Navigating Pregnancy with Multiple Sclerosis

This is not medical advice, please consult with your doctor for your individual situation.

Pregnancy is a time full of changes, hope, and excitement. If you have multiple sclerosis (MS), you might wonder how the condition will affect your pregnancy —or how pregnancy might affect your MS.

The good news? With proper planning and care, women with MS can enjoy a healthy pregnancy, delivery, and postpartum experience.

Let’s explore how MS interacts with pregnancy and what you can do to stay healthy and comfortable through every stage.

Does Multiple Sclerosis Affect Fertility?

First things first: multiple sclerosis does not affect fertility. Women with MS have the same chances of becoming pregnant as those without the condition. So, if you’re planning to start or grow your family, MS itself doesn’t stand in your way.

However, if you’re on medications for MS, it’s important to talk to your doctor. Some disease-modifying therapies (DMTs) can affect pregnancy, so your healthcare provider might adjust or pause your treatment.

Steps to Take Before Getting Pregnant

Pre-Pregnancy Planning with MS

If you’re thinking about starting a family, planning ahead is key. Here are the steps to take before you get pregnant:

1. Talk to Your Healthcare Team: Schedule an appointment with your neurologist, OB-GYN, and primary care provider to create a personalized pregnancy plan.
2. Review Your Medications: Some MS treatments may not be safe during pregnancy. Your doctor may suggest stopping or switching medications to ensure the safety of your baby.
3. Boost Your Health: Focus on a healthy lifestyle by maintaining a nutritious diet, staying active, and managing stress. Taking prenatal vitamins with folic acid can also support a healthy pregnancy.
4. Plan for Symptom Management: Discuss how your MS symptoms, like fatigue or mobility challenges, might affect pregnancy and what strategies can help.

How Pregnancy Affects Multiple Sclerosis

Many women with MS find that pregnancy actually provides a temporary “break” from relapses, particularly in the second and third trimesters. Here’s why:

• During pregnancy, hormone levels increase, especially estrogen and progesterone. These hormones have an anti-inflammatory effect, which can reduce MS activity.
• The immune system shifts to protect the growing baby, which can also help calm MS symptoms.

Postpartum Relapse Risk

While relapses tend to decrease during pregnancy, there is an increased risk of relapse in the first 3 to 6 months after delivery. This is due to hormone levels dropping back to normal and the immune system returning to its pre-pregnancy state.

The key to managing this risk? Working closely with your neurologist to plan postpartum care and monitoring.

MS Symptoms During Pregnancy

Although MS symptoms may improve during pregnancy, you might still experience some challenges. Fatigue, muscle weakness, and balance issues are common MS symptoms that can overlap with pregnancy-related changes.

Tips for Managing Symptoms During Pregnancy

1. Rest Often: Prioritize sleep and take naps when needed. Pregnancy and MS can both cause fatigue, so listen to your body.
2. Stay Active: Gentle exercises like walking, prenatal yoga, or swimming can help maintain strength and reduce fatigue.
3. Eat Well: A balanced diet can help with energy and overall health. Focus on nutritious foods like fruits, vegetables, lean proteins, and whole grains.
4. Talk to Your Team: Keep your healthcare providers in the loop. Share any new or worsening symptoms so they can help you manage them effectively.
5. Make an Wishlist: Expecting parents already usually have a baby wish list, so make sure to include gifts that will make your pregnancy with MS easier. For example, an easy-on bra or other helpful items. 

Planning for Delivery with MS

Women with MS can usually deliver their babies without complications, but certain considerations might come into play:

• Epidural Anesthesia: If you’re worried about pain management, rest assured that an epidural is safe for women with MS.
• C-Sections vs. Natural Birth: MS doesn’t increase the need for a cesarean section (C-section), but your doctor will assess your situation and recommend the best delivery method.
• Postpartum Support: After delivery, make sure you have a strong support system in place. Whether it’s help from family, friends, or professional caregivers, having support will make recovery easier.

Breastfeeding with Multiple Sclerosis

Breastfeeding is generally considered safe for women with MS. However, some disease-modifying therapies (DMTs) may not be compatible with breastfeeding.

If you’re planning to breastfeed, speak with your neurologist about the best way to manage your MS medications while keeping your baby’s health in mind.

Addressing Emotional Wellness After Birth

The Importance of Postpartum Mental Health

Postpartum recovery can be challenging for anyone, and women with MS may face additional hurdles. It’s important to prioritize your emotional wellness:

1. Watch for Mood Changes: MS-related fatigue and postpartum hormone shifts can increase the risk of postpartum depression (PPD) or anxiety. If you feel persistently sad, overwhelmed, or irritable, reach out to a mental health professional.
2. Build Your Support System: Don’t hesitate to ask for help from family, friends, or healthcare providers. Emotional and physical support can make a big difference in managing MS and new motherhood.
3. Prioritize Self-Care: Even short breaks can help. Take time to rest, relax, and recharge as you adjust to life with your new baby.
4. Join a Community: Connect with other moms who have MS through online forums, support groups, or local meetups. Sharing experiences can help you feel less alone.

Final Thoughts: Multiple Sclerosis and Pregnancy

Having MS doesn’t mean you can’t experience a healthy, joyful pregnancy. By working closely with your healthcare team, planning ahead, and managing symptoms effectively, you can enjoy this exciting chapter of your life.

Remember: Pregnancy often brings relief from MS symptoms, but postpartum care is essential to reduce the risk of relapse. Prioritize your emotional and physical health, and don’t hesitate to lean on your support system.

With the right preparation and care, you can focus on what truly matters—welcoming your new baby and embracing motherhood with strength and confidence.