If you are considering pregnancy while managing ankylosing spondylitis, you may have a lot of questions, such as will you have the typical back pain that most pregnant women have, or will your A.S. make it worse? You might also wonder if any effects the disease has on your sacroiliac joints where the spine meets the pelvis, will prevent you from pushing during labor?
The good news is while you may have decisions to make regarding ankylosing spondylitis and labor, by working closely with all of your doctors you should be able to enjoy this special time in your life.
Dr. Keith Eddleman, the director of obstetrics at Mount Sainai Medical Center in New York City says there is a fair amount of evidence that A.S. doesn’t affect the health of the baby, nor does it routinely affect a woman’s fertility, or ability to become pregnant. He states, “During pregnancy, one-third of women with A.S. will notice some improvement in their pain and stiffness, one-third will stay the same, and one-third will have more involvement.
One thing to consider is you may not be able to take some of your A.S. pain meds while pregnant or nursing because of potentially harmful effects on the baby. That’s an important discussion you will have to have with your doctors, so that appropriate changes to your treatment regimen can be made.
According to the Spondylitis Association of America, women who have A.S. can carry to term and deliver healthy babies, but they may find some differences when they go into labor, and then delivery. For example, if inflammation has caused a woman’s spine to fuse into a fixed position, having a epidural, the anesthetic that blocks pain in the lower spine, may not be possible. According to Dr. Melvyn A. Harrington, Jr., an associate professor of orthopedic surgery at Baylor College of Medicine in Houston, “We just can’t physically get the needle in there, so [a woman] may need a general anesthesia or sedation.” Dr. Eddleman, however, states that inflammation in the sacroiliac joints doesn’t preclude a woman from getting an epidural, suggests consulting with an anesthesiologist before childbirth to have a plan in place. In addition, consulting with the obstetrician and rheumatologist will help women with A.S. have healthy pregnancies.