Pregnancy is such an incredible journey. Every week, exciting new things take place within your body and developing baby. It’s truly an awe-inspiring experience to go through! Thankfully, the majority of pregnancy is the same for all moms, regardless of a pre-existing condition or risk status. All of the enjoyable aspects of pregnancy – maternity clothes, baby showers, and nursery planning – are very much part of the journey. For autoimmune moms, the biggest difference comes from the level of care, frequency of prenatal tests, and self-monitoring symptoms, in order to prevent a flare-up.
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Autoimmune Disease & Pregnancy
Will pregnancy exacerbate my condition?
There is no standard answer to how your body will respond during pregnancy. Some factors include the type of disease(s) you are dealing with, the timeframe since the onset of the disease, how well it was managed prior to pregnancy, and the level of care received throughout. While some research has identified certain conditions as more problematic throughout pregnancy, it is really a case-by-case basis. Likewise, two different pregnancies can result in different experiences for the same mother.
Are moms with autoimmune diseases at greater risk for complications?
Researchers have found that women with autoimmune diseases are more likely to experience pregnancy complications. That said, many autoimmune moms experience complication-free pregnancies and deliveries. Each pregnancy is unique, making it impossible to predict who will and will not experience complications. Because of this, additional monitoring and preventative measures are utilized throughout pregnancy. These include:
- Additional ultrasounds to ensure the proper development of baby.
- More frequent blood draws to test antibody and inflammation levels.
- Medication adjustments and changes throughout pregnancy.
- Increased monitoring for early signs of preeclampsia or other complications.
Often, moms with autoimmune diseases are also considered “high risk,” due to the unpredictable nature of a given disorder. Being classified as “high risk” does not eliminate the possibility of a vaginal delivery, as many mothers initially assume. Rather, early intervention is utilized to minimize the risk to mother or baby. Your care provider can share more information on your unique situation in the context of pregnancy and delivery.
Do autoimmune diseases affect infant outcomes?
When unmanaged or mismanaged, autoimmune diseases can greatly impact infant outcomes during and following pregnancy. Lupus, rheumatic diseases, Antiphospholipid Syndrome, and autoimmune thyroid diseases are especially known to impact baby’s health. That said, many mothers with these conditions have experienced healthy pregnancy and delivered healthy babies with no complications. If you have any concerns about the wellbeing of your baby, please speak with your care provider, specialist, and pediatrician to better understand prevention and risks.
Is the postpartum recovery more difficult?
Due to the significant drop in estrogen following delivery, it is common for moms to experience a flare-up of an autoimmune disorder during the postpartum period. Hormone levels balance out around three months postpartum, but extra care should be taken during that time frame to monitor blood levels and medication dosage.
Listen to Your Body
Now, more than ever, it is important to pay attention to the signals your body is sending. It’s easy to assume that a feeling or an ache is merely a part of being pregnant. After all, pregnancy changes within the body can cause a host of odd symptoms for every expectant mother, not just those with a compromised system. But unlike a healthy mother, thinking that minor discomforts will just go away is a recipe for disaster.
Pay attention to the pre-flare symptoms.
Little, annoying symptoms are often the first indicators that the body is struggling. For autoimmune moms, it doesn’t take long for things to progress from a nuisance to debilitating. Monitoring changes in your physical or mental function and recording any symptoms that are especially prevalent before a prenatal flare are vital for avoiding total-body burnout.
For some moms, the symptoms that precede a prenatal flare-up are different or more exaggerated than what is experienced during non-pregnant times. Knowing this, be sure to pay attention to all symptoms, not merely the ones you typically experience.
Take Prenatal Movement Recommendations with a Grain of Salt
For healthy, low-risk mothers, thirty minutes of exercise five days a week is recommended. Studies have shown that staying active during pregnancy provides a host of benefits, ranging from lower weight gain and increased blood sugar regulation to shorter labors and easier recoveries. While this is all well and good, we have to remember the population utilized when acquiring this data: healthy moms.
Women with autoimmune diseases must seek out fitness recommendations and workouts that are compatible with their unique limitations. Too frequent or too strenuous workouts can deplete the body’s precious energy stores. By figuring out your body’s unique tolerance for exercise, you can minimize flareups and debilitating episodes of fatigue.
Pay attention to how you feel while working out and don’t be surprised if you discover that your prenatal exercise tolerance is less than before.
