What if you’re ready now?
MythMy doctor doesn’t have time to discuss pregnancy; they just want to focus on my Crohn’s.
Your doctor is there to try to help you stay healthy through all phases of life, and that includes pregnancy!
- If you’re in remission leading up to and when you conceive, the chances of staying in remission are good
- It's best to be in remission for 3–6 months before conceiving
- Conceiving during an active flare isn’t good for you or the baby
- No medicines carry zero risk, but it may be possible to take certain Crohn’s medications while conceiving, carrying, and breastfeeding
- Don’t be afraid to get chatty—talk about anything and everything with your gastroenterologist and OB/GYN. They’re there to answer questions and make sure you’re satisfied and as healthy as possible throughout this process Read Less
How will pregnancy affect your Crohn’s?
MythPregnancy is going to have me flaring all over the place.
Good news! The chances of having a flare-free pregnancy are better if you’re in remission before conceiving.
What can you expect with flares?
Some data suggest that pregnant women with Crohn’s who conceived while in remission and nonpregnant women with Crohn’s may have the same rates of flares. And another study of 145 women with Crohn’s found that nearly 9 out of 10 women who conceived while in remission stayed in remission.
But (you knew there’d be a but, right?), it’s a different story for women who conceive during a flare. When conceiving during a flare, about 1/3 of women will have their disease stay consistently active, 1/3 will go into remission, and 1/3 will have worsening disease activity.
Post delivery, the data aren’t completely clear. Some research suggests that the rate of flares could decrease after delivery while other research found that as many as 1/3 of women may experience a flare after giving birth. One study did find that conceiving during a flare was a predictor for a postpartum flare.
The important thing is that you keep the Crohnversation going even after delivery. Your body just went through a lot! Tell your gastroenterologist everything you’re feeling so they know how to help.
You may also be going through some medication changes in this time period. We know we sound like a broken record at this point—but it’s worth repeating! Make sure you’re telling your gastroenterologist everything you’re feeling so they can help you feel your best.
How will pregnancy affect your ostomy?
- displacement
- enlargement
- retraction
- stenosis
- prolapse
Your gastroenterologist might suggest working with a nutritionist so that you can avoid excessive weight gain during pregnancy (while still completely nourishing your baby) to help manage any issues. Read Less
How will Crohn’s affect your pregnancy?
MythI won’t be able to have a
healthy pregnancy.
With information and planning, you may be able to have a healthy pregnancy.
Let’s get into the nitty gritty here
We won’t sugarcoat it. Yes, there is a chance that Crohn’s could affect your pregnancy. But just because you have Crohn’s, that doesn’t mean you’ll inevitably run into issues. Let’s break it all down.
First, it’s important for you to be in remission for 3–6 months before conceiving. (If you’re not ready to start trying yet, talk to your OB/GYN about the type of birth control that could be right for you.)
Now let’s dig in to why being in remission is so important. Conceiving during an active flare isn’t good for your health or your baby’s health.
For you, it could mean continuing or worsening disease activity.
For your baby, depending on the trimester, there is a possibility for miscarriage, not growing to their full potential, or pre-term delivery. We know that sounds scary. Before anxiety gets the chance to take over—let’s take a breath and look at some data around this.
One study paired pregnant women with Crohn’s and pregnant women without Crohn’s. Nearly 87% of women with Crohn’s were in remission at conception/first trimester. Let’s look at the data:
9.1%
of women with Crohn’s
had a pre-term delivery
(that’s birth before 37 weeks)7.6%
of women without Crohn’s
had a pre-term deliveryThat’s a difference of 1.5%
Now this particular study didn’t find a significant difference in pre-term delivery between women with Crohn’s and women without Crohn’s. So, this study suggests that just because you have Crohn’s, it doesn’t mean pre-term delivery is a definite outcome. But remember, this is only one study. There are other data that show Crohn’s may be a risk factor for certain complications.
Two studies that used retrospective data (meaning they looked at information from past studies) suggest that having Crohn’s could be a risk factor for pre-term delivery and other complications.
We know—it’s frustrating not to know what could happen, but it’s important you have the full picture so you can make informed decisions.
So yes, there are risks—but you may be able to have a healthy pregnancy with the proper planning. It’s all about communicating early and often with your doctors.
What can you do to help manage these risks?
- It’s important to keep your Crohn’s under control during pregnancy. A healthier mom means a healthier baby.
- Avoid drinking alcohol. Alcohol has a number of negative effects on your growing baby.
- Quit smoking. Smoking can increase the risk of a pre-term delivery.
