Crohn's Disease: Pregnancy Questions and Answers
I was 19 years old when I diagnosed with Crohn's disease. I had many questions about this new disease. In particular, I wanted to know if this would hurt my chances of having children. For as long as I could remember I had wanted to be a mother. I felt that I could handle whatever this disease threw at me as long as I could still have children. Doctors and websites assured me that I would be able to have children and 6 1/2 years later my beautiful son was born.
Despite all the assurances I had early on I still had a ton of questions. However, I decided to take it one step at a time. I felt a little blind and lost as I went through my pregnancy, even with the help of some amazing doctors. One by one, though, my questions were answered. Partly because of my own personal experience (I had more than one "ah-ha!" moment) and because I figured out the right questions to ask (usually after the fact).
I have decided to share some general questions with you (all of which I asked) and answers to those questions. My goal is that if you have Crohn's disease and are planning on becoming pregnant or are pregnant, that this information might help ease the journey. Also, if you know someone (a friend, a wife, a daughter, etc.) who has Crohn's disease and is pregnant, then maybe you will be able to better understand some of the challenges she is facing.
Can I get pregnant?
Yes! If your Crohn's disease is under control and in remission, then your chances of getting pregnant are the same as any other woman. However, if you have active Crohn's disease then it might be a little more difficult.
If you want to become pregnant I suggest that you get your disease under control. I absolutely hate going to the doctor, I really do. However, I wanted to make sure that I was in the best health possible before I became pregnant. I did this for me and for my precious little baby. This won't always be an easy journey. It took me almost a full year before my doctor gave me the green light. It might take more time or less time. No matter how much time it takes, it is well worth it if it means that, in the end, you have a strong, healthy baby.
How will Crohn's affect my pregnancy?
This all depends. For many women, pregnancy will actually help your Crohn's either go into remission or stay in remission. This is mostly due to the fact that, when you become pregnant, your body naturally suppresses your immune system. Since your immune system is what causes all the problems, this natural suppression can be a wonderful reprieve from your disease. I have heard some women call it their 9 month vacation from Crohn's disease.
Other women aren't so lucky. Despite the immune suppression, they might still experience a flare up during their pregnancy. If this does occur, you need to make sure and notify your doctor immediately. With Crohn's disease your body has a hard time absorbing nutrients and, when you're pregnant, you need those nutrients even more. Sometimes it might be difficult to tell if the symptoms you are experiencing are related to Crohn's or the pregnancy. Always discuss your symptoms with your regular doctor and, if you are unsure, a call to your gastroenterologist is never a bad idea. Remember, your primary goal for the next 9 months is to be as healthy as possible. It may require a few extra visits to the doctor, but when you hold your healthy, newborn baby in your arms everything you have gone through with your pregnancy and Crohn's suddenly seem insignificant.
- Discuss your medications with your doctor
- Know the effects (if any) your meds might have on the baby
- Revisit this discussion if any new medications are introduced
- Never change your meds or dosages without the consent of your doctor
What medications can I take when pregnant?
Most likely you will be able to continue your medication regime during pregnancy. In fact, your doctor will most likely insist that you do not make any changes. You don't want to risk having a flare-up. The following medications are safe during pregnancy:
Aminosalicylates - this includes drugs such as Sulfasalazine (Azulfidine) and other 5-ASA compounds.
Immunosppressives - this includes Azathioprine.
Biologics - such as Remicade, Humira, and Cimzia.
Corticosteroids - in limited dosages, corticosteroids such as prednisone can be used during pregnancy. However, it is important to not use them during the first trimester.
The following medications are not recommended for use during pregnancy:
Antibiotics and Thalidomide
With all medications it is important that you discuss them with your doctor. Discuss which medications you are currently taking and how they may or may not affect your pregnancy. If you do have a flare-up and you need to take any new medication, be sure to discuss what effects it might have on your baby. Never stop taking a medication or adjust dosages without first consulting your doctor. While you might not like the idea of taking medications while pregnant, the risk of what would happen if you have really bad flare-up during your pregnancy far outweighs the risk of taking the medications.
How healthy will I be after pregnancy?
This is another question that does not have a direct answer. It all depends. Simply because your Crohn's was completely controlled throughout your pregnancy does not mean that you will not have a flare-up after your baby comes. In fact it seems to be more common that new mothers often experience a flare-up post-pregnancy. This can occur within a couple of weeks or up to six months later.
However, rather than worry about whether or not your are going to flare-up, spend your energy enjoying your precious new baby. Also, do everything you can to live a healthy lifestyle and try to prevent a serious flare. If, despite all your efforts, you do have a flare-up call your doctor immediately. Now that you have a little one dependent on you it is important to try to be as healthy as possible. You don't want to delay going to the doctor and then, because of the delay, end up getting admitted.
Since my little guy was born, I have had a couple small flare-ups. I know my body and, luckily, neither flare-up required a call to the doctor (they were over within 24 hours). However, I have tried as hard as I can to eat well, exercise, and reduce stress. All three are difficult with a new baby and I have had my struggles, but so far I have yet to experience severe symptoms.
This video is an excellent source of information
A couple more things
Hopefully this hub has answered some of the questions you might have. Pregnancy with an IBD such as Crohn's disease is no walk in the park. However, it can be made easier the more informed you are. Along with being open and discussing your concerns with your doctor, I encourage you to continue your research. The website Crohn's and Colitis Foundation of America is a good place to start. Also, I recommend that you find others that are in a similar situation. Nothing can replace having support. The Crohn's Forum is an excellent place to discuss what you are experiencing in an open and honest environment. If we all share our experiences then, perhaps, we will be able to help each other with the many questions and concerns we face at this point in our lives.