Info and Tips: Autoimmune Disease and Pregnancy

Autoimmune Disease and Pregnancy

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last updated: 06.02.2024

    Can You Have a Healthy Pregnancy with Chronic Illness?

    • Complication-free pregnancies are possible for women with autoimmune diseases as well as chronic respiratory issues or heart conditions. Good medical care and practical support are essential — possibly even after delivery.
    • Pregnancy may even cause a chronic illness to improve.
    • Usually, the babies of chronically ill mothers are born healthy. Confirming which medication is safe to use is essential in early pregnancy.

    Common Chronic Health Conditions — Pregnancy Information for My Situation

    Encountering a chronic illness, disability, or recurring condition is usually exhausting and may restrict everyday life. The desire for a baby or an unexpected pregnancy may cause questions and concerns to arise: Should I have kids if I am chronically ill? Is a successful pregnancy possible? How does my chronic disease affect pregnancy? Will I be able to take care of my baby?

    According to research, 27% of pregnant women have a preexisting illness. This relatively high percentage shows that many other women have also overcome health challenges in pregnancy. Maintaining a healthy pregnancy while chronically ill is usually possible. Ask your doctor when specific questions or concerns arise. They will decide whether to monitor your pregnancy more closely — so that you and the baby can thrive.

    Click on each section for more information specific to a particular health condition.

    Your health concerns may stem from an accident or a recent illness you are still recovering from. Perhaps you had intended to be completely healed up before becoming pregnant.

    Physiologically, it can be assumed that if your body allows for conception and implantation, it is usually able to sustain the pregnancy. Sophisticated mechanisms must work together for a pregnancy to happen: If your body were not "healthy enough," your fertility level would probably be affected (which may be evidenced by the absence of menstruation). Conception would either not happen, or a very early miscarriage would take place, which would usually go unnoticed.

    Nevertheless, it is understandable and responsible to consider what to look out for and what support may be beneficial.

    Preparing for Pregnancy or Surprise Pregnancy: What Do I Do Next?

    • Unplanned Pregnancy and (Chronic) Health Condition — Tips

      You may have only recently learned about the pregnancy. Understandably, you may have been feeling upset and overwhelmed since then. Perhaps you are even debating whether to keep the baby.

      Depending on the type of disease you are battling, you may want to see your doctor as soon as possible — especially if you take medications regularly. Your prescriptions may need to be changed since some medications should be avoided during pregnancy.

      Frequently, women are asked by their doctors to discontinue taking certain medications before trying to conceive. Here, the desire is to keep the medication from entering the fetal bloodstream. Of course, this is only possible if the pregnancy is planned. However, unplanned pregnancies are common even while taking potentially harmful medications. If you find yourself in this situation, it is probably reassuring to know that embryos are not yet linked to their mother’s blood supply in early pregnancy.

      Perhaps other circumstances are weighing on you, or the timing of the pregnancy is challenging. Take the time to consider your situation from all angles. What kind of support would you find helpful right now? If you are concerned about the practical aspects of raising a child, ask your doctor for advice, join a support group, or contact a pregnancy resource center.

      • 💡 If you prefer not to talk to anyone right now, use our Solutions Finder Test to determine which steps you want to take.

    • Planning a Pregnancy while Chronically Ill — Tips:

      If you have a medical condition and desire to have a baby, gather as much information as possible to best prepare yourself.
      Contact your specialist or family physician and ask them what you need to know regarding a future pregnancy — e.g., what medications may need to be discontinued. You may even be able to build your stamina in preparation for pregnancy.
      Sometimes, women are told not to hope for it or are advised against getting pregnant. If this is your experience, it may be worth seeking a second professional opinion. You may also find it helpful to talk to a support group of moms diagnosed with the same or a similar medical condition.

    Guilt is a common emotion among women who desire a baby while dealing with a chronic disease. "Should I have a baby if I have…,” is the recurrent question that is asked because of certain social norms and expectations. They don't want to be a burden on others or have to ask for help.

    You can choose to live life to your fullest capacity — including pursuing motherhood — rather than viewing yourself as the victim of your circumstances.

    Medication in Pregnancy

    If you routinely take medications for a medical condition, you are probably wondering whether you can continue taking them during pregnancy.

    This depends on the type of medical condition you are dealing with and the active ingredients in your medication. Most drugs have been categorized for use in pregnancy:

    A — no risk
    B — no evidence of risk
    C — risk cannot be ruled out
    D — evidence of risk
    X — contraindicated in pregnancy

    Discuss the usage of medications during pregnancy as soon as possible with your doctor, since not all drugs are risk-free.

