how to plan for a safe, healthy pregnancy with a chronic inflammatory condition

it used to be considered implausible or unsafe for a woman with a chronic inflammatory disease to start a family. now, such an endeavour is more viable than ever before. but this newfound confidence poses a new set of risks for both mother and child, as not all women are involving their specialists in family planning early on.chronic inflammatory disease (cid) is a group of life-long conditions, including psoriasis, rheumatoid arthritis, and ankylosing spondylitis, affecting about 7 percent of the population. as cid cannot be cured, it can take an enormous toll on one’s mental health and wellbeing if poorly managed.rheumatologist, dr. maeve gamble counsels many women with cid, prior to and during pregnancy. “of course, there are physical symptoms, like stiffness, pain, and swelling,” she says. “but there is also the emotional burden of having a chronic disease that women with cid are faced with.”the anxieties of living with a chronic inflammatory disease increase tenfold when a woman decides to start a family. this was true for leah timmermann, who recently became a mother. “i was cautious about how cid may affect my pregnancy in case it put additional strain on my body,” she recalls. a woman entering into motherhood should consider:

• what the implications of poorly controlled cid might be for the baby,
• whether her cid medication is safe to take while pregnant, and
• if pregnancy may cause a cid flare-up.

“women with active inflammation may have worse pregnancy outcomes, such as an increased risk of miscarriage, pre-term delivery, or low birth weight,” explains gamble. “cid can also worsen following pregnancy. for example, up to 90 percent of women with some forms of inflammatory arthritis can experience a flare after birth.”

many of these risks could be avoided if women were to involve their cid specialist early on in the family planning process. for timmermann, the discussion with her rheumatologist about starting a family only began at week 12 of her pregnancy. “i only saw my specialist once every six months. but a lot can change in that time,” she says.with around half of all pregnancies unplanned, even if you’re not planning on starting a family soon, it’s a good idea to ask your specialist if your cid medication is safe to take during pregnancy and be on contraception if it’s considered unsafe.so, how can women with cid feel empowered to have these conversations sooner rather than later?according to timmermann, women are more likely to discuss family planning if their specialist creates a safe, comfortable environment for them. gamble makes a considerable effort to foster open conversation with her cid patients but stresses that it’s a two-way street. “women need to be proactive about starting this dialogue,” she says. “the patient needs to advocate for their own health, and the specialist needs to educate the patient on why it’s important for them to know about family planning. it’s really a collaborative effort.”gamble believes women need reassurance that, nowadays, there are plenty of cid treatment options safe for pregnancy and breastfeeding – it’s just a matter of knowing your options. “healthy babies are born to healthy mothers. women should consider their long-term plan to ensure their therapy allows for a healthy pregnancy,” explains gamble. “the possibility of adjusting one’s meds to reduce associated risks shouldn’t be considered a barrier to getting pregnant.”“it was challenging to have to change my cid medication during pregnancy, but i wanted to keep both myself and my baby safe,” shares timmermann.if you’re a woman looking to start a family, or there’s a possibility you may become pregnant, it’s important to be open with your specialist and start a dialogue early on. this is a great way to maximize your chances of a successful, healthy pregnancy and minimize stress or anxiety. “try to enlist supportive people, including your specialist, before attempting to get pregnant,” advises timmermann. “i know my rheumatologist would have responded favourably if i’d raised the topic sooner.”for women hesitant to initiate these important conversations or who want to prepare accordingly, useful online resources, such as advantage hers, offer information and tools to empower women with cid. wendy gerhart, executive director of the canadian spondylitis association, encourages women to become aware of all available options. “it’s a promising and hopeful time for women with cid who are having or planning to have children,” she says. “there are safe and effective treatment options available in canada.”if you’re pregnant or would like to start a family, talk to your cid specialist as soon as possible. the sooner you begin working together, the better your chances of having a safe and healthy pregnancy.the canadian spondylitis association (csa) is one of many organizations dedicated to supporting women with cid who wish to start a family. wendy gerhart, executive director of the csa, encourages women to become aware of all available options.disclaimer: this story was created by content works, postmedia’s commercial content division, on behalf of ucb canada.