When I was younger, I always knew that I wanted to have children. I grew up in a family of four girls and my best friend was from a family of six kids! My entire life, I was always surrounded by kids and it just made sense that I would have a big family of my own.
I met my husband right out of high school - I was 17 and he was 19 years old. We fell in love immediately and moved in together as soon as I turned 18. Since we were so young, we decided to live together for a long time before getting married. We lived together for nine years, and then once we decided that we were ready to start a family we planned on getting married. We had set the date for August 2, 1997. Four months before our wedding date, I was diagnosed with Rheumatoid Arthritis. What luck! At the time, though, I really wasn’t having any major symptoms other than a few swollen knuckles. Luckily, I made it through the wedding and we headed off to our honeymoon in Hawaii for two weeks. Throughout the first week I was fine. The second week I began to have some serious swelling in my hands and legs, but I wanted to stay for the entire trip.
The day after we returned home, I couldn’t get out of bed. It was as if my body just wouldn’t move. That was the beginning of our RA journey. At that time I was only 27, and I figured we had plenty of time to have a family. I was still naïve as to how my RA would affect pregnancy. Unfortunately, I became very ill and for many years our main focus was my condition. We had to put children on the back burner and really focus on my health. When we decided to really think about starting a family we met with my doctors and talked to others about how this would affect my health. I was already very limited as to what I could do – I couldn’t lift anything heavy, I was in constant pain and the fatigue was overwhelming. My husband, who is the most supportive, loving and amazing man had serious concerns for me. How on earth would I be able to care for a baby?
When I looked into finding out how pregnancy affects RA, I read that most women reported going into “remission” during their pregnancy. Basically, all of their symptoms would disappear throughout the pregnancy and awhile after giving birth. Although this was encouraging, it was also concerning because when the RA came back, the symptoms would be worse. Nobody knows why women with RA go into remission during pregnancy. Studies have shown that female sex hormones play a large part in easing RA during pregnancy. It has been shown that the number of regulatory T cells expands substantially to prevent the rejection of the fetus. The expansion of these T cells appears to be driven by the elevated hormone levels associated with pregnancy. So what ends up happening is the immune system becomes less active instead of overactive as with RA. Unfortunately, once birth has occurred, the hormone levels drop and the symptoms of RA return, sometimes even greater than before. Current studies involve looking at the change that occurs in the cells during pregnancy and trying to find a way to mimic those changes.
Another concern when thinking of getting pregnant is medications. We have all been privy to the latest and greatest treatments for RA such as Enbrel, Remicade and Humira, but do we really know the long term affects of these medications? For me personally, I have more questions than answers. I’m sure that all of us who suffer from RA and want children have the same concerns. The most important thing you can do is talk to your doctors. The Arthritis Foundation also hosts speakers that cover a wide range of topics including pregnancy. There is an endless amount of information available and a lot of opinions on the topic. I am 36 years old and feel as though my clock is ticking. I want to make the best decision possible for all involved. My health is obviously the first issue as well as my potential childrens’ health. I also need to make sure that I can care for a baby and provide a safe environment for him or her. These are all real issues and not something to take lightly. I am considering all of my options and hopefully will be able to make the best decision for myself and my family.
Have you gone through a pregnancy with RA? Share your story in the message boards.
Published On: November 16, 2006