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Pregnancy and AxSpA

Reviewed by: HU Medical Review Board | Last reviewed: March 2023

If you have axial spondyloarthritis (axSpA), you may wonder how pregnancy will affect your condition. While there is little research on the subject, some studies show that axSpA can flare up or get better during pregnancy and after the delivery. Others have found no difference in disease activity during pregnancy. Here's what you need to know about managing your axSpA during pregnancy and beyond.1

Is it safe to get pregnant?

Becoming pregnant can bring up a lot of questions and concerns. You may be wondering whether axSpA will affect your chances of getting pregnant. Or you may be concerned that your condition will affect the health of your baby.2

In most cases, having axSpA is not likely to affect your ability to get pregnant or affect the health of your baby. But treatments for axSpA can affect the health of your baby. So, it is important to carefully plan for a pregnancy and talk to your doctor.2

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Managing axSpA during pregnancy

If you do become pregnant, it is important to manage any flares and maintain a healthy lifestyle throughout the pregnancy. This includes:3

Drug treatments and your baby

Taking medicines for axSpA during pregnancy can be tricky. While most treatments are considered safe, some have a chance of being passed to your baby. This can happen through the placenta or while you are breastfeeding.1,2

Talk to your doctor about the pros and cons of each axSpA drug treatment before, during, and after pregnancy. And always talk to your doctor before you make any changes to your medicines.1,2

Labor and delivery

Labor and delivery can be more challenging for people with axSpA than for other people. This is because it can be hard to move your joints. The pain and stiffness may make it difficult to get into some positions during labor, such as squatting or kneeling.1,4

Talk to your doctor in advance about how you will handle labor and delivery while managing your condition. Many people with axSpA have safe deliveries close to their due dates without complications.1,4

Some studies show that having axSpA increases the chance of needing a cesarean section (C-section) delivery. Going into labor prepared is an important step in ensuring a healthy birth process for both mom and baby.1,4

After childbirth

It is not uncommon for axSpA to flare in the postpartum period. After childbirth, your body may feel vulnerable to change. Up to 6 out of 10 women with axSpA have an increased number of symptoms or a worsening of existing ones during this time. You should be aware of this and have strategies to manage your symptoms if a flare occurs.1,5

This may include managing stress levels as well as maintaining a healthy diet and lifestyle. Speak with your doctor and get regular checkups after giving birth to ensure proper monitoring and treatment.1,5

There is still a lot that is not known about the course that axSpA takes. This makes planning for pregnancy and delivery challenging. Before you make any changes to your treatment regimen, talk to your doctor first. Remember, a healthy pregnancy starts with taking care of your body and mind before conceiving.1,3