Having a baby is a difficult decision to make when you're healthy, but when you are chronically ill, it takes a lot of thought and planning to figure out if it's even possible.
When I was diagnosed with Rheumatoid Arthritis (RA) it changed everything...my career, my health, my goals, and my ability to do so many things that most people take for granted. And yet, despite being on full time disability and my continuing daily struggles with my health, I've suddenly found myself wanting to have a baby. The idea of having an amazing little person growing inside of me and bringing new light and life to this tired body of mine has given my husband and I much to think about and discuss lately. There are so many factors to look at and so many questions to consider. Here are some of the realities that we came up against while trying to decide if having a baby is the right thing to do.
Your Health & Fertility
One of the first things you need to assess is your own health. Is it physically possible for you to have a baby? Those of us with RA have taken many prescription drugs over the years, including chemotherapy medications, DMARD's and strong immune suppression medications that may have an effect on overall fertility levels. Just having RA itself has been shown to lower overall fertility. Many people with RA also have other autoimmune (AI) diseases that can contribute to fertility problems and/or the ability to carry a baby safely to term. For example, I learned the AI liver disease that I have, Primary Biliary Cirrhosis, can cause a higher than normal level of complications and spontaneous miscarriages during pregnancy. It's critical to talk with your doctor and find out whether its safe for you to think about pregnancy before making any quick decisions.
Your Baby's Health
Next on your list of considerations should be the health of your baby, both during your pregnancy and after. Although risks tend to be low, RA and other diseases can be passed down through the genes, so are you willing to accept the fact that your baby could end up fighting the same diseases you have? You and your spouse need to think about your family histories of disease and possibly even speak with a genetic counselor to help you decide if the risks are something you are ready to deal with.
It's also important to talk to your doctor to determine if your medications are safe to take during pregnancy and/or during breastfeeding. Many people with RA are on medications and are fairly well controlled disease-wise. Are you ready to go off those medications if they are not safe for your baby's development? For example, I use Fentanyl pain patches and the likelihood that they could cause problems with the fetus is pretty high. Not to mention that the baby could be born dependent on the pain meds and have to go through a painful withdrawal cycle after being born. By talking with your doctors early on, you may be able to make changes that allow you to feel your best while also allowing the baby to grow healthy and strong.
The Physical Demands of Having a Child
Finally, it's important to think about the physical demands that a baby brings to your daily life. When they are newborns, there may be a lot of downtime spent on the couch or rocking them in a chair. But, there is still the constant flurry of feeding and diaper changing. Plus you'll have family members and friends that will want to visit, not to mention outings for the baby to the doctor, for walks, etc. Is this something that you think you can physically handle with your level of fatigue/pain from RA? Once they get older, can you get down on the floor with them to play, or carry them around when they need attention? How about starting school, playing sports or activities with friends? Will you be able to be there for them every step of the way? These aren't things most people worry about early on, but knowing that there is no cure for RA and there may or may not be treatments that continue to work for you down the road, it's really important to look at all the possibilities the future might hold for you.
Bringing a baby into the world is a big decision. For me, it was difficult to take a real look at my current situation and my health. I realized that, in all honesty, I can barely take care of myself and I have no idea what my future holds health wise. I can't imagine bringing a beautiful bundle of joy into the world only to have to sit on the sidelines as they grew up instead of being an active part of their lives. And, since I'm not getting any younger, the likelihood of ever having my own baby is highly unlikely. But we still haven't ruled out the possibility of adoption later in life if, by some miracle, my health takes a big turn for the better. That's always another option to consider...and another article to write!
Helpful Links & Information
- Heredity & Arthritis
- Pregnancy and Parenting
- Pregnancy & RA
- OTIS Fact Sheets: Medications Safety During Pregnancy/RA
- Rheumatoid Arthritis, Pregnancy & Parenthood: An Interview with Suzie Edward May
- Chronic Illness: A Beginner's Guide to Parenting
- Moms with RA
- DisABLEd Positive Parent
- Breast Feeding & RA Drugs: What is Safe to Take?
- Parenting Choices and RA: Extended Nursing and Medication
Carrie Beth Brown is the author of the blog Dancing in the Rain.