Wednesday, October 10, 2012

Crohn's Disease, Ulcerative Colitis and Pregnancy

The decision to have a child is an important one, and there are many things to think about before you take the plunge. For people with Inflammatory Bowel Disease there is an extra layer of considerations to add to the list.

When I spoke to my doctor, he told me about the 'thirds' rule. That generally speaking women with IBD who get pregnant find that one third feel worse, one third feel better and one third feel the same. Not a very helpful rule in my opinion. My research has found a consistent statistic that if you are in a flare-up when you conceive, you will possibly feel worse and potentially have more complications than if you are in remission. So if possible, try to time a pregnancy between flare-ups. I was in remission and my own pregnancy went pretty smoothly.


The main things I encountered were a continuation of my remission, some stretching and painful tugging of my surgery scars, and a post-delivery return of symptoms. Luckily I was not on any medications other than vitamins before conceiving.

Talk to your doctor before planning a pregnancy. This is the most important tip, which precedes the entire following list. Here are some helpful tips and pieces of information to consider and discuss with your doctor.
  • Drug interactions can be potentially serious for a fetus or breastfeeding baby. Even some drugs taken by the male partner can be dangerous during conception. Talk to your doctor about what you are taking. Some common dangerous drugs are methotrexate, sulfasalazine , steroids like prednisone, and antibiotic. There are also many drugs which are safe for pregnant women.
  •  Pay special attention to your nutrition, especially if you are on a restricted diet. Ask your doctor about pre-natal vitamins and especially folic acid. Pregnant women need to slightly increase their calorie and nutrient intake during pregnancy.
  • Past abdominal surgery may be a factor for pregnant women. Check with your doctor. Scar tissue from past surgeries can cause slight to severe painful tugging, stretching sensations. Scarred skin is not as stretchy, so moisturize well.
  • Simplify your life as much as possible before you conceive. You'll thank me once your little bundle of work - I mean joy - arrives! You might also feel more tired during pregnancy and not up to tackling household projects.
  • There is a slight increased risk of miscarriage for women with IBD.
  • Some research indicates that being pregnant may decrease your risk of future flare-ups or surgery. Yay!
  • The procedures and medical tests you can undergo safely during pregnancy are restricted. X-rays are out but ultrasound and colonoscopy are safe.
  • If both parents have IBD, there is a 33% chance that a child will have it. If only one parent, there is a 9% chance.
  • Some women report a return of symptoms shortly after delivering.
Ultimately you should consult seriously with your partner and doctor to make this decision. It is a life changing step and you should not put aside your desire to have children out of fear, until you have explored all your options. A baby can be a blessing and a miracle, just be careful with your planning.

4 comments:

  1. Interesting information. I've heard conflicting evidence for the occurrence of flare-ups during pregnancy, but I think that is as unique as each pregnant woman. I think women with IBD need to be especially cautious when considering family planning and conception. I have an IUD because I don't want to get pregnant while on Remicade. I'd rather do it when not on such potent mediation or not at all.

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  2. Dear Brightside,
    I am turning 40, had surgery a year ago. Now I am finally steroid & med free and in remission , so now I want to concieve. I truly enjoy your blog, keep on posting your experiences, pls, I feel that I am learning a lot from you. Thanks again!A

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  3. Glad I can help! Good luck and if your doctor gives you the thumbs up then go for it!! :)

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