Pregnancy is a joyous and exciting time for the mother-to-be as well as her family and friends. However, for women with lupus, they may feel that it is a dream which can never be achieved. Though some of them may insist to plan for a pregnancy, they are circled with doubts and questions if the newborn baby will be healthy. Besides, feeling of guiltiness may sets in when they cannot take care of the baby if the lupus condition is too severe.
So a few common BIG question marks which will be lingered in the minds of all women with lupus is:
- “Is it wise to get conceive with lupus or not?”
- “If I decided to get conceive, what are some of the important issues related to conception and pregnancy do I need to take note?”
- “Will lupus be genetically transmitted to my baby?”
- “Will lupus results in a difficult and unsafe pregnancy?”
If you have lupus and are trying to conceive, do discuss your thoughts with your doctor, gynecologist or rheumatologist. This is especially important if you are experiencing frequent flare-ups as your doctor can advise you if this is the right time to plan for a pregnancy. In fact, some doctors believed that pregnancy should not be attempted until the symptoms of lupus have been controlled or in a remission stage for at least several months to a year.
If pregnancy is not advised or for whatever reason you do not wish to become pregnant, the only way to make sure that you do not conceive is to use an effective form of birth control. Contraceptives available to women with lupus are the same as for other women, but with one noticeable exception. Women with lupus should not use birth control pills, unless your doctor has specifically approved their use for you.
Other acceptable birth control options include barrier methods such as the diaphragm plus spermicide or condom. The risk of unplanned pregnancies with any of these birth control options is reduced as long as the techniques are used correctly. Talk with your doctor to find out which method will work best for you.
Certain immune-suppressive drugs should also be discontinued prior to conception. As such, discuss with your doctor any medications which you are on, to determine which may need to be stopped and how long you need to wait before trying to conceive.
Next, most women will have this question on their mind:” Will I have more difficulty conceiving because of lupus?” Generally, it may not be the case although some women have problems conceiving regardless of their medical condition. In some cases of lupus, menstruation may cease or periods become irregular when they used to be regular.
However, doctors have indicated that even if menstruation ceases, ovulation can still take place and contraception can still occur. So if you are not menstruating, that does not mean you cannot become pregnant.
When you and your partner decide to try for contraception, check with your doctor to make sure that there are no other reasons to hold off. For example, other than flare-ups issues, should you try to get conceive if you have high blood pressure or kidney problems? So the best is to have an open discussion with your doctor since each case is very individual. Some may be concern that there is a possible genetic factor involved in lupus.
In fact, though there is a genetic predisposition to lupus, and there are families in which several members do have lupus, it is less common for lupus to be transmitted genetically to your children.
After you become pregnant with lupus, it is essential to stay close in contact with your doctor. Although you may have had an obstetrician before you were diagnosed with lupus, be sure that he or she will take care of you now, considering your condition. Some may prefer not to take individuals with lupus and may suggest you switching to a different obstetrician. But is this unfair then? Well, you may not feel happy about it , but you certainly want to know if your obstetrician feels uncomfortable.
Does Lupus Affect Your Pregnancy?
Unfortunately, your pregnancy may not be without problems if you have lupus. Typically, women with lupus have a statistically greater chance of premature births and neonatal complications. There is a greater chance of miscarriage and stillbirth. Pregnancy problems may also be due to hypertension, gestational diabetes and lupus activity. Besides these problems, other things that can disrupt any normal pregnancy can still occur such as morning sickness, nausea as well as fatigue.
Does Pregnancy Affect Your Lupus Condition?
Pregnancy can cause a higher than normal level of stress, although it is impossible to predict what will happen during anyone’s pregnancy. It is possible that you will feel better than usual during your pregnancy. Or you may experience more marked symptoms and be in a flare for almost the whole time.
As a matter of fact, some people first learn that they have lupus during or after their pregnancy. Why? This is because symptoms develop which prompt them to go to the doctor and that is when they discover that they have lupus. In more than half of women with lupus, pregnancy has no bearing at all on the way lupus affect them. For the most part, be reassured that even if pregnancy does affect your lupus, either during or after the pregnancy, these problems are rarely serious to the extent of life-threatening.
Medication And Pregnancy
If possible, it is usually a good idea to avoid most medication during pregnancy. But this is not always possible especially during pregnancy with lupus. Many women, for example have used aspirin during their pregnancies without any damage to the fetus. Other medications, such as predisone have been used during pregnancy. However, do not take decisions lightly with regards to medications and pregnancy by discussing whatever thoughts you might have with the doctor.
