Hints for Women with FM who are Considering Pregnancy 

Karen Moore Schaefer, RN, DNSc, Assistant Professor Nursing

 Temple University, Philadelphia, PA 19140

The following are suggestions that might help you as you consider becoming pregnant or may help improve the quality of your pregnancy if you are already pregnant. Most of these hints are based on clinical experience and what is currently known about pregnancy, and therefore, require testing to know if they will affect the interaction between FM and pregnancy. You are encouraged to discuss any of the suggestions with your obstetrician or nurse midwife/practitioner *so that you can work together towards a healthy pregnancy.  

Before Pregnancy 

Prior to conception, talk with your obstetrician about pre-natal counseling. 

            Talk with you obstetrician about his/her experience with women with FM. Ask how many women with FM
            that they have in their practice.

            Ask how they help the women through the FM and the pregnancy.These questions will help you decide if
            this is the best obstetrician for you.  

            If appropriate, include significant family members or friends in your pregnancy decision. They may be a
            good  resource for support during and after your pregnancy.  

            Eat a well balanced diet and start pre-natal vitamins for the health of you and your baby. 

During Pregnancy 

    Discuss your normal FM symptoms with your obstetrician so that he/she can help you distinguish your FM symptoms from the normal symptoms of pregnancy. When in doubt about any symptom please ask. Do not assume it is related to your FM. Review any prescribed or over-the-counter medications you are taking with your obstetrician to determine whether they are safe to take during pregnancy. If needed, request interventions to reduce nausea and vomiting associated with pregnancy. Some women find that room temperature cola that is flat helps. If you decide to try cola, use the decaffeinated.  

    Ask about alternative interventions to reduce discomforts associated with FM and pregnancy. Partner massage (with instruction), imagery, music therapy, heat /cold, relaxation and positioning for comfort may help. 

    When positioning on your side, especially during the last trimester, use pillows tucked against your back when side-lying with your body slightly forward or backward to avoid lying directly on your tender points. 

    Engage in gentle exercise. Walking is one of the best for your muscles and your pregnancy. 

    Plan to meet the need for additional rest, especially in the first and last trimester of pregnancy.     

    If you hope to breast feed your child, discuss your plans with a lactation consultant or an expert on breastfeeding. They will help you practice techniques before your baby is born so that you will be ready to work with your new infant.

     If you have any concerns about miscarriage related to your FM, talk with your primary care provider. There is no evidence to suggest that FM increases the chance that you will have a miscarriage. 

During Labor

    If you are able to, walk during labor. It will help to keep your muscles active and encourage labor to progress.Practice relaxation during contractions. Nice slow deep breaths or imagery might be easiest to do. These can distract you from the discomfort of labor and relax the muscles.   

Ask the nurses and other health care providers to respect your need to keep the noise and lights to a minimum while you are in labor. This may help promote relaxation and reduce muscle tension. .

 After Delivery 

    Avoid drafts and cold temperatures for several days. Plan for additional help at home. If possible seek the help of a family member or close friend for about two weeks after delivery.

 If you Plan to Breastfeed 

    Request the assistance of a lactation consultant or visiting nurse to help you get started once you are at home. They can provide interventions to help the baby latch on and work with even simple things such as breast size and how that will affect latching.
    Try using a pillow or commercially made product (Boppi) for support while you breast feed. This will reduce the intensity of holding a child in one position for an extended period of time. You can also try lying on your side to breast feed with a pillow to support your head.Change positions while breastfeeding so that your muscles do not get stiff and tired.
    Breast-feed in a quiet place and use interventions to help you relax (music, the sound of water, muscle relaxation, imagery). 

    Delegate as much work as possible to other people who have offered to help so that you and your new baby can rest.

 * It is recognized that women may have an obstetrician, nurse midwife or a nurse practitioner that cares for them while pregnant. Use of the term obstetrician encompasses all care providers.