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Pregnancy is an exciting time. But if you’re living with multiple sclerosis (MS) you probably have questions about how the chronic disease may impact your birthing plan, treatment plan and plans for breastfeeding.
MS can be unpredictable and relapses can have a severe impact on your quality of life. So, it’s important to talk to your healthcare provider (HCP) and be open about the health goals you have for yourself and your baby during every step of the family planning process. Knowing your options for disease-modifying therapies (DMTs) in advance can help you have the healthiest experience possible.
Here are some frequently asked questions about pregnancy, childbirth and breastfeeding if you have MS.
Does multiple sclerosis affect pregnancy outcomes?
The great news is that the disease itself does not affect pregnancy outcomes. Studies show that women with MS don’t have higher rates of miscarriages, stillbirths, birth defects or other pregnancy complications compared to women without MS. However, some DMTs may cause harm to the fetus. So, it’s important to talk to your HCP before you get pregnant.
Read: Newly Diagnosed with MS? Here Are 10 Questions to Ask Your Neurologist. >>
Can I take my multiple sclerosis medications while I’m pregnant and/or breastfeeding?
Managing multiple sclerosis during pregnancy and breastfeeding comes down to carefully weighing the benefits versus the risks. And everyone’s situation is unique, so it’s important to have a conversation with your HCP about the specific medicines you take and your personal circumstances.
You may be able to take DMTs throughout your pregnancy and/or continue to take them if you’re breastfeeding. But it depends on the medication. Some MS medications may cause harm to the fetus and get into breast milk and may need to be stopped months before getting pregnant.
For example, studies show that interferon-beta and glatiramer acetate are generally considered safe during pregnancy. But some oral DMTs can harm the fetus so they’re often avoided. And monoclonal antibodies (mAbs), such as rituximab, natalizumab, ocrelizumab, ofatumumab and ublituximab, are usually avoided because of the risks they may pose to the fetus.
We don’t have a lot of information on how much medication gets into breast milk for most medicines. But, based on the data we do have, the injectables and mAb DMTs are likely safe for breastfeeding. Oral DMTs appear to be less safe. Breastfeeding is associated with decreased risk of postpartum relapses. Again, talking to your HCP can help you decide what the best option is for you and your baby.
Does having multiple sclerosis affect childbirth?
Symptoms of MS can be different for each person, which can affect labor and delivery during childbirth. MS can affect the nerves and muscles needed to push during labor, which can make vaginal childbirth more difficult for some people. If this is the case, you may need a cesarean, also called a C-section. In rare cases, forceps or a vacuum can help with the birth.
Read: How MS Affects the Body >>
What do I need to know about restarting my medication after I give birth?
Some studies show there may be a slightly higher risk for relapse right after pregnancy. So, people with active MS should talk to their neurologist or MS specialist soon after birth to figure out when they should start taking DMTs again. One study found taking natalizumab or fingolimod within the first six weeks of giving birth significantly reduced the risk for relapse three months after delivery but not immediately after birth.
Breastfeeding, however, may help decrease the risk of postpartum relapses overall. One review of 24 studies found lower rates of postpartum relapses in women who were breastfeeding compared with those who were not. Researchers noted that more research is needed into breastfeeding and postpartum relapse. As mentioned before, not all medications are recommended if you want to breastfeed. The risks of stopping or changing a medication may not outweigh the benefits.
If you’re living with MS, talk to your HCP about your options and have a plan in place so you can feel your best for yourself and your baby during this exciting time.
This educational resource was created with support from Novartis, a HealthyWomen Corporate Advisory Council member.
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