If you’re having a difficult time, there is support. Our resources section has numerous organizations and groups that can be there for you. And don’t forget, your doctor is also a resource. Let them know if you need help.
Let’s talk about medicines
MythI can’t take my Crohn’s medication while I’m pregnant.
There are certain medications that you may be able to take from conception to delivery and beyond.
No medicine carries zero risk.
That’s for all medicines, not just the ones that treat Crohn’s. Even over-the-counter medications for headaches and nausea aren’t 100% risk-free during pregnancy.
That’s because nearly everything you put into your body can travel to your baby through the placenta. The placenta is an organ that attaches to the wall of your uterus and provides oxygen and nutrients to your baby and removes any of their waste.
You and your gastroenterologist can walk through your current medications and whether they’re ok to take while conceiving, carrying, and breastfeeding. Your OB/GYN can give you more information about what vitamins, supplements, and over-the-counter medications are ok to take, as well.
During your pregnancy, there are medicines that may be ok to take and others that may not be.
Medicines that shouldn’t be taken during pregnancy include (but are not limited to)
- Methotrexate
- Thalidomide
- Corticosteroids for maintenance therapy
- Loperamide and diphenoxylate should be discontinued when possible
Will you need to stop your medication?
That’s a very personal decision that will be informed by your medical history, how your pregnancy is developing, and how your gastroenterologist decides available data should be applied to your case.
Ask as many questions as you need to feel comfortable, because remember, the Crohnversation is meant to be a discussion. Tell your gastroenterologist and your OB/GYN about any and all concerns. You’ll need to decide what is right for you together based on your medical history, your goals, and the potential treatment options.
Let’s talk about delivery
MythI can’t carry or deliver a baby because of my Crohn’s.
Delivery options are different for everyone, but it may be possible to carry and deliver a baby when you live with Crohn’s (especially if you’re in remission when you conceive).
You heard us right
It may be possible to carry and deliver a baby when you live with Crohn’s (especially if you’re in remission when you conceive).
But remember that, even for women without Crohn’s, things can change as a pregnancy progresses. Any change in your delivery plan is all about keeping you and your baby as healthy as possible.
Now let’s talk about the delivery itself. It’s possible you may be able to give birth vaginally. If you have active perineal disease at the time of delivery (or other complications), your medical team may recommend a C-section.
Determining if a vaginal delivery or a C-section is right for you and your baby depends on a lot of different factors. Some factors that may play a role in your delivery team’s recommendation include if you’re experiencing or have:
- an active flare
- perianal complications (like fistulas or abscesses)
- IPAA surgery or a J-pouch
- an ostomy
Consider bringing up how you feel about this particular procedure. Some studies suggest that episiotomies may impact a woman’s Crohn’s disease. You and your doctors can discuss how, when, and if this procedure will be used in the delivery room.Read Less
Let’s talk about post-delivery
MythI won’t be able to breastfeed
my baby and take my Crohn’s medication.
It depends. This will be a discussion between you and your doctor. So it may be possible to continue your treatment while breastfeeding if your doctor advises it and you feel comfortable doing so.
First off—yay!
It’s so wonderful that you brought a little human into the world, and we know you’re going to be a fantastic mama.
Managing your Crohn’s
Your body has been through a lot. Between the physical labor of delivery, the change in your hormones, and the stressors of parenthood it’s understandable if you’re not feeling in tip top shape.
We wish we could tell you exactly what was going to happen with your Crohn’s, but the data aren’t completely clear. Some research suggests that the rate of flares could decrease after delivery while other research found that as many as 1/3 of women may experience a flare after giving birth. One study did find that conceiving during a flare was a predictor for a postpartum flare.
That's why the Crohnversation can keep going even after delivery. Continue to discuss any new symptoms, new side effects, or if you feel like your medication isn’t working like it used to. Together, you and your gastroenterologist can modify your treatment plan to help get things under control.
Breastfeeding
Similar to when you were carrying your baby, what goes in your body can possibly be passed to your baby through your breast milk. Keeping your Crohn’s stable is a priority though, and we want you to know that there are medications that may be options while breastfeeding. And you’re not alone: in a study of 132 women with Crohn's, 80% chose to breastfeed, and half of them breastfed for more than 24 weeks.
Of course, discuss all the benefits and risks with your gastroenterologist, OB/GYN, and (if available) lactation specialist, so you can choose what’s right for you and your baby. If you want to read the most current breastfeeding information, you can visit LactMed here.
Vaccines
Your baby’s vaccine schedule may need to be modified depending on what medications you took during your pregnancy. So be sure to discuss which medications you took with your child’s pediatrician.
