Image by Annie Spratt from Pixabay
Embarking on motherhood is one of the most exciting times in every woman’s life. Whilst pregnancy can be fraught with ups (that first magical scan!) and downs (hello, morning sickness!), having arthritis can understandably bring additional uncertainties along the way. Many women feel at their best when pregnant whilst others might find symptoms more of a challenge. However, preparation is undoubtedly key, so read on to learn about what to expect from each of your trimesters, beginning with this article about the first trimester.
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What to expect in the second trimester
What to expect in the third trimester
What to expect in the first trimester
Many women breeze through the first few months of pregnancy, reporting no real symptoms or changes at this point, and perhaps not even realising they’re pregnant until this trimester is close to finishing! However, for some women there can be some challenging aspects that might be a little tricky to handle. For example, in some cases the first trimester is the time when morning sickness first rears its ugly head and fatigue can hit hard.
Changes in your arthritis symptoms
Once your pregnancy is confirmed, one of the key questions you’ll want to know the answer to this trimester is: will my arthritis symptoms change?
As your pregnancy progresses, you might be surprised to notice an improvement in your symptoms, as many women find the illness can go into remission due to the sudden surge of pregnancy hormones. However, this really is individual and depends on a variety of factors.
But even if you do find the first trimester a bit difficult, it doesn’t mean you’ll always feel this way. “Anecdotally, I’ve found many women do find an improvement in their condition” explains specialist midwife Lauren Kearney. “However, it tends to improve more in the second trimester. Whether you have RA or not, the first trimester is sometimes the hardest to manage because of the rapid surge of hormones but the oestrogen and progesterone then start to settle in the second trimester.”
It’s worth remembering that many women are also dealing with potential changes to medication when trying to conceive, which could be another factor in changing symptoms.
Finally, remember that every pregnancy is different too. Mum of two Natalie Gardner, who blogs about motherhood with arthritis and Crohn’s Disease over at The Spoonie Mummy, says: “My second pregnancy was hard as my arthritis flared. I was put on steroids, which I took for nearly my whole pregnancy. But my first pregnancy was great; I had to come off my medication and use painkillers if necessary, but I rarely needed them.”
Whatever changes you notice, never stop any medication without speaking to your medical team and always talk to your doctor if you feel you are flaring.
If you haven’t been taking it already, now is the time to start taking folic acid: the NHS recommends all expectant mothers take 400mg of folic acid in the first twelve weeks of their pregnancy to help protect against neural tube defects in your baby but always check with your doctor as to what is right for you.
Fatigue
Some women, arthritis aside, will find that hormonal changes can make them feel extra tired in this trimester. Unfortunately, there’s no magic solution for this, other than taking it easy and getting plenty of sleep. While rest is important, exercise is extremely beneficial to many women with arthritis, so it’s advisable to try to exercise when you feel up to it. “It’s important to keep active during pregnancy when suffering from arthritis and even gentle activities such as walking and swimming can be beneficial,” explains Consultant Rheumatologist Dr. Rod Hughes of St Peter’s and The Runnymede hospitals in Chertsey, Surrey.
Morning sickness
For some women, one potential pitfall of the first trimester is morning sickness. Whilst many might not experience it all, others might find it kicking in at around seven weeks, leaving them low on energy.
If that’s you, keeping your fluid intake up at this time is important. Some women find foods that contain ginger or using acupressure bands can help lessen the impact of morning sickness but it’s all about trying different things to see what works for you. Do let your GP and midwife know about your symptoms regardless as they can always give you the correct advice.
Test and scans
Towards the end of the first trimester, it will be time for your first round of hospital appointments. You’ll be seen by your midwife but might also be referred for consultant-led care too. “A woman with arthritis would be booked under consultant-led care initially,” explains midwife Lauren Kearney. “But providing she hasn’t conceived whilst on potentially problematic medications or has active disease, she would usually be treated like any other woman without arthritis”.
Every woman has their first antenatal scan at around 12 weeks, but your doctor will often do blood tests too. Some of these are to monitor your condition, whilst others are standard tests to monitor your pregnancy. Your midwife will be able to explain these to you in more detail.
“After their scan, pregnant women with arthritis would be reviewed by their consultant obstetrician; who would work together with her regular rheumatoid consultant to manage the RA throughout.” adds Lauren.
