Managing Multiple Sclerosis While Carrying a Child
For women living with multiple sclerosis (MS), the decision to start a family can be both exciting and intimidating. Many worry how pregnancy will affect their condition, whether the baby will be safe, and how they will manage their health while carrying a child. Fortunately, with the right care and support, most women with MS can have healthy pregnancies and deliver healthy babies.
This article explains what multiple sclerosis is, how it may affect pregnancy, what challenges to expect, and practical tips for managing the condition throughout the journey to motherhood.
What is Multiple Sclerosis (MS)?
Multiple sclerosis (MS) is a chronic autoimmune condition where the immune system attacks the protective covering of nerves (myelin) in the brain and spinal cord. This results in inflammation and damage that can affect various bodily functions, including movement, vision, and coordination.
MS symptoms can be unpredictable and vary widely. Some common ones include:
- Muscle weakness
- Fatigue
- Difficulty walking
- Numbness or tingling
- Vision problems
- Bladder or bowel issues
There are different types of MS, but the most common is relapsing-remitting MS (RRMS), which features periods of symptom flare-ups followed by recovery.
Can Women with MS Have Healthy Pregnancies?
Yes, absolutely. Many women with MS go on to have smooth pregnancies and deliver healthy babies. In fact, research shows that MS does not increase the risk of infertility, miscarriage, or birth defects. Pregnancy often has a positive effect on MS symptoms due to hormonal changes that suppress the immune system.
That said, every pregnancy is unique. Women with MS should work closely with a multidisciplinary team, including a neurologist and an obstetrician familiar with high-risk pregnancies, to plan and monitor their health throughout the process.
How Does Pregnancy Affect MS?
During Pregnancy
Many women with MS experience fewer relapses during pregnancy, especially in the second and third trimesters. This is due to increased levels of oestrogen and progesterone, which reduce immune activity and inflammation.
Postpartum Period
The risk of MS relapse increases in the first 3–6 months after childbirth. Studies suggest that up to 30% of women with MS may experience a flare-up in this time. However, these relapses usually return to pre-pregnancy levels after about a year.
Is MS Medication Safe During Pregnancy?
Not all MS medications are safe during pregnancy. Some disease-modifying therapies (DMTs) may pose risks to the developing baby, while others can be continued safely. Your neurologist will help decide whether to pause or switch medications before conception.
Key points include:
- Interferon beta – May be continued in some cases
- Glatiramer acetate – Considered relatively safe
- Tysabri (natalizumab) – Used with caution; may continue until late pregnancy in certain cases
- Fingolimod or teriflunomide – Generally avoided; teriflunomide requires a washout period before pregnancy
Never stop MS medication without consulting your doctor, as doing so abruptly could cause a relapse.
Pre-Conception Planning for Women with MS
Planning ahead is key for managing MS during pregnancy. Consider the following steps:
- Schedule a pre-conception consultation with both your neurologist and obstetrician
- Review your medications and make any necessary adjustments
- Maintain good nutrition and start taking folic acid supplements
- Manage stress and fatigue by building a strong support network
- Discuss delivery preferences and breastfeeding plans with your healthcare team
Delivery Considerations for Women with MS
Most women with MS can have a vaginal delivery. Caesarean sections are only recommended if medically necessary, not just because of MS. In some cases, physical limitations (e.g., fatigue, spasticity) might lead to alternative birth plans.
Epidural anaesthesia is generally safe for women with MS, although it's always important to consult your anaesthetist beforehand.
Breastfeeding and MS
Breastfeeding is encouraged for mothers with MS, as it offers numerous benefits for the baby and mother. Some studies suggest that breastfeeding may delay postpartum relapses, although findings are mixed.
If you're taking medication, it's crucial to discuss with your doctor whether it’s compatible with breastfeeding. In some cases, DMTs may need to be paused or delayed until breastfeeding is completed.
Postpartum Management and Relapse Prevention
After delivery, the risk of MS relapse rises. Here are key steps to manage this phase:
- Resume DMTs as advised by your neurologist
- Get adequate rest—enlist support from your partner or family to manage night feeds
- Prioritise self-care—don’t hesitate to ask for help
- Watch for early signs of relapse and communicate with your medical team promptly
Raising a Child with MS
Parenting with MS is entirely possible. While fatigue and mobility issues may add challenges, many parents with MS find creative ways to adapt. Support services, assistive devices, and accessible home environments can help you care for your child effectively while preserving your health.
Internal Links for Further Reading
- Difference Between Infertility and Sterility
- Advisory on Epilim Use in Pregnancy
- How to Get Pregnant Naturally and Quickly
- Explore More Pregnancy & Women’s Health Articles
FAQs: Multiple Sclerosis and Pregnancy
Can MS cause infertility?
No. MS does not directly affect fertility. Women with MS have the same chances of becoming pregnant as women without the condition.
Is it safe to take MS medication during pregnancy?
Some MS medications are safe, while others are not. Always consult your neurologist before planning pregnancy or making changes to your treatment.
Can MS symptoms get worse during pregnancy?
Symptoms often improve or stabilise during pregnancy due to hormonal effects. However, relapses may occur postpartum.
Can women with MS have normal deliveries?
Yes. Vaginal delivery is possible for most women with MS unless there are other medical complications.
Is breastfeeding safe if you have MS?
Yes. Breastfeeding is encouraged, but you should check if your medications are safe for nursing.