“Until now there was only anecdotal evidence suggesting that women with FM had a rougher time during pregnancy,” and as a result healthcare providers often misdiagnose and under treat these symptoms as a normal part of pregnancy, says Karen M. Schaefer, DNSc, RN.
A pilot study she led recently at Temple University’s College of Health Professions provides evidence that on average a group of pregnant women with FM had a harder time functioning, felt more stiff and tired, and experienced pain in more body areas than a comparable group of pregnant women without FM.
The study, which recruited participants online, included only women in their third trimester of pregnancy, between the ages of 29 and 31, and with no history of stillbirth or any chronic illnesses other than FM. The study findings were based on detailed questionnaires covering fatigue, depression, pain, and ability to function, and took into consideration factors such as marital status, education, hours slept, and use of medication.
Next steps, says Dr. Schaefer, are to gather more information on FM’s effects during pregnancy, and identify ways to provide comfort and support. And for now, she recommends pregnant women with FM make a point of discussing their pain and fatigue with their doctor. Also, while the drugs they might normally take to ease pain may be ruled out during pregnancy, a support group can be helpful, and it’s advisable to plan for additional help during and after the pregnancy. Dr. Schaefer presented these findings at the recent 2006 Association of Women’s Health, Obstetrics and Neonatal Nurses convention in Baltimore.
In an earlier study, Dr. Schaefer identified the increased difficulties women with FM often confront in trying to nurse their babies, including pain, failure to produce sufficient milk, and infections such as thrush. She suggests this indicates a need for “healthcare providers to learn more about FM when advising breast-feeding mothers with the condition,” and that “before discouraging a mother's nursing efforts, providers should first explore non-prescription methods for reducing discomfort and pain.”
In particular, she advises that nurses be proactive advocates, communicating information to both mothers and physicians on the issues related to breastfeeding for women with FM. The study report, “Breast-feeding in Chronic Illness – The Voices of Women with Fibromyalgia,” was published in the July/August 2004 issue of the American Journal of Maternal/Child Nursing (www.mcnjournal.com) .