Pregnancy and Arthritis - Overcoming Difficulties

Asking the Tough Questions

Pregnant woman looks tired as she sits.
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Whether or not to have a baby is a major decision for any woman. The decision is made even more complicated if a woman has arthritis and must deal with physical pain and physical limitations. According to the University of Washington Department of Orthopaedics and Sports Medicine, you must ask yourself:

  • Am I ready to have a baby?
  • Is my arthritis well-controlled?
  • Will my child inherit arthritis?
  • Will arthritis affect my pregnancy?
  • Will pregnancy affect my arthritis?
  • How can I plan ahead and make it easier?

Am I Ready?

Since arthritis affects physical ability, strength, and endurance, it is imperative to honestly assess whether you would be able to care for a baby. A newborn is wholly dependent on others, so it is appropriate to question your capability. The Self-Test for Strength and Endurance can help assess your potential limitations:

  • Can you lift a 10 lb. bag of potatoes from the height of your bed?
  • Can you hold a 10 lb. bag of potatoes in one arm while sitting for at least 10 minutes?
  • Can you go up and down stairs easily while carrying a 10 lb. bag?
  • Can you walk around the house carrying the 10 lb. bag for up to 10 minutes?
  • Do you get increased pain in the hips, knees, or feet when carrying the 10 lb. bag?
  • Can you twist the top of a baby bottle on and off?
  • Can you get through an average day without taking a nap?
  • Can you bend your neck, chin to chest, to see the baby if you were holding it close?

    Will My Arthritis Go Away?

    Rheumatoid Arthritis

    In some cases, the symptoms of rheumatoid arthritis are relieved during pregnancy. This can occur at any time during the pregnancy. In most women, the improvement occurs by the end of the fourth month. Although joint swelling may decrease, joint pain and stiffness can still persist due to existing joint damage.

    Unfortunately, the improved symptoms do not continue after the pregnancy is over. A flare in the disease can occur approximately two to eight weeks after the baby is born.


    During pregnancy, symptoms of lupus may stay the same, improve, or get worse. Ideally, to minimize the chances of a flare, the lupus should be in remission for six months prior to becoming pregnant. The remission should be reflected in both how you feel as well as in normal blood test results.


    Research on scleroderma and other types of arthritis is not as definitive. Some studies indicate that scleroderma flares, and other studies report that it improves with pregnancy.

    Abortion / Delivery

    Having an abortion does not prevent a flare. Any type of delivery, spontaneous abortion, therapeutic abortion, or stillbirth can result in a flare of arthritis symptoms.

    Will My Child Inherit Arthritis?

    The cause of most types of arthritis is not known. Researchers have found genetic markers that may indicate whether people have a greater risk for developing certain types of arthritis.

    The relationship between these markers and the actual development of arthritis is indistinct. Having the markers does not guarantee that you will pass on the disease to your child. There is no definite way to know if your child will develop arthritis.

    Heredity is not regarded as the single factor in developing arthritis. Environment is viewed as a contributor as well. As best we know, a person may be born with a susceptibility to the disease, but it still requires something to "trigger" the disease.

    Will Arthritis Affect My Pregnancy?

    In most women, the actual course of pregnancy is not affected by arthritis. However, individuals with rheumatoid arthritis have a statistically greater chance of premature births and neonatal complications. There is a greater chance of miscarriage and a small possibility of congenital abnormalities.

    The types of arthritis that affect internal organs (i.e., systemic effects of arthritis) may cause problems during pregnancy. Pregnancy can be life-threatening for women who have lupus, scleroderma, or other rheumatic diseases, especially if the disease has caused kidney problems or high blood pressure.

    If the rib joints are affected by arthritis, the pregnancy may be uncomfortable because it is more difficult to breathe abdominally. If the hips have been affected by arthritis, it may complicate normal delivery and a Cesarean section may be necessary. If lungs are affected, more shortness of breath may be experienced.

    Will Pregnancy Affect My Arthritis?

    The joints and muscles may be affected by the physical changes that occur during pregnancy. Problems with weightbearing joints (hips, knees, ankles, and feet) may become worse due to increased weight. Muscle spasms in the back may occur because as the uterus grows, the spine curves slightly to support it. This can also sometimes cause pain, numbness, and tingling in the legs.

    If there is any problem with pericarditis (inflammation of the sac around the heart) or with myocarditis (inflammation of the heart muscle), pregnancy would further complicate the problem. Blood flow through the body is increased during pregnancy, so it is important for heart function to be normal.

    Arthritis Medications and Pregnancy

    It would be optimal to be off all medications during pregnancy, but this is not always possible. If medication must be continued, some medications are considered more safe than others. Aspirin has been used by many women during pregnancy without any damage to the fetus. Gold and prednisone also have been used during pregnancy, but should be avoided if possible. Generally-speaking, immunosuppressive drugs, also called DMARDs, should be avoided during pregnancy.

    Whether or not to stop medications is a decision that must be based on your doctor's advice. Some medications can be stopped abruptly, but a flare up may result from their discontinued use.

    Planning Ahead for Pregnancy

    Open Communication

    All points of concern should be brought into open discussion between husband and wife, doctor, obstetrician, and rheumatologist. In most cases, pregnancy should not be a problem at all, especially if the disease is mild.

    Arthritis Medications

    Know whether or not the arthritis medication you currently take is safe to continue. This includes over-the-counter drugs, herbs, and dietary supplements.


    Participate in regular exercise to maintain muscle strength and joint flexibility.

    Diet / Nutrition

    Eat a balanced diet and maintain good nutrition.

    Joint Protection

    Learn how to protect your joints from stress and strain.

    Stress Management

    Adopt stress management techniques. Stress can affect arthritis.

    More Information About Pregnancy/Birth


    Coping With Rheumatoid Arthritis, Robert H. Phillips, Ph.D.

    Pregnancy and Arthritis, University of Washington Department of Orthopaedics and Sports Medicine.

    Rheumatoid Arthritis and Pregnancy: Beyond the Basics. Up-To-Date. Bonnie L. Bermas, M.D. Reviewed 04/2016.

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