If you want to start a family, multiple sclerosis (MS) doesn’t have to stop you. It doesn’t keep you from getting pregnant or hurt your unborn baby. Odds are your pregnancy and delivery will be just like those of women without MS.
Still, moms-to-be with MS face unique challenges. Make a plan and learn what to do before, during, and after pregnancy to make your next 9 months a little easier.
Before You Get Pregnant
Talk to your doctor. Let them know you want to have a baby. If your MS is under control, you’ll probably get a green light.
Some MS drugs -- like interferons, and teriflunomide (Aubagio) -- aren’t safe during pregnancy. You’ll need to stop taking them at least 1 month before you start trying. Glatiramer acetate (Copaxone) is considered safe, but always consult your doctor about risks and benefits.
Time it right. Just like any other woman, you might not get pregnant right away. To limit the time you’re off your medicine, try to learn your “fertility window.” That’s the time of the month when you’re most likely to conceive. You can buy an ovulation kit at the drugstore to help you figure it out. Your doctor can recommend other ways to help your timing, too.
Build a support team. MS can wear you out, and pregnancy can, too. Don’t be afraid to ask family and friends to fix meals or help around the house so you can save your energy. Make sure your team is ready to pitch in after the baby comes, too.
While You’re Pregnant
Expect some relief. You may get a break from your MS symptoms. That’s because pregnancy naturally protects many women from new flares, especially after the first 3 months. So enjoy it! Focus on getting the right foods, exercise, and plenty of rest.
Watch out for urinary tract infections (UTIs). They are more common for pregnant women with MS. Drink lots of water, and tell your doctor if you feel burning when you go to the bathroom or if your urine is cloudy or smelly. You may get monthly urine tests to check for UTIs.
You also may have trouble with constipation. A stool softener can get things moving.
Prop yourself up. As you get bigger, your balance may be off. Use a cane or other walking aid so you don’t fall.
Prepare for your special delivery. Chances are you’ll be able to give birth just like any other woman.
If you can’t push because of fatigue or muscle weakness, your doctor may use special tools to help you deliver naturally. Or you might need a C-section.
You might not know when labor starts if you have lost feeling in your pelvis. In that case, your doctor will watch you more closely during the last month. They may want to use drugs or other procedures to put you in labor.
Medicines to block pain, including shots called epidurals, are safe for people with MS. If you want one, tell your doctor.
After Baby Comes Home
Be aware of flares. In the first 9 months after birth, up to 40% of women with MS will have a relapse. But a flare doesn’t raise your risk of a long-term disability.
If you had many flares before pregnancy, you may be more likely to have one now. It may be a good idea to start taking your MS medicine right away to help stop one.
Think carefully about breastfeeding. Pediatricians suggest breastfeeding for at least the first year of your baby's life and exclusively (meaning you don't add formula or food) for the first 6 months. That doesn't change because you have MS. Breast milk naturally has the vitamins and nutrition your growing baby needs, as well as antibodies that boost their developing immune system.
Breastfeeding can be good for you, too. Studies suggest that exclusive breastfeeding for at least 2 months may delay an MS relapse. When you stop nursing or you breastfeed less often, your MS symptoms will probably come back, around the time your period returns.
But if you have to go back on your meds, you won’t be able to breastfeed. Steroids, drugs that modify your disease like interferon beta, and drugs that weaken your immune system could harm your baby through your milk. But if your doctor says it’s OK to wait to take your medicine, breastfeed if you want to. It’s perfectly safe for you and great for your little one.
Try to pump extra milk during the day and store it in the fridge so your partner can tackle middle-of-the night feedings. You need your rest now more than ever.
Don’t feel guilty if you choose medication over breastfeeding. After all, your new addition needs a mom who can stay healthy.
Mind your mood. Women with MS have a higher risk of depression during pregnancy and especially right after they give birth. Call your doctor if you start to notice any symptoms, like feeling sad or hopeless. Your OB/GYN may also screen you for depression during a routine prenatal or postpartum visit. Your doctor can help treat your depression symptoms.
Will your baby grow up to have MS? It’s a common concern for many parents-to-be. MS does have some genetic links, but the adult children of parents with the condition have a 96% chance they won’t have it.