It’s no secret that Lupus disproportionately affects women of childbearing age. According to the Lupus Research Alliance, 90% of Lupus patients are women, and most are diagnosed between 15 and 44 years old. Each case is unique, and no two women share the exact same set of symptoms or medical complications. Still – despite varying degrees of severity – many women with Lupus wonder about how the disease will impact their ability to have a safe and healthy pregnancy.
In the past, women with Lupus were discouraged from becoming pregnant. Concerns related to blood clotting, miscarriages, and fears for both mother and the baby left many doctors advising women against taking the risk. However, advancements in technology and treatments developed over the last 20 years have really helped professionals better understand the dynamics of pregnancy and this unique illness.
Now rheumatologists and gynecologists agree that many women with Lupus can go on to have safe and healthy pregnancies with careful planning and close monitoring. It is important to remember that less than 50% of women with Lupus have complications during pregnancy. If your doctor says you are healthy enough to try to have children, there are things you can do to lower your risk of Lupus related complications.
6 Months of Remission
The Center for Disease Control & Prevention (CDC) recommends a minimum of 6 months without flares before becoming pregnant to lower risk of miscarriage or life-threatening complications. “Women with Lupus can safely get pregnant, and most will have normal pregnancies and healthy babies. However, all women with Lupus who get pregnant are considered to have a “high-risk pregnancy.” While flares are not completely under your control, there are some lifestyle measures that can be taken to lower your risk. (Be sure to speak to your physician to determine what specific lifestyle measures are safe for your level of disease activity):
- Stop drinking alcohol or reduce intake
- Get plenty of nighttime rest
- Take walks or engage in regular low-impact exercise
- Practice yoga or find a reliable counselor to help you manage stress levels
- Consistently eat an anti-inflammatory diet filled with foods like walnuts, flax seeds, fruits, vegetables, turmeric, and ginger
- Aim for at least 5 servings of foods containing antioxidants and polyphenols per day
- Avoid sugar and heavily processed foods
- Add Calcium and vitamin D3 to your diet
A 6 Month Plan
The most important step you can take in attempting a healthy pregnancy is to make an appointment with both your rheumatologist and your gynecologist at least six months prior to trying to conceive. Let your doctors know about your desire to have a baby, and ask them whether they believe it is safe for you to start this journey. Megan Clowse, M.D., M.P.H., assistant professor in the Division of Rheumatology, said, “Pregnant women with lupus should never try to go through their pregnancy alone and simply hope for the best.”
Developing a plan with your doctors ahead of time will help inform the best course of treatment during your pregnancy. Certain medications need to be stopped or changed before becoming pregnant. If you take hydroxychloroquine and/or azathioprine, and ACE Inhibitor, or an anticoagulant, you will need to ask your doctor how to best modify your treatment before, during, and after pregnancy.
Avoid Common Complications During Pregnancy
Some women with Lupus may experience certain compilations during pregnancy, such as preeclampsia and/or blood clots. According to a study reported on the Better Health Channel, “About one-third of women with Lupus have antibodies that may cause blood clots and interfere with the proper functioning of the placenta. This is most likely to happen in the second trimester.” This means you should avoid long periods of inactivity during pregnancy. You can also use an at-home blood pressure monitor and perform self-checks multiple times a day. Your doctor may also want to analyze your urine regularly for excess proteins. And while some pregnant mothers with Lupus are also at a higher risk of miscarriage, premature birth, and a prenatal condition called IUGR, your doctor can prescribe a pregnancy-safe blood thinner to reduce these risks.
Stay in Touch
After giving birth to a healthy baby, you may feel that your risks of pregnancy-related complications have disappeared. This is simply not the case. The chance of maternal blood clots, cardiac events, Lupus flare-ups, and even death is increased postpartum. This is why staying in touch with your doctors and keeping your appointments is so important after you give birth. Keep an eye on your mood, too. According to the American College of Rheumatology, postpartum depression- and other major depressive conditions- are twice as likely in mothers who have Lupus.
Many women with Lupus can have safe and healthy pregnancies if they plan in advance with their healthcare teams. If you feel discouraged by things your friends say or things you hear about through the grapevine, remember, less than 50% of pregnancies among Lupus patients have complications. You are a Lupus Warrior, and if your dream is to become a mother, there is a good chance that your doctor can help you get there with the proper treatment plan. If you are currently trying to conceive or are thinking about starting that journey and need a little hope – here is a picture of my two sweet girls. As a Lupus Chick myself, my pregnancies were not without complication; however, the end result was two happy and healthy little girls!
Summer (10yrs old) & Keira (1yr old)
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