There are certain medications that should not even be considered during pregnancy, such as immuo-suppressive drugs. If you are on any of these medications, do not even attempt to conceive yet. Wait for your doctor’s instructions to continue after discontinuing their use during pregnancy times.
So what if you discover that you are pregnant while you are on medication? Your doctor may want you to stop the medication as soon as possible. In fact, it is alright to stop certain medications abruptly. However, do take note that it is possible to go into a flare after discontinuing their use and stopping certain medications like predisone suddenly can be dangerous as well.
Therefore, whether you should continue medication, stop it or even consider pregnancy is a matter that you should discuss with your partner, family and the doctor or rheumatologist.
Nutrition During Pregnancy
Nutritional planning is essential during pregnancy as you will need sufficient calories to support both your own strength as well as the growth of the baby. Your doctor will determine specifically what your nutritional and weight goals are, depending on your size, pre-pregnancy weight, ideal weight and other factors.
During pregnancy, you will probably need to increase your intake of protein as well as iron, folic acid and calcium. You will also need additional vitamins and nutritional supplements to support the growing fetus. As such, discuss and devise a nutritional plan with your doctor, nurse or dietitian so that you and your baby will stay healthy.
Exercise During Pregnancy
Exercise during pregnancy is now just as important as before you get conceived. The benefits from regular exercising such as relaxation, better fitness, better body image, increased sense of well-being are necessary during pregnancy.
Therefore, do not stop exercising but you can lower the intensity of your workout. Being physically fit and staying that way will help you to deal better with labor and childbirth. It can also moderate or reduce the chances of excessive weight gain.
Exercise will also increase your strength and stamina, and lower your anxiety level. Discuss with your obstetrician as well as your rheumatologist, in order to determine how much exercise is ideal for you.
What To Take Note After Delivery?
To try to avoid flares resulting from delivery, steroids are usually increased just prior to delivery. You should also try hard to avoid any stressful circumstances because of your increased vulnerability at this time.
If you do go into a flare, it may occur in the short period of time (anywhere between from2 weeks to 2 months) following delivery (the postpartum period). Increased lupus problems often relate to kidney problems or emotional distress, although flares can occur for any reason. However, close cooperation with your doctor can probably reduce the likelihood of such a postpartum flare or at least of such a flare become serious.
Generally, the babies of mothers with lupus do not show any more evidence of lupus at birth than the babies delivered by women who do not have lupus. However, newborns of mothers who have lupus may show a higher incidence of congenital heart block. This medical problem is usually associated with the presence in the mother of one of the anti-nuclear antibodies, called anti-Ro.
Therefore, experts feel it would be reasonable to check all newborns of mothers with lupus for this problem, so that appropriate treatment can be started if necessary. If your baby was tested for the presence of LE cells or given an ANA test when born, these tests might come back positive. But the results are most likely positive because the mother’s blood has been circulating within the baby. The tests no longer usually show a positive result after the baby is a few months old.
The period of time following childbirth can be tiring for any mother especially when lupus adds more potential stress to the mix. Therefore, before the delivery, try to talk to other women with lupus who had children. Find out and learn from them their personal experiences so that you can more or less prepare yourself when the newborn arrived.
Such of the questions which you can ask include:
- How did they deal with their lupus symptoms?
- How did they deal with the added physical and practical pressures around the house?
- How did they deal with any guilt they might feel if they cannot do as much with the baby as they might like?
- How did they deal with the need to change certain responsibilities within the family?
If you are planning to breastfeed your baby, you will be happy to know that breastfeeding is perfectly safe for mothers with lupus. In fact, breastfeeding appears to offer some advantages over bottle feeding. For example, doctors say that breastfeeding causes the uterus to return to its pre-pregnant state faster.
Breast milk is an ideal food for your bay as it is packed with nutrients, and it contains some of your own antibodies, which will help your baby to fight off illness. However, do take note that if you have more than just a mild case of lupus, or if you have been on moderate dosages of steroids for prolonged periods of time, do consult with your doctor regarding breastfeeding. This is because the medication may get into the milk that may affect the baby.
If you and your partner are planning a pregnancy with existing lupus condition, bring all of the issues that concern you openly during the discussion with your family, obstetrician and rheumatologist. Besides, any concerns or potential risks of pregnancy should be taken into serious consideration. Typically, pregnancy should not be a problem at all especially if you have only a mild case of lupus.