Family Planning When Living With A Chronic Illness by Natasha

If you would have given me a crystal ball as a kid, I would have had so many questions to ask. But I wouldn’t have thought to ask what illnesses I would be diagnosed with, and how that could impact my hope of becoming a mother.

Growing up, I only had to consider how I would deal with things on my own. It wasn’t until my husband and I became serious in my early twenties, that I realized that my illnesses wouldn’t only impact my life, but my partner’s. And it wasn’t until recently, that I realized that my illnesses could impact my hope of having a baby.

I was diagnosed with psoriasis vulgaris during adolescence. For those who don’t know, psoriasis is an auto-immune disorder that causes inflammation in the body. For me, there are visible signs of the inflammation, such as scales on my skin. Shortly after, I was diagnosed with gastroesophageal reflux (more specifically, with a hiatal hernia). These were likely caused by severe stress.

I’d spent years learning how to manage, and live with, the above. But what ended up being a turning point for me, was the most recent diagnosis of psoriatic arthritis. I’d read that psoriatic arthritis affects one in three people who have psoriasis, but that didn’t prepare me for being diagnosed with arthritis at twenty-eight. I mean, my husband and I had just gotten married, and I was diagnosed right after returning from our honeymoon. 

With diagnosis comes treatment, and I was ready to jump on board with what the physician recommended. He said that he’d prescribe me the best medication available for my situation, and that I would be able to get off of it after two years, as long as I was in remission. What I didn’t realize at the time, was the impact the medication would have on our plans to get pregnant. 

After picking up the injections, I did what I always do, and I read the information leaflet. To say I was surprised at what I read under the section titled pregnancy, breastfeeding and fertility would be an understatement. It states that you should not take the medication if pregnant, or trying to get pregnant. And that this medication, specifically, can cause birth defects, harm the unborn child, and cause pregnancy loss. Furthermore, it says that you should be off of the medication for a minimum of six months before pregnancy. 

That was a shock. Based on this, our plans of trying for a baby moved forward at least two-and-a-half years. Fortunately, we were in a transitional phase with jobs and house, so the wait was something we came to terms with. 

Two years later however, I went back to the doctor with very high hopes. My levels had been good, and based on his initial comments, that meant I was going to get off the medication. When I said such during our appointment however, he advised against it. 

“It could come back.”

“It could come back worse.”

“The numbers aren’t actually all that stable.”

I was absolutely deflated. 

Since the doctor didn’t want me to get off of my medication, I asked for alternatives due to my interest in becoming pregnant. He didn’t seem surprised by the question, and his enthusiasm was definitely measurable. All he said, was that I couldn’t be on that specific medication anymore, but there was another medication I could take.

I felt hopeful again. I got the new prescription, picked up the injections, and drove home to (once again) read through the information leaflet.  Then came the next surprise.

It said you should not get pregnant for at least five months after completing treatment. It also said however, that you are able to breast-feed while taking the medication. That certainly felt like conflicting information. And with the potential side effects of a stroke, leukemia, multiple sclerosis and more, I didn’t feel much better about this medication. 

I called my physician back and asked for other alternatives. He said there weren’t any. 

I didn’t know what to do, so I followed my instinct, and had long talks with my general practitioner, gynecologist, and dermatologist. All three of them are familiar with my medical history, and honest, personable women.

What I got out of these conversations was clarity. I could not stay on the medication I had been taking, I should not be taking this new medication, and there was risk associated with stopping all medication.

The most memorable of these conversations, was the exchange between myself and my general practitioner. When the tears came, she handed me a box of tissues, and just listened. When I was through, she calmly listed out the options ahead of me. After reading my reactions, she just said:

“… or you can take the risk of your arthritis coming back. It may be uncomfortable, and it may get bad, but at the end of the day, you could have a healthy baby in your arms. You can always take the medication again at a later time.”

And that’s when I knew. 

I mean, I want to have a child. My husband and I are ready, and we want to start our family. If leaving out risky medication for the sake of a healthy child is what I have to do, then that’s exactly what I’m going to do.

I’m privileged to be in a position where I can stop taking the medication without detrimental impact to my immediate health. I’m aware that not everyone has that option. 

There are so many mamas, and wanting-to-be mamas out there battling various illnesses and challenges. I applaud you. Each of us is navigating our own journey, and the path isn’t always clear – and it definitely isn’t easy.

But what I can say from my experience so far, is not to take anything at face value. Ask questions, read up on things, have the uncomfortable conversations – and if you feel like you need to, speak to other doctors about your situation, and how you feel.

Once I’d made the decision to stop my medication with immediate effect, I called back my physician, and told him which route I’d chosen. He didn’t seem surprised, and just told me to call back if my issues return. “After all, no one can force you to do what you don’t want to”.

And he’s right.

My body isn’t perfect. It’s so far from it sometimes. But my husband and I have a lot of love to give, and I’m trusting my body to do what it can, in order to make our dreams become reality.

I’m Natasha. I’m 31, and I’m a German/American woman living in the western area of Germany with my English/Irish husband. I have a BA in Communication Studies and a postgraduate diploma in International Events Management. And while I’ve worked in advertising, I currently work in Human Resources. I’m a lover of all things community, family and friendship, and believe in the truest form of “service” to others.