What's it like to be a mum and have Parkinson's?
In this video Shamsa talks about motherhood and family life - and how Parkinson's affects this.
While the majority of people who are diagnosed are older, younger people can get Parkinson's too. For younger women, it may be possible to become pregnant while having Parkinson's.
No figures are available for the number of babies born to women with Parkinson's, and most GPs, neurologists, obstetricians and Parkinson’s nurses have little or no experience of dealing with women with Parkinson’s who become pregnant.
However, the majority of cases written about ended in successful, full-term delivery of healthy babies.
The very small number of cases reported in medical journals means that it's difficult to predict what happens to women with Parkinson’s when they become pregnant.
We can't predict the effect of pregnancy on Parkinson’s symptoms. The available evidence from recorded cases is not particularly helpful. It simply states that some women’s symptoms worsen and some women's do not.
During pregnancy, a woman’s body changes to enable her to carry and deliver a baby. Some of these changes are visible, while others occur within the body’s circulation and hormonal systems.
Many of the changes that happen with pregnancy are also symptoms of Parkinson's. So having Parkinson's while pregnant can make these changes more profound.
Pregnancy-related changes can include:
- change in body shape/weight gain
- change in centre of gravity
- slowing down
- needing to urinate more often
- morning sickness
- increased saliva
- disturbed sleep
How pregnancy changes and Parkinson's symptoms may interact
Changes to body shape and a shift in centre of gravity when you're pregnant can mean that your sense of balance is affected. Together with Parkinson’s symptoms this can increase the risk of falls.
Constipation is another common Parkinson’s symptom that can also happen in pregnancy, increasing the risk of urinary problems and haemorrhoids before or during childbirth.
Pregnancy is often very tiring. This can be because you're not as comfortable as night and it's more tiring during the day to carry out your usual activities. Parkinson's can also cause fatigue and tiredness.
Morning sickness (not always confined to mornings) can cause a number of problems. You may vomit your Parkinson’s medication before they've had a chance to work. Morning sickness can also mean you're dehydrated, tired, nauseous, have increased saliva and generally feel unwell.
Importantly, commonly prescribed anti-sickness medications, such as Metocloperamide (Maxalon) and Prochlorperazine (Stemetil) should not be given to people with Parkinson’s as they can make Parkinson’s symptoms worse. Find out more about drugs to avoid when you have Parkinson's.
Ask your health visitor for advice on posture and, if necessary, a physiotherapist for advice on balance and using a walking aid if necessary.
Slowness of movements
Allow more time to do daily tasks. Remember, you will probably feel more tired than usual, so this will have a dual benefit.
Nausea and vomiting
Consult your GP or hospital team for advice. Point out to them certain anti-sickness drugs can't be used by people with Parkinson's as they may not be aware.
Try to eat 6-8 small meals a day, as well as avoiding high fat and very spicy foods. Starchy foods, such as bread or dry breakfast cereals, can help with nausea.
Drink plenty of fluids and have a diet rich in fibre to reduce the risk of becoming constipated.
Remember, caffeine in drinks such as tea, coffee and coke can make you need to urinate more often.
Try to get 8 hours sleep every night, and rest during the day when possible.
The safety of taking Parkinson’s medication while you're pregnant is a complex issue.
The only advice given to doctors is that pregnant women shouldn't take Parkinson’s medication.
This may be due to the lack of safety in pregnancy testing of these drugs in humans, rather than because of any proven evidence that they are unsafe.
To be very clear, the current situation is that there isn't enough scientific evidence to show that these drugs can be safely used in pregnancy and some safety testing using animals has pointed to potential problems.
However, a number of cases have been reported in medical journals (approximately 35 pregnancies) where women who have Parkinson’s have given birth to healthy babies while remaining on their medication regimens.
There are only 2 cases reported (out of 23 pregnancies) where patients taking levodopa had problems, and it's not proven that levodopa therapy caused the problems.
Animal testing suggests that selegiline should not be taken, although there is 1 recorded case of a woman who gave birth to a healthy infant after taking selegiline for the duration of her pregnancy.
There is strong evidence that pregnant women shouldn't take amantadine, as there have been a higher proportional number of problems with pregnant women taking this drug.
The reality is that the amount of evidence so far is inconclusive, so any woman with Parkinson’s who becomes or wishes to become pregnant should discuss the risks with her neurologist, obstetrician and Parkinson’s nurse.