Theme 3: care and medications during pregnancy and lactation
| Care in pregnancy | “Um, they did some bloodwork to see about the arthritis and sexually transmitted diseases, and to see how I was doing in general. They also did the genetic ultrasound and, that’s generally it, and well my consultations, that I go get a checkup each month.” (20–25) “I saw my rheumatologist, um, the psychologist, the nutritionist, um I forgot the name, yeah the gynecologist and I also went to the endocrinologist because the pregnancy altered my thyroid, it was out of control … I don’t remember the names of the studies they did, but there were a lot of studies to see that my disease and everything was ok. They did some ultrasounds um well to see that the baby didn’t have any malformations and to hear that everything was ok. They did studies just to see how I was controlled so that it wouldn’t affect the baby.” (20–25) “I imagine that the follow-up [during pregnancy] is monthly. And the frequency, well um in my case I image that it might be a little more frequently than monthly because of the lupus.” (30–35) “No, we haven’t talked about frequency. I would think that every two months, I don’t know, because I imagine it’s like a normal appointment for example for the lupus I go every 3 to 4 months, but it wouldn’t be like a monthly appointment like with a gynecologist.” (30–35) |
| Counselling on medication use | “Hmm no, I haven’t asked. It’s just that, I mean, when she [the rheumatologist] told me ‘you know, if you get pregnant then I have to take you off so many medications and it’s a whole process’ so then I was like um no then and I never asked any questions.” (20–25) “Well, first I would look for my doctor’s counseling and I would ask if it affects the baby, I mean if it’s harmful or not.” (35–40) “Hmm no, but I won’t be able to breastfeed because well they can’t take me off hydroxychloroquine … Look, since I already have a little boy, when I had him, at the full health coverage center they did tell me that I should breastfeed but nothing was coming out and it hurt a lot and, I mean, nothing else. I left and around two days after I think I came back and they told me to stop because I was taking hydroxychloroquine and I don’t know what …” (30–35) |
| Knowledge of medication use during pregnancy and post partum | “Before, well I, still, I mean, they told me that I’d have to be off methotrexate 3 or 4 months before to detoxify the body to conceive, but I didn’t realize I was pregnant [laugh] … Yeah, I stopped the medication when I knew I was pregnant and, um, afterwards I had an appointment with the rheumatologists and they, um, changed them.” (25–30) “Well, the ones I was taking they told me that they were very strong and actually high-risk if I got pregnant, um, the baby wouldn’t be born or would be born with malformations, so yeah, it’s a little bit worrying to take the medication and not be cautious because well you’re worried that it’ll happen, you know. I don’t really know which ones they are now that I’m, that they prescribed new ones that I’m taking right now, ones that I can take during pregnancy. But really, I don’t know in detail which medications to take, no … I can’t remember, to be honest.” (25–30) “The biggest greatest fear is always the malformations that babies can have, or that if when you’re breastfeeding you’re taking a medication you can pass it on through um through breastfeeding. So um I think that the biggest fear would be that for example the patients that are taking methotrexate that their babies would later have problems in their development, in their [laughs] organogenesis … very embryology but … yeah, that would be the biggest issue, that they had developmental problems.” (20–25) “I know that there are a lot of myths that you can’t take medication or even eat certain foods when you’re lactating, I mean, I feel like there’s a lot of disinformation about this and that really it’s a very limited number of medications that interfere with breastfeeding.” (30–35) |