Having inflammatory bowel disease (IBD) shouldn't prevent you from starting a family. Despite the challenges, women with ulcerative colitis (UC) can have healthy pregnancies. But it's important to know how your illness will affect conceiving and giving birth to a healthy baby.
Will ulcerative colitis make it harder for me to get pregnant?
The chance of a woman with ulcerative colitis getting pregnant is no different from other women her age. But although UC doesn't directly affect fertility, women who have had surgery may have a harder time getting pregnant.
A full colectomy, when the entire large intestine is removed and the surgeon creates an internal pouch to hold waste, can leave scar tissue in the pelvic area. If you need to have surgery and know you want to have children, a partial colectomy with a pouch on the outside could be a better choice. It won't affect your chances of getting pregnant. After you've had children, you can have the rest of your large intestine removed and a pouch made on the inside.
How can I raise my chances of a healthy pregnancy?
The most important thing you can do is get active UC under control and into remission before trying to get pregnant. If you get pregnant while the disease is still active, there's a good chance your symptoms will continue or get worse during pregnancy.
Active UC flare-ups can leave you underweight and without the nutrients you need to get pregnant and carry a baby to term. Being underweight makes having a miscarriage in the first trimester much more likely. If you're underweight, your baby could be premature or underweight, too.
As soon as you start thinking about getting pregnant, make an appointment to see your doctor as well as your OB-GYN. Talk with them about how to make sure you're getting the care you need to have a healthy pregnancy. A dietitian can help make sure you're eating a well-balanced diet.
Like women without UC, you should take a prenatal vitamin every day while you're trying to get pregnant and during pregnancy. Sometimes the iron in prenatal vitamins can be rough on your system, so you may need to try different formulations.
Be sure to get your iron levels checked, because women with UC are prone to anemia.
You may also need to take extra folic acid. Folic acid helps prevent birth defects, but UC, as well as sulfasalazine that's used to treat it, can make it hard for the body to absorb folic acid.