Sleep is crucial for everyone, but even more important when dealing with compromised health. By establishing consistent sleep and rest routines, you can ensure that your body can effectively recover from the daily challenges of pregnancy.
A great rule of thumb, taught by Dr. Ben Lynch, is to be in bed and asleep by 10:30 pm and sleeping until at least 6:30 am. For those who struggle to fall asleep, it is helpful to set aside a few hours prior to bedtime to start winding down. Focus on limiting activities that cause eye and brain stimulation. On days you feel especially worn out, set aside extra time to sleep and rest.
Additionally, give yourself grace on days you are tired. Stick to a strict sleep/rest schedule, but be open to increasing your allotted sleep/resting time on days your body feels worn out.
Emphasize High-Quality Nutrition
Food can be a source of immune stimulation, leading to more frequent or intense flares. Carefully select nutrient-dense foods that are easy to digest and autoimmune-friendly. This alleviates any added burden food may pose on your body.
If you weren’t following a dietary protocol to manage symptoms prior to pregnancy, it is worthwhile to transition to one now. Several dietary frameworks effectively manage autoimmune conditions, the latter two showing the most improvements in all autoimmune conditions:
Know that it can take six weeks before you see any improvements in your symptoms. So, don’t give up if you are still struggling after just a few weeks. Also, be aware that cheating will backtrack any improvements and prolong the time frame to assess a diet’s effectiveness. Cross-contamination is another serious problem that undermines therapeutic diets. Be intentional to avoid ingesting even minute particles of off-limits foods.
Though not specifically geared toward autoimmune disease, Lily Nichol’s Real Food for Pregnancy and Nina Planck’s Real Food for Mom and Baby are excellent resources to support you as you navigate nutrient-dense foods for pregnancy.
Carefully Select Your Prenatal
One unsuspecting source of autoimmune flares is supplements. Due to poor regulation of supplement manufacturing, supplements can contain any number of harmful ingredients or fillers, including immune-stimulating heavy metals. Additionally, there is no guarantee that the label is an accurate picture of a supplement’s ingredients. Because of this, it is extremely important to select a prenatal vitamin from a reputable company.
Maximize the benefits of your prenatal vitamin by selecting one that utilizes natural, as opposed to synthetic, forms. (I share a list of my favorite options here.) Just be sure to check with your primary care to confirm that your vitamin is suitable for your autoimmune condition.
Important Notes on Prenatal Flare-Ups
Some aspects of prenatal flare-ups are unique to pregnancy, alone. The rapid changes – including hormone levels, blood volume, uterus size, and immune function – put added stress on an already taxed body. While some autoimmune moms find their systems temporarily correct, others discover a surge in symptoms as the body struggles to adapt. For moms in the latter category, the symptoms may even increase as the pregnancy progresses, but should normalize within a few months following delivery.
Likewise, due to the surge of energy in the second trimester, it is easy to do too much only to experience a severe flare-up. Recovering from these flares can be a task. With so many resources directed toward growing a healthy baby, few reserves are available to restore your body when it is run down. This makes high-quality nutrition, as discussed above, and recovery protocols extremely important.
Come to Appointments Prepared to Recap the Previous Days/Weeks
Be diligent to keep your care provider informed of any new or recurring symptoms. While you may feel redundant or needy bringing a list to every appointment, this information will help your provider intervene early, should a problem arise.
Track Your Symptoms
The easiest way to track new and recurring symptoms is to keep a daily log. Simply jot down any symptoms that you notice along with severity and duration. You can take this a step further by logging what you eat along with summaries of your workouts and mental state during the day.
Tracking your symptoms will also help you to begin identifying patterns that signal flare-ups. Once you know what to watch out for, you can modify your activities and/or introduce protocols to calm the flare before it really gets started.
Schedule Regular Appointments with Your Specialist
If you were seeing a specialist prior to pregnancy, continue scheduling appointments as your pregnancy progresses. While your OB is skilled in the intricacies of pregnancy, he/she is likely not intimately familiar with your condition. By continuing to see both providers, you can ensure more thorough care as your pregnancy progresses.
Be sure to present your specialist with a copy of your symptom log at each visit. He/she may identify red flags that your OB overlooks.
Even with the best prevention, occasional flare-ups will happen. Having a plan in place to temporarily hand off responsibilities and speed up recovery is essential. Not sure how to organize your recovery plan? I put together a simple worksheet to streamline planning. Gain access by signing up below.