Multiple Sclerosis and Pregnancy

Multiple sclerosis (MS) is a type of immune disease that affects the nervous system. It does not affect the ability to get pregnant. However, it is different for each person and there are a number of factors to consider when planning a family.

Path to Improved Health

Multiple Sclerosis may cause symptoms that make sex challenging. Some women who have MS notice dryness in the vagina that may make sex painful. Some men who have MS experience erectile dysfunction (ED). Fatigue can also make having sex less appealing. Talk to your partner about how you can make sex more inviting. For example, use vaginal lubricants if dryness is a problem, talk to your doctors about options to treat ED, and choose times when you both feel rested and ready to engage in sex.

Once you become pregnant, there are a number of concerns you may have. A big concern is whether the pregnancy will make your MS worse. Being pregnant doesn’t usually make MS any worse over time. Many women notice that MS symptoms actually improve during pregnancy. Unfortunately, symptoms often return within a few months after giving birth.

MS doesn’t appear to increase the risk of problems that can occur during any pregnancy. The risk of having pregnancy-induced hypertension, also called toxemia or preeclampsia, or early delivery (premature birth) does not increase with MS.

There are other areas that may be of concern during pregnancy:

• If MS affects your ability to walk, you may notice that walking becomes even more difficult during pregnancy. This is because the weight you gain during pregnancy can shift your balance. You might need to be extra careful to avoid falls. You may need crutches or other walking assistance devices, or you may need to use a wheelchair.
• Lack of energy. You may also notice that you become tired more easily, especially later in the pregnancy. Plan ahead so your schedule allows you to get plenty of rest. Talk to your partner, family and friends if you need help taking care of other children, doing chores or running errands. Ask for the support you need.
• Urinary tract infections (UTIs). These are more common in pregnant women who have MS. Drink plenty of water and let your doctor know if you have any symptoms. Your doctor may want you to have monthly urine tests.
• Taking your MS medication. If you are planning to get pregnant, talk to your doctor. Certain medicines used to treat MS symptoms are not safe for your baby during pregnancy. These include a group of medicines called “disease-modifying drugs.” There is another group called “chemotherapeutic drugs,” such as azathioprine or methotrexate. Your doctor may suggest that you stop taking these medicines before trying to get pregnant. Some other medicines considered safe during pregnancy can be helpful in treating MS symptoms. Your doctor may recommend that you change medicines while you are trying to get pregnant and during your pregnancy.

Things to Consider

Some women who have MS have damage to the spinal cord that interferes with their ability to tell when labor starts. This is rare but may be a concern for some women. If you have reduced feeling in your pelvic area or abdomen, talk to your doctor. They can talk to you about other clues that can help you tell you are starting labor.

Sometimes, women who have MS experience damage to the nerves that help tell the muscles to push during delivery. If this is the case, you may need some extra help to deliver your baby vaginally or you may need a cesarean section (C-section). You may also need a C-section if you become overly tired during labor.

Taking anesthesia during labor is no riskier for women who have MS than other women.

Babies born to women who have MS are no more likely to have birth defects, or physical or mental disabilities than babies of other women. Sometimes, babies of women who have MS have slightly lower birth weights, but this doesn’t appear to lead to health problems.

The risk of your baby developing MS will be slightly higher than for a baby who does not have a family member who has MS. But the risk is still very low.

If you are planning to breastfeed, talk to your doctor. Some medicines may not be safe if you want to breastfeed. And you may need some of these medicines if the symptoms of MS flare after giving birth. Your doctor can advise you about what options are available that would allow you to breastfeed safely.

It’s a good idea to plan for how you will handle life after giving birth. It’s not uncommon for women who have MS to notice an increase in symptoms (called a “flare”) after giving birth. You also may feel extra tired. The fatigue combined with the disability or impaired movement can contribute to depression. Even women who do not have MS are at risk for depression after giving birth (postpartum depression). It’s important to let your doctor know if you have feelings of sadness or despair.

Questions to ask your doctor

• What complications can MS cause with my pregnancy?
• Is there a danger to the baby?
• Will my baby be born with MS?
• Can I still take my MS medications while pregnant?
• Can I breastfeed once my baby is born?

Resources

National Multiple Sclerosis Society: Pregnancy and Reproductive Issues