Inflammatory Bowel Disease and Pregnancy
It is best to talk to your doctor before you become pregnant to optimize your health for your body to take care of a growing baby. Although most medication for inflammatory bowel disease may be continued during pregnancies, some are preferred over others. Your doctor may take this into consideration when starting or changing a medication. Most studies have shown that if you are doing well and your disease is in remission (under good control) before you become pregnant, you and your baby will do well during pregnancy.
Is it safe for me to become pregnant?
For the most part, pregnancy is not unsafe just because you have inflammatory bowel disease. During pregnancy, one-third of inflammatory bowel disease patients will have improvement of inflammatory bowel disease symptoms, one-third with no change, and one-third will have a flare. The best predictor of how your inflammatory bowel disease symptoms will respond to pregnancy is how well they are controlled before you get pregnant.
Do I need to stop my inflammatory bowel disease medications if I want to become pregnant?
In general, you do not need to stop most medications if you become pregnant. Do not stop your medications until you speak with your doctor.
The medications with known risk of birth defects you must stop (before becoming pregnant) include:
- Thalidomide (rarely used)
- Most other medications, you can discuss with your gastroenterologist before you stop.
I have Crohn's disease or ulcerative colitis, and I'm pregnant. What should I do now?
First of all, congratulations!
The next step is to make an appointment with your gastroenterologist and go through the details of your pregnancy, your disease, and your medications. If you are pregnant and you have inflammatory bowel disease, make sure you tell us this when you call to make an appointment.
Do I need to have a C-section?
It is not a requirement that you have a C-section if you have inflammatory bowel disease. Most C-sections will be necessary only for obstetrical reasons. From your disease standpoint, if you have inflammation in your perianal area such as fistulas, you, your gastroenterologist, and obstetrician can decide jointly on what the best method of delivery is.
Dubinsky M, Abraham B, Mahadevan U. Management of the pregnant IBD patient. Inflamm Bowel Dis. 2008 Dec;14(12):1736-50.
Hou JK, Mahadevan U. A 24-year-old pregnant woman with inflammatory bowel disease. Clin Gastroenterol Hepatol. 2009 Sep;7(9):944-7.