Out of the 1.5 million Americans diagnosed with lupus, a type of autoimmune disease, approximately ninety percent are individuals assigned female at birth. The Lupus Foundation of America (LFA) notes that oftentimes, the development of this condition surfaces during someone's child-bearing years causing quite a number to navigate through it while trying to start or expand their families.
There was believed previously in medical circles that those suffering from lupus shouldn't get pregnant but this opinion has changed over time according to the director of Pregnancy and Reproductive Health at Brigham and Women's Lupus Program in Boston, Laura L. Tarter, MD. In her view now, most people inflicted with lupus have the potential for pregnancy and even carrying it full term delivering healthy babies.
Although achieving successful pregnancies when living with lupus is very achievable these days there might still be some increased risks associated with certain health issues that should not be ignored.
According to data form the Centers for Disease Control and Prevention (CDC), pregnancies involving women who have been diagnosed with Lupas produced higher instances of more serious complications like preeclampsia gestational hypertension premature births blood clots kidney problems among others ailments
This certainly doesn't mean that you will face these conditions inevitably but one needs to take precautionary measures by obtaining extra medical observation both before conception as well as all throughout your pregnancy period leading up till childbirth.
The thought process around possibly navigating such health hazards can indeed lead towards creating choke points leading toward anxiety riddled outcomes so here mentioned are eight solid steps an individual battling through symptoms related towards Lupas can take to ensure that they receive the best care possible when trying for pregnancy and then eventually delivering upon those intentions.
1. Make Prior Preparations
It is undeniable that not all pregnancies are premeditated. However, medical professionals emphasize the significant benefits of carrying a pregnancy while your lupus symptoms are well-controlled or non-existent for no less than half a year.
Dr. Bonnie L. Bermas, an esteemed professor in the Department of Internal Medicine at UTSouthwestern Medical Center and part of the Lupus Foundation of America Medical-Scientific Advisory Council states decisively: "The crucial piece of advice for individuals with lupus considering pregnancy is to aim to conceive during periods when their disease is dormant or very effectively managed."
This strategy confirms starting your journey towards parenthood with minimal active lupus as it's critical to guaranteeing you have a wholesome pregnancy experience according to American College of Rheumatology's guidelines for reproductive care issued in 2020. Dr Tarter emphasizes, "Attaining well-managed diseases proves beneficial not only for the expecting mother but also her unborn child."
Therefore, if you've plans on conceiving anytime soon or even later down the line, make sure to communicate your aspirations promptly and openly with your rheumatologist. Together you can strategize on symptom management and evaluate if there's any need for altering current medications (more details on this below).
2. Building Your Pregnancy Care Group
For those who are pregnant and not categorized as high risk, they often only require one prenatal care provider during the gestation period (usually an obstetrician, family practice physician or certified nurse-midwife). However, with lupus pregnancy care group may be slightly altered.
Dr. Bermas advises patients to form a health team that consists of providers experienced in rheumatology and high-risk pregnancies expertise.
Those living with lupus anticipating childbirth generally means retaining their pre-existing meeting schedule with their recessive gene-treating expert whilst also seeking out a fetal maternal medicine professional.
Otherwise known as perinatologist – is this field's specialist who focuses on risky pregnancies post extensive training. Depending upon the progress of your pregnancy, your healthcare givers might additionally recommend you meet a neonatologist or another suitable specialist as quoted by American College of Rheumatology (ACR).
Agreeably it does seem like multiple physicians to juggle around (including numerous appointments scheduled). But rest assured understanding that your healthcare squadron plays critical role in working synchronously for curtailing risks related complications such as preeclampsia or premature labor.
3. Regular Check-ins Are Necessary
All expectant individuals are advised to diligently adhere to their prenatal check-up schedules; this is incredibly vital for those diagnosed with lupus.
The importance of regular consultations rests on the fact that you will likely require additional tests and screenings. This might be necessary if your test results indicate the presence of certain antibodies synonymous with autoimmune conditions that potentially have unfavorable effects on pregnancy outcomes.
For instance, should your body produce anti-Ro and anti-La antibodies, you may need consistent fetal monitoring to ensure healthy heart development in your baby. Harvard Health Publishing notes these specific antibodies are also linked to uncommon lupus symptoms present in newborns according to LFA reports.
Continuous communication with your prenatal care team equips them better at regularly screening for flare-ups (more details below) as well as performing routine checks like measuring blood pressure for preeclampsia - a dangerous condition which patients suffering from lupus find an increased risk of being susceptible to Dr Bermas points out such risks could exhibit similar traits akin lupus itself
"Preeclampsia can manifest through high blood pressure levels, unexpected weight gain, or swelling", states Dr Bermas However it's essential noting some individuals showing no symptoms at all, amplifying the significance of having each appointment and scan religiously undertaken
4. Consume a Prenatal Vitamin
The American College of Obstetricians and Gynecologists (ACOG) recommends that all expectant individuals, including those living with lupus, should regularly intake prenatal vitamins.
These multi-nutritional tablets provide the needed assurance that both you and your unborn child are receiving the necessary amounts of vital nutrients such as folic acid, iron, calcium, vitamins C and D, omega-3 fatty acids, and choline.
According to Dr. Tarter's advice; unless otherwise advised by your health care provider, individuals with lupus do not need additional supplements or custom-designed prenatal vitamins during pregnancy.
