Talking Babies With RA

I’m not talking about babies talking about RA, or talking babies that have RA.

I am talking about having babies when you have RA.

For me, with a foot in both the lupus community and the RA community, I have seen more examples of women with lupus having babies than women with RA having babies.  Why that is, I really have no idea.

But what I do know is that I have both lupus and RA, and I really want to have a baby.

So I made it a priority to talk about it at my recent rheumatologist appointment.  My old rheumatologist would not talk to me about this topic.  He felt that we shouldn’t discuss it until it wasn’t hypothetical anymore.  But I’ve been dating the same guy for almost two years now, so it’s not really hypothetical.

And my new doctor is a woman, so maybe she can relate better, and understand that it doesn’t matter how sick you are, but there are some things we are not willing to lose – there is often so much we are forced to give up with illness – and for me, children is one of those things that I’m not willing to give up at this point.

When I was diagnosed, at the age of 22, I was knee-deep in graduate school, and having children wasn’t really on my radar at that point.  I was mainly concerned about getting better.  So I took several medications unquestioningly, which could have an impact on my fertility.

It’s interesting.  When women of a similar age are diagnosed with cancer, they are often urged to freeze their eggs before they start treatment, if they have any desire to have children in the future, given that many cancer treatments cause fertility issues.

The same thing is not done for young women with RA, as far as I am aware of, and I think as a community it is time for us to really start talking about this issue out in the open.

Although no one has told me directly that I might have fertility issues, it is definitely a concern of mine.  I am realistic and know that, fertility issues aside, a pregnancy for someone with RA is going to be more complicated than for my healthy counterparts.

It will not be a spontaneous event, but rather very planned and highly regulated and monitored.  Not that, that is a bad thing in that the goal is to have the healthiest baby possible.

It’s important to talk to your doctor early on about pregnancy, as this might impact the treatment that you receive.  It is also important to have a frank conversation with your doctor about whether they think it is safe enough – and that you are healthy enough – to conceive and give birth to a healthy baby.

There are several important things to keep in mind when considering pregnancy with RA:

  • Some medications used to treat RA are not safe for use during pregnancy.  And many of these medications require a “washout” period, which depending on the medication, can take months or even years to be rid of.
  • As long as you are on meds or in the washout period, multiple forms of contraception are necessary in order to prevent accidental pregnancy and birth defects.
  • Getting pregnant when RA disease activity is low tends to be better than getting pregnant when disease activity is high, even though women with RA can get better during pregnancy, worse during pregnancy, or disease activity can stay the same the same during pregnancy, regardless of how the disease is managed at the time that pregnancy occurs.
  • While a woman with RA can have a successful pregnancy, the pregnancy is considered high-risk and requires coordination with your medical team, which will include an obstetrician.
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