Pregnant Women

Inflammatory bowel disease (IBD) is an umbrella term for diseases that cause inflammation or ulcers in the intestines or along the digestive tract, including Crohn’s and ulcerative colitis. Most women who have IBD will have it throughout their reproductive years.

It’s common to wonder how IBD might affect you during a pregnancy. You should know that many women with IBD have healthy, happy pregnancies—but it’s important to plan ahead.

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Before You Get Pregnant

If you’re thinking about a pregnancy, talk with both your gastroenterologist and your obstetrician to do some advance planning. IBD should not affect your ability to conceive or deliver a baby.

When you experience an IBD flare, common symptoms include:

  • Severe stomach cramps
  • Diarrhea
  • Vomiting
  • Gastrointestinal bleeding

If these symptoms are active while you are pregnant, you will need extra help to get you and your pregnancy off to a healthy start.

The Crohn’s and Colitis Foundation recommends that women wait to get pregnant until they’ve been in remission and off steroids for at least three to six months. Waiting several months will increase your chances of conceiving and will lower your risk for complications.

It’s also essential to eat a healthy diet and take any recommended vitamins before getting pregnant.

Risks During Pregnancy

If you get pregnant during a flare-up, your IBD is more likely to stay active throughout your pregnancy. However, if you get pregnant while your IBD is in remission, you have a better chance of staying in remission throughout your pregnancy. With stable IBD, the relapse risk is about 30 percent — the same as in non-pregnant women.

If you stay in remission, you’ll also have a much lower risk of complications with your pregnancy. It’s important to stay in close contact with your medical team so they can monitor your IBD. Your obstetrician (OB) will monitor you closely to determine if you can deliver vaginally or may need a C-section.

IBD Medications and Pregnancy

Most medications for IBD are safe and carry low risks during pregnancy and breastfeeding. However, there are a few IBD medications that you should not use during pregnancy, so make sure to tell both your gastroenterologist and your OB when you find out you’re pregnant.

Your gastroenterologist will work with you to alter any medications that might pose a risk to you or your baby, while still keeping your IBD symptoms under control. Do not stop taking your IBD medications without speaking to your doctor.

After Pregnancy

It’s normal to wonder whether you should breastfeed after the baby is born. Breastfeeding offers great benefits to your baby, but you may have concerns about breastfeeding while taking IBD medicines. Fortunately, most are safe to use while breastfeeding.

Talk with your doctor about your decision to breastfeed so that you can find the safest combination of medications. It’s also a good idea to work with a registered dietitian who can help you plan a diet that supports your recovery and your baby’s nutritional needs.

IBD is a challenging condition for women, especially if you’d like to start a family. But with proper planning and coordination with your health care team, there’s no reason you can’t have a healthy pregnancy and baby even with IBD.

For more information about preparing for a healthy pregnancy with IBD, check out the IBD Parenthood Project or speak with your doctor.

Sources

Crohn's and Colitis Foundation. Pregnancy Fact Sheet. Link

Digestion. Update on the Management of Inflammatory Bowel Disease During Pregnancy and Breastfeeding. Link

Gastroenterology. Inflammatory Bowel Disease in Pregnancy Clinical Care Pathway: A Report From the American Gastroenterological Association IBD Parenthood Project Working Group. Link

About Digestive Disorders

The UPMC Digestive Disorders Center cares for a wide range of gastrointestinal conditions and diseases, from diagnosis to treatment. Upon referral from your physician, we coordinate your testing and treatment. If you have a complicated condition, we can refer you to one of UPMC’s digestive health centers of excellence. Most of our office visits and outpatient procedures take place at UPMC Presbyterian or UPMC Magee-Womens Hospital in Oakland. We also provide inpatient care at UPMC Montefiore or UPMC Presbyterian in Oakland.