PoTS most often affects women of child bearing age and therefore the effect of PoTS and its treatment in pregnancy needs to be considered. Often women have concerns about the use of medication whilst pregnant, potential worsening of symptoms during pregnancy and any effect PoTS may have on their unborn baby. The following information will address these issues. There are many women with PoTS who have given birth to beautiful healthy babies.
It is very important that you talk to your doctor before trying to become pregnant, particularly if you are on medication. The benefits for you of continuing to take your medication versus the consequences of stopping need to be considered alongside any potential impact of medication on your unborn child. The effects of taking most medicines on the unborn baby are unknown. Occasionally, taking certain medication just before you become pregnant can also be harmful. The very early stage of pregnancy, when you are not aware that you are pregnant, is a time of significant risk. Make your decision about whether or not to continue your medication once you know all the potential risks and benefits. If you do plan to stop some or all of your medication, you should discuss how to go about this with your doctor FIRST.
Beta-blockers, Midodrine, Fludrocortisone and SSRIs (antidepressants) have been taken during pregnancy by a small number of women with PoTS. However, there has been very little research about the safety of these drugs during pregnancy and their effect on the baby cannot be predicted.
Remember that leading a healthy lifestyle will benefit your baby whether you have PoTS or not.
- Take folic acid supplements. Some people need vitamin D supplements.
- Avoid drinking alcohol or taking recreational drugs.
- Avoid undercooked meat, fish and eggs, unpasteurised milk, soft cheeses, unwashed fruit and vegetables.
- Don’t smoke
There is further information here: diet-and-lifestyle-during-pregnancy
Early pregnancy may be difficult as symptoms can sometimes worsen. This is especially true if you have Hyperemesis Gravidarum (excessive vomiting) and are unable to keep down fluids. Occasionally anti-vomiting medication or hospital admission for intravenous fluids is necessary.
Fortunately, for the majority of patients, PoTS symptoms improve or stabilise after 6 months of pregnancy. Fluid retention occurs which may account for this improvement in symptoms. Some may experience a worsening of symptoms towards the later stages of pregnancy.
- It is important to keep as fit as possible with regular gentle exercise.
- Drink plenty of fluids.
- Even people without medical problems that cause fatigue find that pregnancy can be very tiring so make sure you include rest periods.
- You may also wish to consider support/compression tights*. Further information about compression can be found here - HERE
The majority of women in recent studies had a normal vaginal delivery. A small number had a caesarean section; both methods of delivery were found to be safe.
Make sure that your obstetrics consultant and the anaesthetist know about PoTS before your delivery. It may be helpful to print a leaflet about PoTS from PoTS UK website.
- *Get up and get going as soon as you can after birth.
- *Consider using compression stockings.
- *Drink extra fluids when breast feeding.
- *Pace yourself - there is always another day.
Many women see an improvement in PoTS symptoms after childbirth, possibly due to the increased activity of looking after a child. However, a minority of people with PoTS find that their symptoms deteriorate after giving birth. Plan ahead and accept help from family or friends if it is offered – and don’t be afraid to ask.
The pros outweigh the cons. Parenting is very hard work, especially with PoTS symptoms, but it is also the best thing in the world” (a parent with PoTS)
Further information regarding pregnancy in Joint Hypermobility Syndromes can be found on the HMSA website.
Read Anita's Pregnancy diary here.pdf
*Currently no available medical evidence. Based on patient experience and opinion.
Written by: Lorna Nicholson
Medically approved by: Dr Meena, Dr Lesley Kavi