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Pregnancy and birth

Many women who have MS are diagnosed in their twenties and thirties, at a time when they may be thinking about starting a family.

Having MS shouldn't stop you having a baby, but careful planning with your family, friends and your doctor becomes more important.

Often, an MS nurse will contact your midwife to ensure appropriate pregnancy care plans are in place.

Read more about pregnancy and MS

Having a baby

MS doesn't affect your fertility. If you get pregnant, this won’t make your MS worse in the long run. You’re not more likely to get any disability because you got pregnant.

Some disease modifying therapies (DMTs) can harm unborn babies. So if you’re trying to have a baby, or if you become pregnant, let your neurologist know straight away to see if you need to stop taking your DMT.

One DMT has a licence that allows it to be used during pregnancy. That’s Copaxone, a brand of the drug glatiramer acetate. Neurologists might advise some pregnant women to keep taking certain DMTs - such as beta interferons or natalizumab (Tysabri) - if the risk to them of stopping is bigger than any possible risk from the drug.

If you want to get pregnant and decide to stop taking your DMT, you must do this a few months in advance. This lets levels of the drug in your body drop to levels where it’s safe to become pregnant. This can range from one to 12 months depending on the drug. Only stop your DMT with the advice of your neurologist.

For men who want to father a child, there are two DMTs that are known to affect sperm and so might harm an unborn baby. These are teriflunomide (Aubagio) and cladribine (Mavenclad).

Pregnancy and relapses

There've been many studies examining the impact of pregnancy on MS. They all show that pregnancy appears to have a positive protective influence, with relapse rates going down, especially during the third trimester (between six and nine months). The reasons for this are not fully understood, but it's thought hormone levels play a role.

However, in the first three months after the baby is born, your risk of relapse rises. We think this happens because your hormones return to pre-pregnancy levels.

Research suggests post-pregnancy relapses don't increase long-term levels of disability. In other words, pregnancy should have no effect on the progression of your MS in the long-term.

Pregnancy and MS symptoms

Although women may have fewer relapses during pregnancy, other MS symptoms can be affected.

> fatigue

> balance

> back pain

> bladder problems

> bowel trouble

Taking medications and getting pregnant

Some DMTs can harm unborn babies and shouldn’t be taken if you’re a woman expecting a baby. With medications that aren’t DMTs, the usual advice is to wait at least three months after stopping treatment before trying to get pregnant. Discuss your medications with your doctor before making any changes. It can be dangerous to suddenly stop taking medications.

If you have a relapse and need steroids, it’s safe to have these at any stage of a pregnancy. But if you have a relapse during the first three months, ask your neurologist about the benefits of taking steroids this early in the pregnancy.

Pregnancy and giving birth

Having MS will not directly affect your pregnancy, labour or giving birth. Several studies have shown that mothers with MS are just as likely as any other mothers to have healthy pregnancies and babies. And there is no research to show MS may increase risk of ectopic pregnancy (where a foetus develops in the fallopian tube), miscarriage, premature birth, still-birth or birth abnormalities.

Having MS doesn't mean you need to have a caesarian. And both epidurals, and anaesthetics for caesarean births, are as safe for people with MS as they are for anyone.

What will happen after I have my baby?

Whether or not you have MS, the period immediately after the birth can be very tiring and it can take time to adapt to the demands of having a baby to care for. For women with MS, planning to ensure there is support during this time is particularly important.

You may wish to contact and make lists of family and friends who can help with specific tasks, and find out about health services, local service provisions for mums and support groups. Many women find it reassuring to know local sources of support are available, and find early planning makes life easier when the baby is born.

Children getting MS

Unlike some conditions, MS is not directly inherited from parent to child.

Children with a parent with MS are estimated to have around a 1.5% per cent risk of getting MS. This means around one in 67 children born to a mother or father with MS is likely to get MS themselves. A recent study suggests the risk could be even smaller than this figure.

In the general population one out of every 500 people have MS.

So, although having a parent with MS increases the risk, it is still very small.

Vitamin D

It’s advisable that all women with MS of childbearing age take a vitamin D supplement. Speak to your neurologist about how to do this and how much to take. People with MS often need a higher dose than is recommended for the general population.

If your neurologist has given you a vitamin D supplement, you should keep taking this if you get pregnant and after your baby’s born.

Breastfeeding

Most DMTs shouldn’t be taken if you want to breastfeed. The drug could be in your breastmilk and harm your baby. But with beta interferons and glatiramer acetate (Copaxone), doctors believe the benefits of breastfeeding are bigger than any risk there might be.

Experts also believe that a baby is unlikely to be harmed if its mother breastfeeds while taking natalizumab (Tysabri). Your neurologist can advise you on the different DMTs.