What to Expect During Pregnancy With Fibromyalgia

Medically reviewed by Andrea Chisholm, MD

If you have fibromyalgia and are thinking about becoming pregnant—or if you're already pregnant—you may be wondering what impact your condition will have on your pregnancy, your body, and your baby.

While research on this topic is far from complete, what experts do know about fibromyalgia and pregnancy is mostly encouraging. You may experience some additional challenges, but research indicates that you can have a healthy pregnancy—and a healthy baby.

"There’s no data to show that people with fibromyalgia do not give birth to healthy babies," says Lynne Matallana, founder and president of the National Fibromyalgia Association. "There is the possibility of experiencing more symptoms and discomfort, but there also is research that indicates some [people] do better in pregnancy due to the fact that the amount of relaxin increases, which may help reduce stress and tension in muscles."

Here's everything you need to know about pregnancy with fibromyalgia, including changes you might experience with symptoms, medication, and more.

What Is Fibromyalgia?

Fibromyalgia is a chronic disorder that causes widespread pain and tenderness in many areas of the body, along with fatigue and trouble sleeping. It may also come with joint stiffness, memory issues, digestive issues, and sensitivity to factors like temperature, light, and sound . The causes of fibromyalgia aren't fully understood, and there's no cure.

"[This condition] can be debilitating for the people who experience it," says Laura Purdy, MD, MBA, a board-certified family physician. "It is most common in women ages 20 to 55 years and is estimated that 2% to 4% of the population experiences this condition."

Certain factors increase your risk of fibromyalgia, including having a genetic history of the condition, mood disorders like depression or anxiety, rheumatic diseases, and other pain-causing medical issues. "In most cases, it is thought that fibromyalgia is not caused by one particular factor, but can be a combination of both physical, emotional, and mental contributing factors that ultimately results in the manifestation of fibromyalgia," Dr. Purdy says.

Fibromyalgia also falls into the spectrum of central sensitivity, says Matallana. "In other words, how our brain and spinal cord processes pain is different than someone else. Our brain amplifies that perception of pain."

Related: How to Navigate the Ups and Downs of Pregnancy Mood Swings

Can You Get Pregnant With Fibromyalgia?

There is no known link between fibromyalgia and infertility, says Staci Tanouye, MD, an OB/GYN in Florida. But there are other factors that could make getting pregnant more difficult. For instance, the pain and tenderness that people with fibromyalgia experience may limit sexual activity. There's also the possibility that they have an overlapping condition that increases the likelihood of infertility.

"One of the issues with fibromyalgia is that is occurs with other conditions," adds Matallana. "One example is endometriosis, which can affect fertility. Having other autoimmune diseases such as lupus and rheumatoid arthritis could possibly affect fertility as well."

Additionally, Matallana says that when the National Fibromyalgia Association researched the demographics of those with fibromyalgia, they discovered that 24% of the those with the condition had never had a child. There were several reasons for this, she says. "One was infertility. One was fear of being able to take care of a baby after it was born, and another was because they had probably waited too long to try."

Related: How to Decide if You Are Ready to Start a Family

Fibromyalgia and Pregnancy Outcomes

Though fibromyalgia may create some challenges while expecting, most people will have healthy pregnancies and babies.

How Might Fibromyalgia Affect Pregnancy?

Because everyone experiences fibromyalgia differently, it's difficult to make blanket statements about what someone might experience while pregnant, explains Matallana. Some may feel better in pregnancy and some may feel worse. Here's a general guide.

Change in Fibromyalgia Symptoms

There is a possibility that your symptoms might flare up while pregnant, leading to more pain and stress as well as headaches, depression, anxiety, fatigue, and more. In fact, research indicates that fibromyalgia during pregnancy is a significant contributing to stress, anxiety, and depression.

"[It is possible for] fibromyalgia symptoms to worsen during pregnancy particularly in the third trimester," says Dr. Tanouye. "Pregnant people with fibromyalgia tend to have more fatigue, low back pain, anxiety, and depression."

But there's also a chance that you could feel better while pregnant. Experts theorize that this might be due to increased relaxin hormones, Matallana says. "Sometimes people really feel better once they get pregnant, especially after the first trimester."

