RA, Fibro and due to give birth in 6wks

[Jayfer]

Its my first baby and whilst I've got the normal labour nerves I'm also worried that I'm going to get totally knackered during labour and I'm not going to be able to look after myself let alone a baby. Have discussed these worries with MW but it wasn't my normal MW and she dismissed it.

I'm definitely not the first to go through this but it seems like it!!

Hi Jayfer and congratulations on your first baby .

I have RA too and am pregnant with my second DC. I only developed RA six months after having my DD and it was under control wih sulphasalazine within six months. I'm off my medication now as my joints seem to be fine in pregnancy, but am worried about a flare after DC2 arrives.

Really sorry to hear that you're so worried about labour and afterwards. How far along are you and what does your normal MW advise? Are you going to be able to see your normal midwife and write out a detailed birth plan taking into account how to conserve energy and what will happen if you do become too tired? If you're going to antentatal classes the teacher may be able to give you some tailored advice too.

As for after the birth, I've had some basic information from Arthritis Research UK www.arthritisresearchuk.org/arthritis_information/arthritis_and_daily_life/pregnancy_and_arthritis.a spx mainly around the drugs side of things. I'm also seeing my rheumatologist next month to talk about breastfeeding and drugs following the birth.

I know that for you things are more complicated as you also have Fibro - if you haven't already, can you talk to your consultant perhaps?

If you're having a hospital birth, when you're on the postnatal ward I'd hope that you'd be well looked after and helped with your baby. It's worth asking for help upfront though and to keep asking as the ward can get rather hectic.

As for being at home after the birth, do you have a partner, family or friends that will be able to help you out? And/or could Sure Start volunteers help?

New babys are hard work but with the right support you'll find ways to work around feeding, changing, dressing etc that will make life easier. Good luck and I hope that all goes well

Thanks for the reply cakeywakey. I've had RA and Fibro for almost 12yrs now and have tried most drugs up to anti-TNF. I have only been allowed steroids throughout the pregnancy and the RA unfortunately hasn't gone into remission as promised. I didn't feel too bad through the first trimester but had massive flare through second and now I've got 5 weeks to go I've started with another flare up.

Have spoken to maternity consultant who was very supportive as I'm very worried about exhaustion during labour. Unfortunately I haven't seen the same midwife twice as my 'normal' one has been off ill since the booking appt. I saw a MW last week and talked through my birth plan (the consultant suggests epidural asap once active labour is established and allowed one hour of pushing before intervention). Unfortunately the MW didn't have a scooby doo about exhaustion and dismissed everything the consultant said. I asked what happens if I'm becoming too exhausted and was told that I was on my own unless the baby was in distress. I came out of the meeting in tears (although I am hormonal!) and now fairly worried that I'll get the same response when I'm in labour.

I'm not worried about after we bring the baby home as I've managed to get the council to get a care plan to start from the beginning of May and I'm employing my Mum to be my PA to help with the baby. Can't wait!

How far along are you?

I'm halfway through now, and keeping my fingers crossed that I'm flare free until afterwards - very sorry to hear that you've had that to deal with along with being pregnant.

I think that some MW are unfortunately a little too matter of fact when dealing with expectant mums, especially first-timers. It's always offputing when you encounter one. They're well outnumbered by the lovely ones though IME.

Do you think it would be worth getting back in touch with the maternity consultant to raise your concerns? It might also be an idea to have a really clear birth plan to take with you that your birth partner knows inside out and back to front, making sure that they can be your advocate and stand up for you if needed

Hopefully you'll have a great midwife on the day who will support you and help you to have the birth that you want. Hope that all goes well for you over these last weeks, during birth and after

I also have medical problems that make me very tired, and also wondered how I'd cope during labour. Having gone through it, I'd now advise the following

1. Not all first labours are long and tiring. My DD1 was 4 hours start to finish! You could be lucky...

1. Being in labour provides the greatest adrenaline rush of your life. Every last ounce of energy will automatically be focused upon coping.

1. Most hospital staff are nice. But you may need to explain your difficulties/ask a partner to explain/ask them to read your notes or birth plan. If you think this may be difficult, can you write a prompt card, or rehearse with your birth partner what needs to be explained?

1. Once LO arrives, it'll all be worth every moment of exhaustion and pain

Thanks for the responses. I'm so looking forward to meeting the baby.
My husband will be my birth partner and he will be insistent with the MW (who I'm sure will be lovely - I've only met a couple who didn't 'get it').

Think I might take a highlighter to the birth plan and I'm seeing the consultant on Wednesday for my last scan so will reiterate my worries firmly then.