Henceforth opt for a typical prenatal vitamin tailored in accordance with the nutritional guidelines outlined by ACOG. Primarily seek out for a vitamin supplement containing at least 400 micrograms of B Vitamin (also recognized as folate or folic acid), this is significantly crucial during pregnancy - it becomes extremely vital in the first trimester due to its ability to prevent birth defects.
5. Consult with Your Prenatal Care Team Regarding Medications
It is not just vital to control your lupus symptoms prior to conception but also ensuring that the medication you're taking is safe for pregnancy, says Dr. Tarter.
Certain medications for lupus are teratogenic and could pose a risk to an unborn child. If you are using a medicine that isn't considered safe during pregnancy (like methotrexate), your healthcare provider can assist in switching to one that is, such as hydroxychloroquine.
Dr. Bermas emphasizes, "Not every lupus drug works effectively against pregnancy complications; therefore patients should be shifted towards medicines safer for expecting mothers and monitored over a few months to ensure their condition remains steady."
Lupus drugs may remain in your system for several months according to LFA. Hence the need of making changes at the earliest possible point becomes more significant.
In addition, your doctor may recommend a low-dose aspirin intake strategy as prevention against preeclampsia; ACR's uses 81 or 100 milligrams daily from the first trimester itself for individuals suffering from lupus. The prenatal group will let you know if using baby aspirin would be beneficial.
6. Understanding What to Do in Case of a Lupus Flare
Individuals with lupus are no stranger to the phrase "flare," signifying the sudden manifestation of symptoms. Even if your lupus was under control or dormant when you got pregnant, it might reactivate during your pregnancy.
According to some statistics, the likelihood of experiencing a flare-up is about 40-65 percent as stated by Dr. Tarter. The first and second trimester have been identified as stages where these flare-ups usually occur based on data from CDC.
Dr.Tarter also noted that since there's always chance for reactivation, extreme caution should be exercised while dealing with this disease during pregnancy.” Active lupus and flares pose risks not only to the mother but also to her unborn child."
Interestingly enough, differentiating between lupus flare-ups and typical pregnancy-related discomfort can be quite hard . Backache in lower part, painful joints or carpal tunnel syndrome; all these symptoms may emerge both in normal childbirth process and during a Lupus flare up
However some signs warning against potential flare up appearing suddenly such as exhaustion , pain , skin rash , fever , stomach ache , dizziness or acute headache which could help identifying its onset according to CDC.
Another suggestion provided by Dr.Tarter involves contemplating over how did your Lupus manifest itself before you conceived.
She further explained that patients tend to experience flares mostly resembling those they've had earlier – if an individual typically experienced arthritis related pain split among their joints followed similarly just prior becoming pregnant – then more likely same body systems would be involved now (during gestation)
Fortunately most lupuses erupt mildly throughout pregnancies - however self-diagnosis avoidance remains critical notifying promptly any signs indicating a possible flare towards your rheumatologist besides regular attendance at antenatal appointments because certain type of understated eruptions can be detected only via labwork
If a flare is indeed diagnosed by your medical care team, they'll resort to pregnancy-friendly medications in order to manage the inflammation.
7. Being Prepared for Labor, Delivery and Postpartum
Regarding labor, delivery, and postnatal care, your experience should largely be the same as someone without lupus.
Dr. Tarter mentions that only a small number of individuals with Lupus who are on higher doses of steroids may need additional dosages during delivery. This scenario is most commonly observed in those undergoing C-section deliveries but remains quite uncommon overall.
In terms of post-birth period, if you're taking immunosuppressive medication due to Lupus, it's essential to prioritize vigilant care slightly more than usual. Otherwise your recovery experience should not vary significantly from another birthing individual who does not have Lupus.
As every new parent recognizes well, having a support team available specifically for the first few weeks following childbirth is invaluable given these challenging times whether or not the pregnancy had been straightforward initially. Some people with lupus may unfortunately face flare-ups right after giving birth according to Harvard Health Publishing, underscoring even greater importance for a strong support system in such cases.
Should you opt to breastfeed your baby there's high probability this will be feasible despite any health issues related to lupus notes Dr.Tarter: "The majority of medications prescribed during pregnancy intending treatment for Lupus can safely continue whilst breastfeeding". It's recommended however that seeking counsel from your professional caregiver circle ensure medications being taken currently remain safe enough for infant consumption (For detailed information on drugs compatibility consider exploration via LactMed database) provided by National Medical Library.
8. Collaborate with Your Rheumatologist to Plan for Future Pregnancies
If you're a parent living with lupus, take heart in knowing that future pregnancies are absolutely possible, assures Dr. Tarter. Discussing your family planning aspirations with your rheumatologist is key - whether it's deciding if staying on the medication you used during pregnancy or transitioning into another.
Dr. Tarter explains, "In case a patient responded exceptionally well to their prescription taken during maternity and wants to conceive again after a year or two without experiencing any discomforts or flare-ups - maintaining that same medication might be an option." However, she continues, "Should there have been any disruptions from health issues even as minor as small flares; resorting back to the initial medicine temporarily may be prudent."
The decision-making process here is ultimately personal and depends heavily on one's circumstances suggests (Dr)Tarter. As always when dealing with lupus, pregnancy – not forgetting general parenthood – working hand-in-hand alongside your medical practitioners can help formulate an efficient course of action tailored towards nurturing you whilst accommodating your ever-expanding family life.
