Lupus & Your Pregnancy
It used to be thought that becoming pregnant while having lupus was a bad idea. We now know that women with lupus are perfectly capable of having normal pregnancies as well as delivering healthy, normal babies.
The Necessity of Planning
Before becoming pregnant you should talk with your doctor about your lupus condition. You can greatly reduce the risk of pregnancy complications if you lupus is under tight control or in remission. It is also important to keep your lupus under control throughout your pregnancy to protect the developing fetus. Pregnancies in lupus patients are considered high-risk. Women with lupus have a greater chance of miscarriage, preeclampsia, gestational diabetes, and pre-term birth. It is therefore very important to make sure your obstetrician is experienced with high-risk pregnancies, specifically those of lupus patients if possible. It is also important to find a hospital that specializes in high-risk deliveries, requiring special facilities to care for both mother and baby. Other things to think about include medical insurance. Pregnancies and the medical care they require can be expensive, and potentially even more so if you have lupus. Talk with your doctor about the possible complications that can arise and whether or not your insurance company will cover them.
Care During Your Pregnancy
The importance of preventing lupus flares is just as important during pregnancy as it is when you're not pregnant. While flares are not directly caused by pregnancy, the stress that often comes along with being pregnant can trigger this sudden onset of symptoms. It's essential to maintain a balanced diet, get plenty of sleep, and practice de-stressing exercises like meditation and deep breathing to keep your immune system healthy and your lupus flares at a minimum.
Although most pregnant women with lupus will have a perfectly normal pregnancy, it's good to know the complications that can arise. About 25% of lupus pregnancies end in miscarriage, as opposed to the normal 10-15%. Women with lupus are also more likely to deliver prematurely, occurring in about 25% of cases. Fortunately, premature birth is fairly common even in normal cases and can be cared for with much success. Another complication unique to those with lupus is delivering a baby with neonatal lupus. This condition consists of a temporary rash, abnormal blood counts, and in 50% of cases a congenital heart defect. Neonatal lupus most often clears in 3-6 months after birth. Heart defects, while permanent, can be treated with a pacemaker.
The Postpartum Period
It's also a good idea to consider the months after pregnancy, or the postpartum period. Caring for an infant can be incredibly tiring, especially for those with lupus. It's very possible that you won't feel up to caring for a newborn every day. Be sure to arrange plans for alternate care (spouse, relative, friend) before the baby arrives for those days you need to take care of yourself. Pregnancy and birth should be joyous occasions and now they can be for those with lupus with proper planning and treatment.