When to start
There’s no good time to talk about my baby plan.
It’s always a good time to talk about your plans!
Before we get into the how, let’s talk about the when.
The journey is going to be different for everyone. We all have different bodies and different timelines. But if having a baby is something you think you might want—bring it up now. Starting the Crohnversation means you and your gastroenterologist can plan together to make treatment decisions that fit with your goals.
And speaking of your gastroenterologist, they’re going to be the best person to start this whole journey with. After all, getting your Crohn’s under control is the first priority. Then you can start talking to your OB/GYN and any other healthcare providers who will be on your team.
If you’re not sure how to start the Crohnversation, answer a few questions and we can give you a personalized doctor discussion guide for your next appointment.
Your medical team
I’m going to go through this process alone.
Your doctors are there to make sure you’re happy and comfortable. Check out our resources section for online communities too.
Who is a part of your treatment team?
Who are they and what will they be doing? Let’s look at the different medical providers who may be helping you throughout your pregnancy journey.
Your Gastroenterologist: They’re going to handle managing your Crohn’s throughout the journey of conceiving, carrying, delivering, and beyond. They may weigh in on medication adjustments, delivery methods, and anything else that’s related to keeping you as healthy as possible.
Maybe you and your gastroenterologist have already talked about your family planning goals in the past. Or maybe it’s never come up. Either way, it’s ok if you’re the one to kick things off.
Your OB/GYN or Maternal–Fetal Medicine Specialist (MFM): One of these two providers will coordinate everything related to your baby and the delivery. What’s the difference between an OB/GYN and MFM?
OB/GYN
An obstetrician (OB) is a physician who specializes in pregnancy and childbirth. A gynecologist (GYN) is a physician who specializes in women’s health.
Some physicians will focus on obstetrics or gynecology and some physicians will focus on both areas.
MFM
A maternal-fetal medicine specialist (MFM) is an obstetrician who has completed 3 additional years of specialized training in complicated pregnancies. You might also hear them called a perinatologist.
If your gastroenterologist or regular OB/GYN recommends including an MFM on your team, don’t take that as a bad sign. Because of your Crohn’s, you’ll be considered a "high-risk patient." That doesn’t mean anything’s wrong; it’s all about being proactive.
A note about access
We realize that everyone might not have access to an MFM—and that’s ok. You can receive obstetric care from a general obstetrician, family practitioner, or midwife. The IBD Parenthood Project has information and tools that you can share with your chosen pregnancy care provider so you can build a plan together.
- Colorectal surgeon and an ostomy/wound nurse: If you have an ostomy, your gastroenterologist and OB/GYN may coordinate with these specialists
- Nutritionist: If you’re experiencing an active flare, had significant surgical changes, haven’t gained enough weight during your pregnancy, or are trying to avoid excess weight gain because of an ostomy, a nutritionist can help provide guidance
- Lactation specialist: They’ll be able to help you with the ins and outs of breastfeeding and formula feeding
- Mental health professional: Sometimes it helps talking to someone who can be objective (and has a therapy degree) If you’re worried about accessibility, there are options.
Your partner
We want to take a minute to acknowledge that Crohn’s can be tough at times. You’ve done a lot to take care of yourself and advocate for what you need. And since you’re so used to being the strong one, it might be hard to let others take care of you.
After your baby arrives, you may need to shift that thinking. So many things are going to change, and it’s ok to allow your partner (or family members and friends) to step in and help shoulder the load. Remember, they’re on your team.
While it’s not specific to Crohn’s, the Gottman Institute shared a list of discussion topics that are useful for you and your partner to think about prior to your baby’s delivery. It’s better to be prepared and voice these things ahead of time, rather than waiting until you’re both sleep deprived and not in the most empathetic state.