If you're a woman newly diagnosed with MS, you may be concerned about how MS will affect your ability to get pregnant and deliver a healthy child. The concern is not uncommon. About 200 people are newly diagnosed with multiple sclerosis each week in the United States, according to the National Institute of Neurological Disorders and Stroke – and the majority of these are women of childbearing age.
There are a good number of myths about how MS affects pregnancy. The good news is that scientists have been studying how MS affects pregnancy and fertility for the last 40 years, providing reassurances that MS should not prevent you from getting pregnant or having a child.
MS Does Not Affect Fertility
Multiple sclerosis neither impairs fertility nor increases the chances of stillbirth, spontaneous abortion and congenital malformation, according to the National Multiple Sclerosis Society.
However, you should know that MS symptoms, such as pain, fatigue, poor coordination and sexual dysfunction can interfere with sexual intercourse. It’s important to have open conversations with your partner about dealing with symptoms. You might try different positions and new times for sexual intimacy to aid conception. Don’t hesitate to talk to your doctor too; many times the doctor can offer helpful therapies.
Multiple Sclerosis Symptoms Stabilize During Pregnancy
A majority of studies suggest that pregnant women actually experience fewer MS relapses than non-pregnant women during the nine months of pregnancy. It’s believed that during pregnancy, changes in the immune system help keep MS symptoms at bay. Levels of natural immunosuppressants in the body rise, as do natural corticosteroid levels.
Unfortunately, symptom improvement is usually short-lived. During the first three months after childbirth, relapse rates increase to the tune of 20 to 40 percent, according to the National Multiple Sclerosis Society. Some women experience an immediate return of symptoms, while others will continue to enjoy a symptom-free period.
Dealing With Pregnancy-Related Symptoms
Pregnancy usually brings on fatigue, and that can only compound fatigue that can come as the result of MS. During pregnancy, make sure to schedule plenty of breaks in your day and strive to get full nights of sleep. Ask family and friends to help you with household tasks and errands.
If you have existing gait problems due to MS, these may worsen as you gain weight during pregnancy. You might find that using a cane or wheelchair helps you get around safely.
A woman typically urinates more frequently during pregnancy and experiences more frequent bowel movements. If you have bowel or urinary dysfunction due to MS, expect to visit the bathroom more often.
Pregnant women with MS are also at an increased risk for urinary tract infections (UTIs), according to the American Academy of Family Physicians. You’ll want to drink plenty of fluids throughout your pregnancy. Your doctor may also recommend regular testing for UTIs.
MS Medications and the Developing Baby
The U.S. Food and Drug Administration (FDA) assigns a classification to every drug on the market in the United States that describes its pregnancy risks, based on existing human and/or animal research:
- Class A drugs do not appear to cause harm to a fetus during any trimester.
- Class B drugs do not appear to markedly increase risks to a fetus but birth defects are still a remote possibility.
- Class C drugs might harm a fetus and should be used under close doctor supervision. Some examples: corticosteroids and beta interferon.
- Class D drugs have clear evidence of causing harm to a fetus and should only be used when a woman’s life is at risk. Some examples: cyclophosphamide, azathioprine and mitoxantrone.
- Class X drugs should never be taken during pregnancy because they are considered extremely dangerous to a fetus and may cause birth defects. Methotrexate is a class X drug.
Certain medications used to treat MS can cause harm to a fetus. It is very important to talk to your doctor before trying to conceive. It is also important to avoid unplanned pregnancies. Your doctor will likely modify your treatment plan to decrease the risks.
Labor and Delivery
Many women with MS experience an uncomplicated childbirth. Others may need some assistance. If MS affects the nerves and muscles in the pelvic area, for example, you may need extra help during labor and delivery. Talk to your doctor beforehand to know what you might expect and come prepared with questions.
While a woman with MS may need to make some adjustments before and during pregnancy, the chances are good that she can give birth successfully with the right self-care and support from her doctor, family and friends.
By: R. Elizabeth C. Kitchen
American Academy of Family Physicians. Multiple Sclerosis and Pregnancy. Available at: http://familydoctor.org/online/famdocen/home/common/brain/disorders/1019.html Accessed on June 20, 2011.
American Pregnancy Association. FDA Drug Category Ratings. Available at: http://www.americanpregnancy.org/pregnancyhealth/fdadrugratings.html Accessed on July 14, 2011.
Dadalti Fragoso, MD, MSc, PhD. Multiple Sclerosis and Pregnancy. Available at: http://cirrie.buffalo.edu/encyclopedia/en/article/248/#s5 Accessed on June 20, 2011.
National Institute of Neurological Disorders and Stroke. Multiple Sclerosis: Hope Through Research. Available at: http://www.ninds.nih.gov/disorders/multiple_sclerosis/detail_multiple_sclerosis.htm#176203215 Accessed on June 20, 2011.
National Multiple Sclerosis Society. Pregnancy and Reproductive Issues. Available at: http://www.nationalmssociety.org/living-with-multiple-sclerosis/healthy-living/pregnancy/index.aspx Accessed on June 20, 2011.
Postgraduate Medical Journal. Multiple Sclerosis and Pregnancy. Available at: http://pmj.bmj.com/content/78/922/460.full Accessed on June 20, 2011.
Yale Medical Group. Multiple Sclerosis and Pregnancy. Available at: http://www.yalemedicalgroup.org/stw/Page.asp?PageID=STW023766 Accessed on June 20, 2011