When you’re pregnant, your body changes in ways you never expected. Your joints might ache, your feet swell, and suddenly, your big toe feels like it’s on fire. If you’ve had gout before, you know that pain all too well. But now, with a baby growing inside you, the usual remedies won’t work. Gout during pregnancy isn’t common, but when it happens, it’s serious - and most doctors aren’t prepared to talk about it.
Why Gout Flares Up During Pregnancy
Gout happens when uric acid builds up in your blood and forms sharp crystals in your joints. Normally, your kidneys filter it out. But pregnancy changes how your body handles waste. In the first trimester, your kidneys work harder to clear waste for two people. That means they might not remove uric acid as efficiently. Then, in the third trimester, your body holds onto more fluid - and that fluid can trap uric acid instead of flushing it out.
Studies from the Australian Journal of Rheumatology show that pregnant women with a history of gout are 3 times more likely to have a flare-up than non-pregnant women with gout. And if you’ve never had gout before but have high uric acid levels, pregnancy can be the trigger. That’s because estrogen, which usually helps lower uric acid, drops sharply after delivery - but during pregnancy, hormonal shifts can make your body hold onto more uric acid than usual.
What Gout Feels Like When You’re Pregnant
The pain is the same - sudden, intense, and usually in one joint at a time. Most often, it’s the big toe. But it can also hit your ankle, knee, or even your wrist. The joint swells, turns red, and feels hot to the touch. You might feel like you have the flu - fever, chills, fatigue. But here’s the catch: many pregnant women assume the pain is just normal swelling or sciatica. That’s why gout gets missed.
One mother in Melbourne, 32 weeks pregnant, thought her swollen toe was from standing too long at work. She waited three weeks before seeing a doctor. By then, the joint was so inflamed she couldn’t walk. She didn’t know gout could happen during pregnancy - and neither did her OB-GYN. It took a rheumatologist to connect the dots.
What You Shouldn’t Do
Don’t take ibuprofen or naproxen. These are common gout meds, but they’re dangerous in pregnancy - especially after 20 weeks. They can reduce amniotic fluid and affect your baby’s heart. Colchicine? It’s sometimes used, but only under strict supervision. Allopurinol? It’s generally avoided unless the gout is severe and other options have failed.
And don’t try to ‘tough it out.’ Gout flares during pregnancy don’t just hurt - they increase your risk of preeclampsia, preterm birth, and low birth weight. A 2023 study in the Journal of Maternal-Fetal Medicine found that untreated gout in pregnancy doubled the chance of early delivery.
What You Can Do - Safe, Proven Steps
There are ways to manage gout safely while you’re pregnant. It’s not about eliminating the pain overnight - it’s about controlling it without risking your baby.
- Drink more water. Aim for 2.5 to 3 liters a day. Water helps your kidneys flush out uric acid. Try adding lemon - citrate in lemon juice may help prevent crystal formation.
- Watch your diet. Avoid red meat, organ meats, shellfish, and sugary drinks. These spike uric acid. Instead, eat low-fat dairy, eggs, tofu, and plenty of vegetables. Cherries - yes, real cherries - have been shown in clinical trials to reduce gout flares by up to 35%.
- Elevate and ice. When a flare hits, rest the joint. Put a cold pack wrapped in a towel on it for 15 minutes, 3 times a day. Don’t put ice directly on the skin.
- Choose comfortable shoes. Swelling and gout make feet tender. Wear wide, soft shoes with arch support. Avoid heels completely.
When to See a Doctor - And Who to See
Don’t wait for your next prenatal checkup if you feel sudden joint pain. Call your OB-GYN right away. They should refer you to a rheumatologist who understands pregnancy. Not all rheumatologists do - so ask if they’ve treated pregnant patients with gout before.
Bring a list of your symptoms: when the pain started, what makes it better or worse, how long it lasts. If you’ve had gout before, bring your old test results. Uric acid levels above 6.8 mg/dL are considered high - but during pregnancy, normal ranges shift. Your doctor needs context.
In some cases, your doctor might prescribe low-dose colchicine - the only gout medication with enough safety data for pregnancy. It’s not risk-free, but when used carefully, it’s often safer than letting gout rage unchecked.
What Happens After Baby Arrives
Many women notice their gout flares get worse after delivery. Why? Because estrogen drops fast. Your kidneys also start working harder again - but now you’re sleep-deprived, stressed, and possibly breastfeeding. All of that can trigger another flare.
That’s why planning ahead matters. Talk to your doctor before delivery about your postpartum gout management. Breastfeeding is safe with colchicine and low-dose prednisone - but not with allopurinol. If you’re planning to nurse, get this sorted before the baby comes.
Long-Term Risks - It’s Not Just About This Pregnancy
If you had gout during pregnancy, you’re more likely to develop chronic gout later in life. A 10-year follow-up study in Sydney found that 68% of women who had gout while pregnant developed persistent gout within five years after childbirth.
But here’s the good news: lifestyle changes work. Losing weight (even 5-10% of your body weight), cutting out alcohol, and sticking to a low-purine diet can cut your flare-ups in half. And if you plan another pregnancy, you can work with your doctor to lower your uric acid levels before conceiving - which reduces your risk dramatically.
Bottom Line: You’re Not Alone
Gout during pregnancy is rare, but it’s real. And it’s not your fault. Your body is doing something incredible - growing a human - and sometimes, that process clashes with old health issues. You don’t have to suffer through it alone. Ask for help. Get the right specialists on your team. And know that with the right care, you can have a healthy pregnancy - and a healthy future.