    👍 Tip: Go to MotherToBaby to determine whether your medication could have adverse effects on the baby.

    In addition, it is advisable to follow the most recent medical information. Advances in medical research continually bring new findings. Information received during a previous pregnancy may have become outdated. Therefore, it is important to consult one’s doctor anew.

    ℹ️ Some drugs have no counter-indications but deplete the body of vital nutrients, such as folic acid, which are necessary for a healthy pregnancy. Ask your doctor to check your blood for vitamin and mineral deficiencies.

    In the best-case scenario, a team of doctors will collaborate to develop an appropriate medication protocol. Your team of doctors will likely include the specialist treating your chronic condition, your obstetrician or midwife, and a maternal-fetal medicine doctor.

    In the case of epilepsy during pregnancy, finding suitable antiepileptic drugs can be a challenge. Go to The North American Antiepileptic Drug Pregnancy Registry for more guidance.

    Pregnancy Medical Care

    Most health conditions place the pregnancy in a high-risk category. This is merely a precautionary measure as it allows for closer monitoring, ensuring the prevention or early detection of possible complications.

    Closer spacing of pregnancy check-ups allows your OB/GYN to keep tabs on specific areas affected by your medical condition. If any complications arise, these could be addressed without delay for the best outcome possible.

    In addition to your pregnancy check-ups, you will probably have appointments with your specialist. This is where to address concerns regarding your health condition and pregnancy, such as physical exercise or nutrition.
    You may also be in medical or physical therapy, which would need to be adapted to your pregnancy. This could present an opportunity to ask for tips on lifestyle changes. Use your pregnancy as a catalyst for better self-care and overall health. 

    If you are employed, ask your doctor about workplace accommodations and when to take sick leave.

    Birth Preparation & Delivery

    🏥 If your condition could affect your pregnancy or possibly lead to a pre-term delivery, choose a hospital with a neonatal intensive care unit (NICU). Here, a pre-term baby would receive the best care possible, should your baby be born early.

    Pregnancy Care Tailored to Your Chronic Condition

    Your hospital care team can access your medical records, including vital medication information and other care needs. Your care plan, including the type of pain meds or possible anesthesia, would be adjusted to suit your current medication protocol. Additionally, many mothers make a birth plan, which they bring to the hospital, providing their care staff with details of additional needs and desires. This plan could be discussed with your OB/GYN beforehand.

    Vaginal Birth or Cesarean?

    A (chronic) illness is not in and of itself a reason for a Cesarean. Even though C-sections are more common, the choice always depends on the specific situation. Your OB/GYN will discuss the pros and cons and guide you through this decision.

    Some illnesses, such as MS, can cause muscle weakness or chronic fatigue, making a prolonged birth process too strenuous.

    Ask your medical provider for tips on birthing positions that best suit your needs, for example, when dealing with arthritis.

    Postpartum Support

    Your search may have led you to this page because you are concerned about the day-to-day life of raising a child while having a chronic illness. Perhaps you are wondering how to manage everyday life with a baby, how to prepare, and what support might be available.

    What could provide you with relief and make this change as easy as possible for you?

    • Childcare while at medical appointments or therapies?
    • Practical support in taking care of the newborn?
    • A cleaning service?
    • Meals?
    • Transportation?
    • Talking with other moms who have a similar medical condition?

    Depending on the illness, you may have already learned some strategies by trial and error. Some routine tasks may require much effort, but you have shown perseverance and found what works and how to thrive despite sickness.

    Where Can I Find Support?

    Organizations that focus on a specific disease often provide support groups and financial resources. Refer to our health condition chart for details.

    You can also find help at:

    I Am Still Wondering...

    Perhaps your preexisting condition was not listed here, or you still have other questions that were not addressed. Maybe you are still waiting for a specific diagnosis. Or you may not have anyone to confide in right now.

    Pregnancy may exacerbate these or other concerns.
    In our experience, however, pregnancy can also be an opportunity to gain a new perspective. Rather than focusing on hardships, it may allow you to see the good that could result from it.
    It is not uncommon for some symptoms to improve with pregnancy. This may be due in part to the hormonal changes.

    You may also be considering an abortion because of the challenging situation you are in. Allow us to be your sounding board as you discern the path you want to follow.

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    Disclaimer: While this page provides essential information and resources regarding chronic diseases and pregnancy, this information does not replace the need for instructions from a medical doctor.

    Authors & Sources

    Authors

    Verena Küpper,
    Social Scientist and Humanities Scholar

    Translation: Kerstin Dörbecker

    Checked by

    Our Team of Medical Doctors

    Sources

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