The RA Pregnancy Chronicles: The Post-Birth RA Flare

The RA Pregnancy Chronicles is a series of posts that share my experiences being pregnant while living with RA. This post was written during Week 32 of my second pregnancy.

Though I’ve spent countless hours looking for books and websites and magazine articles and blogs on the subject, in my experience there just isn’t a whole lot of uplifting or useful information out there about dealing with RA and pregnancy at the same time. (Which is one of the reasons I find it so important to share my own experiences here!) But of the information that does exist, there are two points on which the vast majority of sources seem to agree:

1. There’s a high likelihood of experiencing some degree of remission during pregnancy. (This was true for me the first time around, but the second time I sadly have not been as lucky.)
2. Once you give birth, there’s a high likelihood of experiencing a bad post-birth flare within a matter of weeks.

Sources seem to agree, regardless of how your RA behaves while you are pregnant, women with RA are likely to experience a bad flare within a few weeks of giving birth. This can be a scary piece of information for a pregnant woman with RA to read – particularly if she is pregnant with her first baby and isn’t sure what to expect in the postpartum period in the first place. It’s terrifying to think about how you will recover from giving birth (or, in my case, having a C-section), learn to care for a brand new baby, and manage a bad RA flare all at the same time. When I was pregnant with my first baby and people asked me if I was scared of giving birth, I had to tell them honestly that I was more scared about what would happen after he was born.

During my first pregnancy I remember seeing an article in The Huffington Post about a woman who was diagnosed with RA shortly after the birth of her first child. (Unfortunately, it is not uncommon for women to be diagnosed with RA after giving birth, leading scientists to wonder whether the stress of pregnancy might help trigger autoimmune conditions like RA.) While her story was obviously somewhat different from my situation – where I already knew I had RA and would be likely to flare post-birth – I was excited to see how the issue of new mothers dealing with RA would be covered in such a mainstream media source. I remember devouring the article to see what advice and encouragement it would offer me.

Instead I found this:

• “[she] couldn’t get out of bed. She was in ‘excruciating pain.’”
• “I could barely walk. I couldn’t pick up my newborn.”
• “You can’t even flip a light switch.”

Ok. I get it. It’s no fun to deal with RA and a newborn at the same time. But what advice did the article offer for new moms in this terrible situation?

• “Over time, [she] learned how to adjust to her illness through a combination of medication, exercise and diet.”
• “You have to find out what works for you.”
• “Don’t beat yourself up. Take care of yourself first. It’s okay to have a cup in the sink. Get your diet and exercise plan together.”

While I can’t say I exactly disagree with this general information about life with RA, it doesn’t really address the plight of a new mother managing the pain and limitations of a bad flare and caring for a newborn at the same time! And unfortunately I haven’t found any other sources that do a better job either.

So, based on my own experiences with the post-birth flare (which occurred about six weeks after my first son was born) I wanted to see if I could offer some useful advice and ideas to pregnant women with RA:

• Hope for the best but prepare for the worst. Adjusting to life with a brand new baby is difficult enough all by itself, so try to do whatever you can to make that time period as easy as possible in advance of baby’s arrival.
• Make sure your baby gear is as RA-friendly as possible. Ideally you will want to have gear that will help you care for your newborn with as little extra strain on your body as possible.
• Ask for help and accept whatever help is offered. See if you can schedule some time where Grandma or Auntie or a friend will be available to help out regularly post-birth. Having some trusted help at home (especially from experienced ladies who may have had their own kids!) will be a total lifesaver. While this help will be useful right after the baby is born it may be even more important about six weeks in when your RA begins to flare again, so keep that in mind.
• Try to stock your freezer with healthy meals in advance. Or sign up for a meal registry online (like MealBaby or meal Train) where your friends can sign up to help by dropping off meals for you after your baby arrives. You will be way too busy and exhausted (and possibly in too much pain) to do much cooking, but you will still need to make sure to eat nutritious meals to keep your strength – especially if you are breastfeeding. So having access to some healthy meals that can be quickly prepared is key.

Does anyone have any other advice or ideas? As I approach the possibility of a post-birth flare for the second time I am open to suggestion – especially since I will also have a two-year-old to care for this time around!