraping the surface.

Pregnancy planning, RA....and dating?

I'm counting my chickens before they hatch because I need to be seeing someone first.

Can you imagine the conversation on my first date?

"Hey, I'm Monica. Do you think you want kids? With me? If you want children in the next ten years, I need an answer today. I need to accommodate the third person in our new relationship!"

Uhm...You know what? I just played that scene out in my head. Nevermind. I don't think getting pregnant is so much an issue anymore!

For those of you who have had kids after your diagnosis…What was it like? What did you have to consider before becoming pregnant? Please let me know in the comments!