Crohn’s disease is most often diagnosed between the ages of 15 and 25, the period that also happens to be the peak of a woman’s fertility. For women of childbearing age who live with Crohn’s, their fluctuating condition and the drugs that manage their flare-ups may persuade them to believe that pregnancy is not a viable option.
Can You Get Pregnant?
The good news is that within the same age demographic, women living with Crohn’s are just as likely to get pregnant as women living without Crohn’s. That said, factors that can inhibit fertility include scarring from pelvic surgery, especially in cases of extreme procedures such as a total colectomy a surgical removal of the large intestine.
Should You Get Pregnant?
From a health standpoint, women of childbearing age should try to conceive during a period that their Crohn’s symptoms are stable and under control.
Consult with your gastroenterologist and your obstetrician about the pros and cons of continuing medication throughout pregnancy and breastfeeding.
Timing and Tending Your Pregnancy
You’ll want to pause before you attempt to conceive and wait for your Crohn’s to go into remission.
Support your body by consuming a nutritious, vitamin rich diet, with the addition of folic acid. Folic acid is the synthetic form of folate, a B-vitamin found naturally in a variety of fruits and vegetables. Because many plant foods that contain folate—such as beans, broccoli, citrus fruits and peanuts, to name a few—can be problematic for the digestive tracts of women with Crohn’s disease, folic acid is recommended as a necessary supplement.
Folate or folic acid intake is suggested for the period before conception as well as throughout pregnancy. Among its many beneficial properties, folate helps build DNA and RNA, making it crucial for the early rapid cell division phase of pregnancy, protects the DNA from mutations that develop into cancer, and prevents anemia.
Pregnancy & Crohn’s Treatment
Once you become pregnant, create a healthcare trio of specialists, namely your gastroenterologist, obstetrician, and general practitioner. Because the nature of Crohn’s increases your chance for such complications as miscarriage and preterm delivery, your team should follow your progress as a high-risk obstetrics patient.
Drug regimens to treat Crohn’s warrant special attention for women who want to conceive. Obstetricians may recommend ceasing Crohn’s medications for the health of the fetus, but the change of drug regimen may affect the mother’s disease symptoms.
Gastroenterologists may advise staying on the course of Crohn’s treatment by not interrupting a successful drug regimen.
Because you have to consider your health as well as your baby’s, involving both the gastroenterologist and the obstetrician before conception takes place encourages that you construct the best plan to medically manage Crohn’s for the duration of the pregnancy.
Although some medications that treat Crohn’s are responsible for causing birth defects, the majority have been proven to be of low risk and safe for pregnant women. Certain medications, however, such as sulfasalazine, prescribed to control inflammation stemming from Crohn's disease, can affect the efficacy of folate. Consult with your healthcare team about getting the proper dosage. Folate deficiency can lead to low birth weight and premature babies, as well and slow a baby’s growth. Neural tube defects that lead to malformation are another risk of folate deficiency, and can cause spina bifida, a spinal disorder, and anencephaly, a brain disorder.
Women with Crohn’s are capable of vaginal delivery, unless they’re experiencing active perianal disease symptoms, in which case a cesarean section is recommended. C-sections are the best delivery option for Crohn’s patients with an ileal pouch anal anastomosis (J pouch), also called a bowel resection, because they can avert future incontinence issues and protect sphincter functionality.
The Genetic Factor of Crohn’s
Genetics do play a role in developing Crohn’s disease. Ashkenazi Jewish populations are anywhere from three to eight times more likely than non-Jewish populations to develop Crohn’s, although so far there is no test that can predict who will get it.
Europe and North America report the highest incidence of Crohn’s, followed by Australia, Japan, and the tip of South America.
Urban populations also report a higher incidence of Crohn’s than rural populations, which suggests an environmental link to developing the disease.
Cigarette smoking is connected to Crohn’s flare-ups, and worsens the disease to the point of increasing the need for surgery. Expectant mothers with Crohn’s who smoke should quit immediately.