In February 2020, the American College of Rheumatology released its first-ever guideline on managing the reproductive health of patients with rheumatic diseases. This means, for the first time ever, rheumatology healthcare professionals have an official set of evidence-based clinical practice guidelines to turn to when deciding how to counsel patients who are or wish to become pregnant.
The guidelines provide vital background knowledge, recommendations for reproductive health issues, and additional information for diagnoses where pregnancy is considered more complicated, such as systematic lupus erythematosus (SLE) and antiphospholipid syndrome (APS).
The recommendations are separated into six categories:
- Contraception
- Assisted Reproductive Technology (Fertility Therapies)
- Fertility Preservation
- Pregnancy Assessment and Management
- Menopause and Hormone Replacement Therapy
- Medication Use (Paternal and Maternal)
So what does this mean for rheumatology patients? Well, I’ve interacted with many women living with rheumatic diseases who are or want to become mothers as I worked to develop first the private Mamas Facing Forward Facebook group and then this website. Over and over (and over and over) I’ve heard stories from patients whose doctors didn’t know anything about how reproductive health issues intersected with rheumatology issues, or whose doctors gave them information that conflicted with information from the OB/GYN, or whose doctors flat out gave them incorrect information, bad advice, or refused to look at updated research.
My hope is that these official guidelines will help get rheumatology healthcare professionals up to speed with the latest research concerning pregnancy and breastfeeding with rheumatic diseases. It would be amazing if these official guidelines could encourage rheumatology healthcare professionals to support their patients who want to get pregnant or breastfeed their babies. And in the cases where doctors are still uninformed? I’m glad that patients now have an official resource they can pass along to their doctors.
My hope is that these official guidelines will lead to far better pregnancy and breastfeeding experiences than those experienced by many mamas who came before. And improvement is exciting!
If you’re interested, you can view the official guidelines here.
