So today I am really happy to launch my new series all about pregnancy and having kids when you have chronic illnesses. I put a shout out on social media a couple of months ago and received a great response , so alongside my information and story, I have a bunch of other ladies stories to share with you all as well.
I thought I would start right at the beginning, as the road to getting pregnant when you are chronically ill isn’t always straight forward and there are lots of extra things we may need to consider.
Making The Decision
So, the first step is you and your partner deciding that you want a baby. This is a joyful time, an exciting time…but chronic illnesses always like to rear their head in all aspects of our life and this is no different. When one of you is chronically ill, there are a few extra considerations you will need to think and talk about.
Speaking To Your Team
The first place to go is to your doctor. While your GP can give general advice, your consultants and specialist team will be the ones you want to see ideally. They know about your disease and will be able to give you much more accurate information, both in regards to your illness and you, as even when we have the same conditions, they can behave very differently in different people.
Your team will be able to advise you what medications will need to be discontinued, temporarily stopped or may be continued while trying to get pregnant and through pregnancy. Some medications, like Methotrexate have to be stopped at least three months before you even try to get pregnant, for both men and women hoping to conceive. Your doctors may want to see you more regularly to be able to monitor you and your illness, particularly if you have had to stop certain treatments.
Some chronic illnesses may have an effect on your fertility. Some surgeries may also affect this – again for both men and women. Bowel surgery may cause women to have a tilted uterus which can make getting pregnant a little more difficult. Men can suffer with erection and ejaculation issues following this type of surgery. This is something you should discuss with your doctor. Often they set a time limit for trying and if you don’t have any success they may be able to offer things to help.
Generally it is not advisable to get pregnant when you are flaring. A woman’s body is going to need to grow and support this little baby so needs to be in the best possible health to do so. All women trying to conceive should start taking a folic acid supplement and it is a good idea to keep an eye on your iron levels as anaemia is common in both chronic illnesses and pregnancy can make this worse.
So at the end of 2007 I took the decision to move down to Essex to live with my boyfriend. Along with the move, I obviously had the big task of changing over my hospital specialists and things. This was actuality made much easier than I thought it would be thanks to the fab GP’s I joined, but did mean I was off my biologic medication (at the time I was on Infliximab) and my Methotrxate for a while as these weren’t things that could be prescribed by the GP. I was going through a good period health wide and we decided to take the opportunity to try for a baby. My new rheumatologist was really helpful and I stayed on my contraceptive pill for a further month to make sure the Methotrexate was out of my system before we started trying, making it almost four months in total.
My doctor explained that with rheumatoid arthritis, it was often the case that during pregnancy all symptoms disappeared. If I wasn’t one of the lucky ones though, there were options for medications I could use that were safe in pregnancy. I was able to keep taking my painkillers – I was on Naproxen at the time – until the end of the second trimester. After this they can affect the flow of blood between you and the baby, so they can’t be taken during the third trimester. My doctor also advised me that many women experience a big flare following the birth, once all the hormones start to settle so I was prepared for that.
Once I got pregnant I would be monitored closely and have a couple of extra scans with it being my first pregnancy and due to my medical history, and I was to have consultant rather than just midwife led care. They would also book me in for an appointment approximately 8 weeks after my due date so if I did experience a big flare following the birth I could be treated quickly.
With my second pregnancy I had had my hip replacement so had an extra assessment to check my legs could be safely and comfortably put in stirrups should they be needed. I had also had to have a consultation with an anaesthetist during my first pregnancy as I have an allergy to one of the anaesthetics they use. Due to this, they decided that I would need an early epidural placed once labour started so that in the case of an emergency, this could be topped up for an emergency c-section as they couldn’t use that particular drug.
I started taking a pregnancy multivitamin which included the folic acid dose recommended to those trying to conceive and then some other vitamins and minerals to try and give me a boost. I was super lucky and fell pregnant the second month of trying after getting a positive pregnancy test result on February 22nd 2008.
I really hope this series will help answer some questions and give some hope to people who are thinking of tying for a baby when they are chronically ill. It is not easy, but then, parenting isn’t easy for anyone! But it is most definitely worth it and as long as you are sensible and realistic with your expectations you will be good!
As always, I am not a doctor or medically trained. This post is based in my experiences and research and you should always consult your doctor about your care. I am happy to answer any questions in the comments and will continue my story in a future post. If you are interested in sharing your pregnancy with chronic illness journey please pop me an email to firstname.lastname@example.org