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My Labor and Delivery with RA

All pregnant women are nervous about childbirth. We’ve all seen far too many movie scenes where women are screaming, crying, and squeezing people’s hands way too hard. Being a woman with RA, I’ve watched those scenes and have winced for both characters, the mom-to-be in agony as well as her partner, whose hand is in a human vice, as either scenario seems like torture to someone with arthritis. Pregnant women often become obsessed with their upcoming deliveries, and absorb themselves in books and audio cds and attend classes of all varieties in an effort be become better informed, and therefore better prepared, for the experience. There are so many questions swirling in a pregnant woman’s head involving all the possible variables: When will labor start? Where will I be when my water breaks? What if things don’t go according to plan? How much will it hurt? Can I handle it?

While all of these thoughts, and many more, went through my head during pregnancy, I had a few additional ones to add: How will my joints feel during labor? Will the demands of labor send me into a flare? If my hip and sacroiliac joints already hurt, how the heck are they going to hold up during delivery? Does my RA make me more likely to need an epidural or cesarean? Can I do this?

My rheumatologist, gynecologist, and midwife all assured me that I was at no greater risk for requiring intervention during birth than a woman without RA. Yet, I couldn’t help but worry, because if activities that other people can do with ease cause me pain (opening jars, driving a stick shift, holding a bowling ball, turning a faucet, etc.), how could the activity that is generally regarded as one of the most painful experiences people ever endure be anything but harder for me?

I tried not to be overcome by fear, especially since most childbirth experts agree that fear makes the body more tense and prolongs labor, and I did everything I could think of to prepare. I read the books, practiced pre-natal yoga, went to hypnobirthing classes, listened to positive affirmation cds, attended childbirth preparation classes, and meditated. I hired a doula (birthing coach) and packed my hospital bag with all the relaxation aides I could think of such as cds and lavender-scented lotion. I repeated to myself, “I can do this.”

When the big day finally came, it turns out that my doctors were right. Although it took 36 hours past the time my water broke, with hours of painful contractions, some Pitocin, and an episiotomy, I was able to deliver my daughter into the world naturally and without an epidural or any pain medication. What my doctors did not predict is that my RA may have actually made me better prepared for childbirth than many women are. For the majority of my labor, I was able to be very calm, to focus in on my center, and avoid freaking out in the face of the pain. After all, pain and I are not strangers. I have breathed and meditated my way to the other side of many a flare, so I was not an amateur when it came to practicing these methods in my first childbirth. I have survived a lot of pain from arthritis, and I knew I would survive the pain of childbirth. Only this time, the pain was for a wonderful, joyous reason, and was limited in duration to my labor, unlike RA pain, the duration of which is completely unpredictable and which is caused by the very system in my body that is supposed to keep me well. Unlike a flare that can go on for days, weeks, or even months, I knew the pain would be over in hours. And while the intensity of the pain of childbirth did eclipse any pain I had previously known, it was caused by something that made sense and that was worth the suffering, a beautiful new little life.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • stormycea
    2 years ago

    I’m super late to this article lol!! But My husband and I have just began thinking about children. Im worried that since I have a pretty big difficulty with Pap smears (because my hips are both pretty bad and it’s hard for me to open them very wide) that I won’t be able to deliver normally. I noticed you said you had hip pain, but did you have difficulty opening your legs wide? I read about c-sections and they sound kind of terrifying. I don’t particularly want to have a c-section, so seeing that you were able to deliver normally is a glimmer of hope, but I still wonder if I won’t be able to!!! Ahhhhh

  • Tamara Haag moderator author
    2 years ago

    Luckily there’s no expiration date on our articles, so I’m very glad that you found this one that is pertinent for you now. 🙂

    My hips are among my “usual suspects,” those joints that do trouble me more often than others. However, my hip issues have not reached the point where I typically have trouble opening my legs (i.e. this isn’t an issue for me unless I’m in a flare). I recommend that you talk with both your rheumatologist and your OBGYN about your concerns. Your rheumatologist will know your typical range of motion and your OBGYN will have seen many deliveries and know what risk factors to look for.

    While pregnant and since becoming a mom, I’ve been astonished at how each person’s experience with pregnancy and delivery can vary, and how often the challenges people end up contending with are not the ones they expected. Talking to your doctors can give you an opportunity to discuss your concerns, both about natural delivery and about c-sections.

    I have several friends who very much wanted to deliver naturally but ended up being unable to (each for different reasons). Their disappointment levels vary from still feeling a certain amount of disappointment years later to feeling relieved at how much better the c-section ended up being than they thought it would, and everything in between. However, all of them have agreed that the downsides of a c-section don’t hold a candle to the amazing experience of becoming a mom. If you really want a baby, once s/he is in your arms that will far outweigh the specifics of how s/he came into the world.

    I welcome you to check out some other articles about pregnancy and RA; some of these I’ve written and many are from my colleague Mariah Leach: These may be of some help in determining which questions you may want to ask your health care professionals. We also encourage you to continue posting questions on our website or Facebook page any time you like.

    Thanks for being in our online community!

    Gentle Hugs,

  • Stefanie
    4 years ago

    Hello Tamara,

    I have often wondered how experiencing pain my whole life will help me through childbirth. Pain is such a subjective feeling, yet we feel that living with RA we would have a higher tolerance than most. I appreciate your honest perspective on this!


  • Tamara Haag moderator author
    4 years ago

    Hi Stephanie – I’m so glad you found it helpful to read about my experience. You are so right – pain is certainly subjective, and I often feel like a wimp when my joints hurt (all too often we beat ourselves up for the way we feel), but childbirth was one experience where I felt like I definitely had a higher pain tolerance than some. It’s very possible that if I didn’t have so much experience with pain that I might have needed the epidural.

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