Autoimmune Motherhood Movement Aims to Support Women During Pregnancy

Dr. Grace Wright addresses key considerations for women living with autoimmune diseases.

Pain management is complex in and of itself, and it’s well documented that women experience pain differently than men, including how they respond to treatment and how medication impacts their body. When pregnancy enters the equation, women who may have their pain under control, face a whole new set of questions and challenges. Practical Pain Management spoke to Grace Wright, MD, of New York University’s Langone Medicine Center, about how women can manage potential pregnancy early on. Dr. Wright is involved in a campaign called AIM, the Autoimmune Motherhood Movement, which is a community of women living with chronic autoimmune diseases, their family members, and their caregivers. Autoimmune diseases may include, for example, painful conditions such as Crohn’s disease, CRPS/RSD, fibromyalgia, irritable bowel syndrome, Lupus, peripheral neuropathy, rheumatoid arthritis, and more. AIM was created in 2018 by UCB, a biopharmaceutical company that focuses on immunology and neurology research and treatment.

PPM: How can a woman with a chronic inflammatory disease best prepare for a pregnancy?

Dr. Wright:As a rheumatologist who treats women living with chronic inflammatory disease and the pain that is often associated with it, I know that many of these patients are not fully informed about their diagnosis or appropriate treatment options, and many are not prepared to make the most informed decisions before, during and after pregnancy.  Research shows that disease management becomes more important for both mother and child. Autoimmune conditions such as rheumatoid arthritis and Crohn’s disease, for instance, can lead to adverse pregnancy outcomes.

Greater awareness, combined with physician consultation starting early in their family planning journey may help women gain more control over their pain, overall health, and family planning.  This is why I am working with AIM. The awareness campaign works to help these women learn the facts about their conditions, share their experiences to empower one another, and guide them to work with their doctors to combine family planning and disease management early in their family planning journey.  It can be a very effective supplement to ongoing consultation between rheumatologists and their patients.

PPM: Why is it important to avoid certain pain medications while pregnant? What are the risks?

Dr. Wright:Only a patient’s direct physician can answer these complex questions based on a full understanding of each woman’s health, priorities, and treatment options.  In the specific context of appropriate treatments for chronic inflammatory disease, part of this consideration should be that, if unmanaged, these diseases can pose risks to women’s health and to their pregnancy.  For example, active rheumatoid arthritis and Crohn’s disease during pregnancy can have serious implications for both mother and infant, including an increased risk of miscarriage, an increased risk of preterm delivery, the need for a cesarean, and the infant being small for gestational age.

 

PPM: What other considerations should a woman with an autoimmune disease discuss with her doctor, when planning a pregnancy, or upon finding out she is pregnant?

Dr. Wright: Early collaboration with doctors is key for these women, yet a recent global survey by AIM of 1,052 of these women found that only 41% of women surveyed in the United States consulted any healthcare professional before becoming pregnant, which is when many concerns and misperceptions can be addressed. Without consults, those concerns can lead some women to change their plans for a family or discontinue treatment during pregnancy, when maintenance of disease control is important.

For instance, the survey found that 44 % of surveyed women had concerns serious enough that they delayed their plans to become pregnant. Thirty-six percent decided to discontinue their treatment while planning or at the start of their pregnancy, and a full 61% felt they could not combine treatment and breastfeeding.

Helping women resolve these concerns, overcome misperceptions, and make fact-based decisions that address both their treatment needs and plans for a family are key to effective management of chronic inflammatory disease and associated pain. But even the most committed doctor and sincere patient need a larger care team for support. As a practitioner, I see concrete value in the AIM Movement because it can help build a community for female patients. 

 

Grace Wright, MD, is a clinical associate professor in the Department of Medicine at the New York University (NYU) Langone Medical Center. She received her doctorate in medicine from NYU, and conducted her residency in internal medicine and fellowship in rheumatology, both at NYU Medical Center. She has co-authored several clinical articles on disease activity and rheumatoid arthritis.

 

Updated on: 08/22/18
Continue Reading:
Pain in Women: Hysteria or Misjudgment?
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