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How to Balance Chronic Disease and Pregnancy

It’s natural for pregnant mothers to worry about their safety and that of their unborn child, and this may be even more true for women living with chronic conditions. However, there are steps you can take to reduce risk.

Key Takeaways

  • Every pregnant woman wants a safe and healthy pregnancy
  • Pregnant women with chronic conditions are at a higher risk of pregnancy-related complications
  • Some medications that are used to manage chronic conditions are not safe for pregnancy
  • With the proper management, pregnant women with chronic conditions can have a safe and healthy pregnancy
  • Team effort between the pregnant woman and the health care team is critical to ensure a safe pregnancy and delivery

For many women, pregnancy is a time of great joy and anticipation. At the same time, though, the journey can be fraught with great risk. Pregnant women with chronic conditions are at an increased risk of developing pregnancy-related complications.

Although it is natural to be concerned about having a healthy pregnancy if you suffer from a chronic health condition, with the proper management and medications the chance of having a healthy pregnancy and birth and greatly increased.

With continued advancements in medicine and obstetrics, safe and healthy pregnancies are more likely than ever. In fact, data reveal that maternal mortalities (deaths related to childbirth and pregnancy) declined significantly from 2000 to 2017. With proper management, medication, and nutrition, women with chronic conditions can maximize their likelihood of having a healthy and safe pregnancy and childbirth.

Here is something important to bear in mind: Your body does a great job of taking care of your baby during pregnancy. However, if you have a chronic health condition, you will need additional support from your health care providers throughout your pregnancy and even after delivery.

This article describes the chronic medical conditions that may put you at risk of pregnancy complications and shows you how to avoid such risks and improve your pregnancy outcomes.

What is a chronic health condition?

A chronic health condition requires medical care for a period exceeding one year and can be debilitating in the long run. It is also referred to as a chronic disease or chronic illness.

Chronic conditions that can put you at risk while pregnant are:

Autoimmune diseases

Autoimmune diseases cause antibodies in your body to attack healthy tissues. They include inflammatory bowel syndrome (IBS), lupus, multiple sclerosis (MS), ankylosing spondylitis, and rheumatoid arthritis, among others.

Thyroid conditions

Thyroid diseases and conditions affect the balance of hormones, which can put your pregnancy at risk.

Asthma

Steroids used to treat asthma can affect your baby’s health.

High blood pressure and heart disease

High blood pressure and heart disease are high risk factors for pregnancy complications. Hypertension in pregnancy is known as eclampsia, which is one of the leading causes of maternal deaths. Fortunately, it can be managed with anti-hypertensive medication.

HIV

HIV lowers the immunity of the pregnant mother and exposes her and her child to a host of opportunistic infections. There is also the risk of passing HIV on to the unborn child if preventive measures are not taken.

Diabetes

Diabetes mellitus increases a woman’s predisposition to maternal complications such as hypertension, gestational diabetes, and preeclampsia (high blood pressure with protein in the urine). These complications often necessitate C-sections.

Mental health conditions

The drugs to manage some mental conditions, such as bipolar disorder and clinical depression, could harm the growing baby.

The health of your pregnancy can be affected by these conditions or by the treatments prescribed for them. However, hope is not lost. Much can be done to ensure pregnant women with chronic conditions can have a healthy pregnancy and good birth outcomes. If you are concerned, speak to your primary care provider or request a referral to a psychiatry specialist.

How to plan for pregnancy if you have a chronic condition

If you have one or more chronic conditions, there are several things you should do as you prepare for pregnancy. Taking the following steps will help relieve your anxiety, give you peace of mind, and minimize any risks of pregnancy-related complications.

To ensure your condition is managed in the best possible way during pregnancy, you need to assemble a team of health care providers who will work together to provide you with all-around care. This team should be familiar with your condition and get you on the right management plan and medication before conception. The team of healthcare professionals should include:

  • Your prenatal care provider
  • The health care provider who manages and treats your chronic condition

Once you have conceived, you will need to add a health care practitioner who will be in charge of the baby’s health. Here are a few critical things you should do as you plan for the pregnancy and safe delivery of your baby.

Talk to your health care providers about the best time to get pregnant

This team will assess your health and any pre-existing conditions and recommend the best timing for your pregnancy. They may require you to lose weight, boost your blood level, or anything else they deem necessary for a safe pregnancy.

Timing is also important if you have a condition that has flare-ups, such as autoimmune diseases. Ideally, you should avoid getting pregnant when your disease has flared up or when taking new medication or treatments that could harm the baby.

Get your condition under control with the help of your health care providers

Conditions such as diabetes and hypertension should be controlled before becoming pregnant to ensure you experience a much healthier pregnancy. Adhering to your medication while monitoring your sugar and blood pressure is vital, and extra measures such as a change in diet and exercising regularly may also be necessary.

Ask your health care providers to adjust your drugs to safer options for you and your baby

Many drugs used to manage chronic conditions can harm your baby and cause preterm birth or birth defects. Your health care provider should advise you of alternative medications that are safe during pregnancy and can give you the best chance of avoiding preterm delivery or pregnancy complications.

Remain on medication and constant observation throughout your pregnancy

Chronic conditions such as cardiovascular disease, hypertension and thyroid disorders are likely to flare up during pregnancy. It is important to maintain close observation and have your medication adjusted accordingly throughout the pregnancy.

Make a postpartum health care plan

Even after you deliver, you will need to be on observation and medication. Some medications can be passed on to the baby through breastfeeding. Mothers living with HIV may also be advised to breastfeed exclusively for up to three months and stop at once, or avoid it altogether. These concerns should be planned for with your obstetricians and health care providers before delivery.

Final note

While it is true that chronic conditions increase the risk for pregnancy-related complications, there is a lot that can be done to guarantee a safe and healthy pregnancy and childbirth.

Pregnant women with chronic conditions will need to work closely with the health care team from preconception to delivery and beyond. The importance of appropriate medication to manage the chronic condition cannot be overstated.

What about the escalating costs of medication to manage chronic conditions?

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