Arthritis and Pregnancy: What You Need to Know

If you have arthritis and are pregnant - or planning to get pregnant - you may have some questions about how arthritis and pregnancy may interact.

The good news is that having arthritis should not prevent you from getting pregnant or from having a healthy and successful pregnancy. Some medications, however, can affect your baby and may stay in your system for a while, so you will need to stop them before getting pregnant. Read on for what you need to know about pregnancy and arthritis.

It is important to talk to your doctor before you try to conceive if you have arthritis. Your doctor can advise you on how to prepare for pregnancy, such as checking your general health, reviewing your medications, and giving you tips on how to manage your arthritis during pregnancy.

Some medications for arthritis - such as methotrexate, leflunomide, and biologics - are not safe to take during pregnancy and may need to be stopped or switched before you get pregnant. Your doctor can help you find the best treatment plan for you that is both effective and safe for your baby.

It is important to monitor your arthritis symptoms during pregnancy. There are different types of arthritis, and pregnancy can interact with them in various ways.

If you have osteoarthritis, the added weight from pregnancy can put extra pressure on the joints - particularly the knees - and can lead to increased pain and discomfort. Some women may experience an increase in arthritis symptoms when they are pregnant. This can be challenging to cope with, especially when you also have to deal with the normal discomforts of pregnancy, such as swelling, backaches, and tiredness. It is important to keep in touch with your doctor and your midwife throughout your pregnancy and report any changes in your symptoms or any concerns you may have.

Many women with rheumatoid arthritis (RA) actually experience an improvement in their arthritis symptoms during pregnancy, especially in the second and third trimesters. This is because it is evolutionarily advantageous for the inflammatory immune responses that might lead to foetal rejection to be reduced during pregnancy, so your immune system isn’t as flared up or responsive as usual - which can lead to an improvement in symptoms caused by inflammation. Whilst a reduction in inflammation is good news for people with arthritis, it is important to remember that a lowered immune system comes with its own health risks and you should be taking extra good care of yourself during pregnancy.

Weight gain is a normal and healthy part of pregnancy, and it can put extra pressure on your joints, especially your knees, hips, and lower back. This can cause more pain and stiffness and affect your mobility and balance. Whilst you can’t avoid gaining weight during pregnancy (you are literally growing another human being!), you can manage your weight and lifestyle to avoid some of the extra strain on your joints.  

The amount of weight you gain during pregnancy depends on your pre-pregnancy weight, your height, and your baby’s size. Most pregnant women gain between 10kg and 12.5kg (22lb to 28lb), putting on most of the weight after week 20. However, this may vary depending on your individual circumstances. You don’t want to be worrying about weight and avoiding foods when pregnant - you and your baby need plenty of nourishment and this is not the right time to diet - but if you are trying to conceive then it may be worth talking to your doctor or nutritional specialist for advice.

Eating well during pregnancy can help you and your baby get all the nutrients you need for a healthy development. It can also help you manage your weight and reduce inflammation in your joints. You should eat a variety of foods from the different food groups, such as fruits, vegetables, whole grains, lean protein, dairy, and healthy fats. You should also drink plenty of water and limit or eliminate your intake of salt, sugar, caffeine, and alcohol.

Some foods that are good for both arthritis and pregnancy include oily fish, nuts, seeds, berries, leafy greens, beans, lentils, and yoghurt. You should also discuss prenatal supplements with your doctor to make sure you’re getting all the nutrition that you and your baby need.

Exercise can help you stay fit and healthy during pregnancy and prepare you for labour and delivery. It can also help you ease joint pain and stiffness, improve blood circulation, reduce swelling, boost your mood, and prevent gestational diabetes.

“Exercise as much as feels comfortable and does not cause pain,” says Dr Hana Patel, a GP specialising in women's health and fertility. “Try a range of different types of exercises, and focus on flexibility to keep up your muscle strength. Most people prefer walking or antenatal aqua aerobics classes.”

You should aim for at least 150 minutes of moderate-intensity exercise per week, such as walking, swimming, cycling, or low-impact aerobics. You should also do some strength training and stretching exercises to keep your muscles and joints strong and flexible. You should avoid any activities that involve high impact, twisting, or jumping movements that could harm your joints or your baby. Always check with your doctor or midwife before starting any exercise program during pregnancy.

Pain is a common symptom of arthritis and can affect your quality of life and well-being. However, not all painkillers are safe to take during pregnancy. For example, non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and diclofenac, are not recommended during pregnancy, especially in the third trimester, as they can cause problems for the baby’s heart and kidneys.

“Usually non steroidal anti-inflammatories (such as ibuprofen) cannot be taken in pregnancy, as it can cause kidney damage to the unborn baby,” says Dr Hana Patel. “Paracetamol may be safe to use in pregnancy and other prescribed medication for pain can be given with the advice of your GP.”

There are also other ways to manage your pain without medication, such as using heat or cold packs, a hot bath, maintaining good posture, gentle exercise, massage, acupuncture, and relaxation techniques. Try to prioritise sleep, rest when you need to and take plenty of deep breaths. You can also ask for support from your partner, family, friends, or a support group for people with arthritis. You are not alone in this journey and there are people who can help you.

If your arthritis symptoms are likely to affect your labour - if you have back pain and want to find an alternative birthing position, for example - speak to your doctor ahead of time so you can plan ahead and have everything in place.

“Rheumatoid arthritis may also lead to an increased risk of pregnancy complications,” says Dr Hana Patel, “such as pre-term birth, babies small for their age, and children who may need more intervention and help when they are first born.”

Speak to your doctor for advice if you have any concerns about your baby.

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By following these tips and working with your doctor and midwife, you can have a healthy and happy pregnancy for yourself and your baby. Do you have any tips for arthritis and pregnancy? Let us know on Facebook.