Many women who have been diagnosed with multiple sclerosis – an autoimmune disease that affects more than 400,000 people in the U.S. – are convinced that they cannot have children, but the opposite is true. Yes, you face certain risks that women without MS don’t have to deal with, but it is still possible to have a safe, healthy pregnancy. In fact, pregnancy can reduce relapses, according to the National Multiple Sclerosis Society.
Before getting pregnant, you will need to talk with your doctor about early prenatal care and possibly modifying your treatment to ensure the health and safety of your unborn child. So, what can women with MS expect during pregnancy?
“The first and third trimester of pregnancy could cause a lot of fatigue,” says Dr. Bola Oyeyipo, a family physician in San Antonio, Texas and co-founder of Healthgist.com. “A pregnant woman with MS may be a little more tired so pacing herself, taking frequent breaks and relying on communal support are helpful.”
If your MS is more advanced (poor coordination and loss of bladder control), Dr. Oyeyipo says women with MS who are pregnant or want to become pregnant should be open to a possible C-section because “the extensive nerve damage to the pelvic area could make vaginal delivery difficult.”
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Although many women with MS experience relief during pregnancy, the flare-ups often return during the post-partum period due to the hormonal changes that occur. “The primary female hormone is estrogen while the primary pregnancy hormone is progesterone,” Dr. Oyeyipo explains. “During the nine months of pregnancy, women with MS adjust to the gradual rise in progesterone. Delivery brings about a precipitate drop and this sharp swing in the hormonal balance could negatively impact some women with MS by bringing on a flare up of their MS.”
Dr. Oyeyipo recommends getting plenty of rest and talking with your doctor about taking a progesterone-only birth control to reduce the number of flare-ups. Furthermore, disease-modifying drugs are known for reducing the amount of postpartum relapses, but if you plan on breastfeeding, then the use of DMDs isn’t recommended.
“MS has not been shown to negatively impact pregnancy,” Dr. Oyeyipo reassures. “Women with MS are very capable of having a safe, healthy pregnancy and delivery. Some women with MS might even enjoy a long remission period from MS while pregnant.”