The second pregnancy may not have the same results though, Matallana adds. "Experts theorize that the brain has learned pregnancy and birth can be a painful and exhausting process and they end up with a second pregnancy that is a little more difficult."

Potential Complications

There is some preliminary evidence that fibromyalgia may increase your risk of intrauterine growth restriction —"but it is unknown as to why this may be the case," Dr. Tanouye says. "There also is conflicting data on if fibromyalgia increases risk of gestational diabetes. Preterm labor has not been associated with fibromyalgia," but studies have mixed results.

There also may be an increased risk of postpartum depression or other types of depression  because of the decrease in serotonin during pregnancy, Matallana says. "People with fibromyalgia experience a greater decrease in serotonin when they are pregnant so this could have an impact on developing postpartum depression after having the baby."

Need for Support

After delivery, you're going to need a strong support system—both during pregnancy and after the baby is born, Matallana says. Sleep can have major effects on how you feel and your mental state, so have people around you to help so you can get the sleep you need.

You should also recognize that you may have to be on your baby's schedule, especially when it comes to feeding, sleep, and diaper changes, Matallana says. "You also may have a colicky baby, or noises and smells may be amplified. It's important to know that is part of being a mother. Most people are going to struggle and will need the help of their partner or family members and that is OK."

Related: How to Cope With Pregnancy Insomnia

Managing Fibromyalgia While Pregnant

Whether you are pregnant or thinking about trying to conceive, it's important to think about how you will manage fibromyalgia. Here are the primary things you should consider.

Choose the Right Provider

According to Matallana, you should have a healthcare provider who understands fibromyalgia and how it can affect your life. You want them to be cognizant of the things you need and the medications you should be taking.

"You don’t want someone who dismisses your illness," she says. "You need support when you are going through pregnancy."

Most doctors who treat fibromyalgia are neurologists and rheumatologists, Matallana says. Make sure your OB/GYN is talking to them and that they manage your care together.

Discuss Medications and Make a Plan

When it comes to fibromyalgia and pregnancy, you need to make a plan with your medical team. Ideally, the healthcare providers that treat your fibromyalgia should be communicating with your OB/GYN. This is especially important when it comes to your medications and your pain management.

"Determining which medications you can continue taking is most often an individualized discussion with the patient’s doctor," says Dr. Tanouye. "Most antidepressants can be continued during pregnancy if needed after a thorough discussion of what we know about their risks vs. the benefits they may provide for each individual patient. Newer neuro-modulating medications such as pregabalin have much less data on use during pregnancy."

Any medication, including over-the-counter meds and supplements, should be discussed with your healthcare provider to determine if you should continue taking them, Tanouye says. Likewise, you should always talk with your healthcare provider before discontinuing any medication.

"If someone with fibromyalgia is planning a pregnancy, it’s also a good idea to schedule a pre-conceptual consult with your OB/GYN to discuss these options ahead of time," she says.

Relieve Stress

Having fibromyalgia can increase your stress load while pregnant, so think about ways to reduce stress and promote relaxation. Additionally, Matallana recommends being in the best health possible before you conceive. This can be extremely helpful in reducing stress.

"Most non-medication options that are used while not pregnant for fibromyalgia can be used during pregnancy, such as massage, exercise, stretching, behavioral therapy, and mindfulness techniques for stress reduction," says Dr. Tanouye.

It may be helpful to experiment with different anxiety and stress reduction techniques beforehand to see what works for you. If you go into pregnancy prepared, it's likely you will have fewer symptoms than if you go in with fear and concerns, Matallana says.

Cultivate a Positive Mindset

Having fibromyalgia doesn't mean you can't have a baby, but it does mean that you will need to be prepared for what it may mean for you, Matallana says. "The issue isn’t really that new things happen when you become pregnant. It's that the issues you already have may become worse. Some people find this fact difficult to accept because they are already struggling."

Consequently, getting pregnant and having a baby will take the right mindset. Remind yourself that it may be hard or challenging, but you can do it with the right healthcare provider and a solid support system, Matallana says. "While it may be more difficult, the end result is wonderful. Fibromyalgia shouldn’t have an effect on your desire and your ability to go forward and have a child."

Related: The Benefits of Mindfulness in Pregnancy

Read the original article on Verywell Family.