# Biopsychosocial Management of Rural Ankylosing Spondylitis in a Pregnant Woman: A Case Report

## TL;DR

This case report describes the biopsychosocial care of a pregnant woman with ankylosing spondylitis in a rural area, emphasizing holistic and patient-centered approaches.

## Contribution

The paper presents a novel case of managing AS in a rural pregnant woman with tailored biopsychosocial strategies.

## Key findings

- Diclofenac was initially used for pain relief due to its safety during breastfeeding.
- Adalimumab was introduced later as breastfeeding circumstances improved.
- Holistic care, including mental health support and education, improved patient outcomes.

## Abstract

In a rural Japanese setting, this case report delves into managing a post-partum woman diagnosed with ankylosing spondyloarthritis (AS), showcasing the complexities of balancing effective pain relief with breastfeeding. The study highlights a multifaceted approach that incorporates medical treatment, psychosocial support, and comprehensive patient education, which are essential in rural healthcare where resources may be scarce. Initially managed with diclofenac due to its safer profile for breastfeeding, the patient's treatment was eventually escalated to adalimumab, aligning with improved circumstances regarding breastfeeding. This case emphasizes the critical role of holistic, patient-centered care in family medicine, particularly for managing maternal and child health chronic conditions. It illustrates how integrating mental health support, acknowledging patient fears, and educating families can significantly enhance patient care and outcomes. Through this approach, the report advocates for a broader application of family medicine principles to improve maternal and child health services in rural settings, demonstrating the importance of tailored healthcare strategies that consider patients' medical and emotional needs.