Each year rheumatoid arthritis affects 1 in 1,000 pregnant women. Telltale signs include painful, red, swollen joints (fingers are often the first to be affected), accompanied by a feeling of stiffness and fatigue, particularly in the morning. Rheumatoid arthritis is an autoimmune disease, in which the immune system mistakenly attacks the body's joints. If you have this condition, you're just as likely as unaffected women to have a healthy baby. In fact, another nugget of good news is that during pregnancy, your symptoms may get better, or even disappear. Seventy-five percent of affected women experience relief during pregnancy, though doctors don't know why. Less pain may mean less medication -- which is good for you and baby. But it's still important to consult your doctor to discuss treatment options.
While there are a number of arthritis medications that are safe to take during pregnancy, there are some that can be dangerous. You may not need to take any pain medication during pregnancy, but if you choose to, your doctor may recommend acetaminophen (such as Tylenol), which is considered safe for you and your baby. Nonsteroidal anti-inflammatory medications (ibuprofen, naproxen, and others) may also be recommended early in pregnancy, but not later because they can increase the risk of a heart problem in your unborn baby. If you fail to find relief with these options, your doctor may suggest prednisone, a steroid medication. Certain cancer medications (such as methotrexate) and antimalarial drugs that can be used to treat rheumatoid arthritis may also increase your risk of miscarriage and birth defects.
Rheumatoid arthritis shouldn't affect your labor and delivery. But it's still important to discuss any joint limitations you may have with your healthcare provider so she can help you find comfortable labor positions.
A few months after baby's birth, old symptoms are likely to flare up and you may need to resume your medication. If you choose to breastfeed, remember to discuss with your pediatrician which options are safest for baby.