Planning to become a parent

There comes a time in many people’s lives when the desire/hope/dream of becoming a parent takes hold. This is an exciting and anxious time for any person, but it can be made more challenging and stressful if you, or your partner, have a musculoskeletal condition.

However, by working closely with your healthcare team and planning your pregnancy, you’ll be in the best position to have a safe pregnancy and a healthy baby.

General planning

Having a baby doesn’t happen in a vacuum. There are many considerations you need to take into account before becoming pregnant. The sooner you do this, the better.

Pre-pregnancy health checks.

Let’s put the musculoskeletal elephant in the room aside 🐘 🐘 for now. Potential parents should discuss many other things with their doctor to ensure they’re the healthiest they can be before conceiving. Some relate specifically to the person becoming pregnant, while others involve both parents-to-be. They may include:

• Beginning folic and iodine supplements. Both are essential for your baby to grow and develop.
• Other supplements may be necessary if you’re deficient or need help getting the essential vitamins and minerals through your diet. It’s important you discuss this with your doctor before taking any additional supplements.
• Cervical screening.
• Sexually transmissible infections (STI) screening.
• Addressing lifestyle factors such as diet, exercise, smoking, alcohol and illicit drug use.
• Having a dental check-up.
• If you have a mental health condition, discuss how your pregnancy may affect your mental health and how you can manage this.
• Ensuring your vaccinations are up-to-date.

Consider the cost.

The ugly truth is that having a baby is expensive – from medical and health bills to maternity and baby clothing, nappies, car seat, baby furniture, supplements, breast pumps, and formula 🍼👶. And there are many ongoing and future costs that you need to be ready for – food, healthcare, clothes, school costs, childcare, transport, shoes, and social and sporting activities 🛴🤸. Being prepared means that you can save and look at ways to budget for future costs. This Moneysmart article, ‘Having a baby: Budgeting for the costs of a baby’, has information, links and a budget planner to help you understand some of the costs you need to plan for.

Which brings us to work.

How long you and/or your partner choose to take for parental leave before and after the birth of your baby is an individual thing. Factors such as finances, your job/workplace, available leave etc., will impact this timing. Planning for this before you have a baby is a good idea.

Baby furniture, equipment and other doo-dads.

Preparing your home for a baby is important to ensure you and your baby are comfortable and safe. But there’s a big industry around baby bits and bobs. Raising Children Network has a very handy new baby checklist to help you prepare, including what’s essential and how to save money. Also, check out this ABC article, ‘Having a baby on a budget: What items can you buy second-hand?’ for more tips.

Family planning and musculoskeletal conditions

People with musculoskeletal conditions can and do have safe pregnancies and healthy babies. But the planning is even more critical.

The first step is to gather your support team.

Talk with your GP and rheumatologist about your plans. The best time to become pregnant is when your condition is well-managed and controlled. If your condition is active or flaring, it can harm you and your baby. By talking with your rheumatologist, you can develop a treatment plan to get your condition under control before you conceive.

You’ll also see a midwife or obstetrician.

A midwife is a health professional trained to provide support and care during your pregnancy, labour and birth. They’ll also provide you with support in the weeks after you have your baby. An obstetrician is a doctor trained to provide medical care during these times and has the skills to manage complex or high-risk pregnancies and births. Whether you see a midwife, obstetrician, GP, or a combination depends on where you plan to give birth and your health needs.

You may see a physiotherapist and/or occupational therapist if needed. Physios use strategies such as exercise, massage, heat and cold, and education to help keep you moving and functioning as well as possible. An OT can help you learn better ways to do everyday activities and can provide information on aids and equipment to make tasks easier.

Both can help you learn to manage your musculoskeletal condition and the changes your body is experiencing through pregnancy. They can also help you manage after birth.

Other vital members of your support team will be your partner, family and/or friends 💜💚💛.

Fertility

Having a musculoskeletal condition generally doesn’t affect fertility. Some studies have shown that women with rheumatoid arthritis may take longer to conceive; however, it’s unclear if this is related to the condition, medicines, or other factors.

Men with musculoskeletal conditions may find that some medicines affect their sperm count; however, this can often be reversed with a change of medicines.

If you want to conceive, or you’re having problems conceiving, discuss this with your doctor.

Medicines

The use of medicines for most musculoskeletal conditions is a necessity. Active or flaring disease is harmful to both the mother and the baby, so continuing to take your medicines while trying to conceive and during pregnancy is vital.

However, some medicines aren’t recommended during this time. They need to be replaced with safer or ‘pregnancy-compatible’ medicines. You may also need to stop taking some medicines for several months before trying to get pregnant.

This will depend on the medicines you or your partner are taking. Your doctors will help you understand and plan for this to ensure the least pain and disruption, and ensure safer outcomes for all.

The Australian Rheumatology Association has developed a resource, ‘Medications and pregnancy: Information for women and men with rheumatoid arthritis thinking about starting a family’, which goes through many medicines used for treating musculoskeletal conditions. This is a great guide to help you during your discussions with your healthcare team as you plan your pregnancy.

It’s important to understand that some medicines can’t be stopped immediately. So although you may want to become pregnant quickly, to protect the health of the person taking these medicines, as well as future babies, it’s critical that you follow the advice of your healthcare team.

You may also need to use contraception until it’s safe to conceive.

Self-care

The journey to parenthood is full of ups and downs. When you add a painful, chronic condition, it’s even more challenging. So taking time during the pregnancy planning stage to look after yourself is essential. That includes all the usual self-care strategies – exercising regularly, eating a healthy diet, getting good quality sleep, and looking after your mental health.

Lupus

Most women with lupus can have children. However, there’s an increased risk of complications. Again, that’s why planning your pregnancy for when your condition is well-managed and less active, and working closely with your healthcare team, is best for you and the baby. You’ll likely need blood tests before you conceive to check for the anti-Ro and antiphospholipid antibodies that may affect a baby. This would require more frequent fetal monitoring.

Other ways to become a parent

If you can’t become a parent biologically for whatever reason, there are other ways to become one. They include:

• Adoption
• Fostering
• Surrogacy.

While these options may not be what you’d initially dreamed or planned, they provide other choices for many people and may be worth exploring.

Contact our free national Help Line

Call our nurses if you have questions about managing your pain, musculoskeletal condition, treatment options, mental health issues, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

More to explore

• Pregnancy and arthritis – webinar recording (2021)
  Musculoskeletal Australia
• Becoming a parent: What to expect
  Beyond Blue
• Considering pregnancy and have lupus? Plan ahead
  Harvard Health Publishing
• Family planning, pregnancy and parenting
  Arthritis Foundation
• Having a baby
  Services Australia
• Patient education: Rheumatoid arthritis and pregnancy (Beyond the Basics)
  UpToDate
• Planning for pregnancy
  Pregnancy, Birth and Baby
• Preconception health for men
  Pregnancy, Birth and Baby
• Preconception health for women
  Pregnancy, Birth and Baby
• Pregnancy and arthritis
  Arthritis Ireland
• Pregnancy, Birth and Baby
• Pregnancy, fertility and arthritis
  Versus Arthritis
• Pregnancy: preparing for a baby
  Raising Children Network
• Preparing for a healthy pregnancy with arthritis
  Arthritis Foundation
• Preparing for pregnancy
  The Women’s
• Preparing for pregnancy
  Sexual Health Victoria
• Pre-pregnancy planning and healthy pregnancy
  Family Planning Australia