Risk management: choosing between treatment and pregnancy
Despite poor evidence, the guidelines were clear. If I wanted to get pregnant, I would need to come off all treatment.
I was extremely anxious about the prospect of pausing treatment during pregnancy. Of course I wanted to put my baby’s health first, but I was concerned about the risk to my own health and ability to cope during pregnancy. Research shows that the discontinuation of AS treatment during pregnancy often leads to disease flares, and my consultant was also unclear about whether the treatment would be as effective once I resumed it after I had given birth.
Once I had become pregnant, I decided to transfer my care to a specialist hospital that had a joined-up multidisciplinary clinic led by both rheumatologists and obstetricians. During my 20-week check-up, my new team of consultants told me that it would, in fact, be possible to continue treatment throughout pregnancy as I still showed active disease levels. They explained that treatment decisions are often at the discretion of the consultant, and many pregnant women do continue with their medication.
At this point, I felt extremely frustrated about the conflicting advice I had received. I was then faced with another difficult decision about whether to remain on the treatment and prioritise my own health, possibly at the expense of my future child’s health. After some lengthy discussions with my healthcare team, husband and family, I decided to continue the treatment.
Throughout my pregnancy, I remained healthy and fit with low levels of disease activity. In late 2019, I gave birth to our daughter. She is now a thriving and active seven-month-old, with no health issues.