Crohn’s disease is most often diagnosed between the ages of 15 and 25. This period also happens to be the peak of a woman’s fertility.
If you’re of childbearing age and have Crohn’s, you may wonder if pregnancy is a viable option. The good news is that women with Crohn’s are just as likely to get pregnant as those without Crohn’s.
That said, scarring from pelvic surgery can inhibit fertility. This is especially true 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, you should try to conceive when your Crohn’s symptoms are under control. Consult with your doctor about the pros and cons of continuing medication throughout pregnancy and breastfeeding.
Support your body by eating a nutritious, vitamin-rich diet. Folic acid is especially important for pregnant women. It’s the synthetic form of folate, a B-vitamin found naturally in a variety of fruits and vegetables.
Folate helps build DNA and RNA, making it crucial for the early rapid cell division phase of pregnancy. It also protects the DNA from mutations that develop into cancer, and prevents anemia.
Foods that contain folate include:
- citrus fruits
Folate can be tough on the digestive tract if you have Crohn’s disease. Your doctor will probably recommend that you take folic acid supplements before conception as well as throughout pregnancy.
Pregnancy and Crohn’s Healthcare
Having Crohn’s disease increases your chance for complications such as miscarriage and preterm delivery. Assemble your team of specialists: a gastroenterologist, an obstetrician, and a general practitioner. Your medical team will track your progress as a high-risk obstetrics patient.
Your drug regimen to treat Crohn’s warrants special attention if you want to conceive. Your obstetrician may recommend stopping Crohn’s medications for the health of the fetus. However, changing your drug regimen may affect your disease symptoms. Your gastroenterologist may advise you to continue a successful drug regimen.
You have to consider your health as well as your baby’s. Work with both your gastroenterologist and your obstetrician before conception to construct the best plan to manage the disease during your pregnancy.
Pregnancy and Crohn’s Treatment
Although some medications that treat Crohn’s can cause birth defects, the majority have been proven safe for pregnant women. However, certain medications that control inflammation from Crohn's disease (such as sulfasalazine) can disrupt the effectiveness of folate.
Folate deficiency can lead to low birth weight, premature delivery, and can slow a baby’s growth. Folate deficiency can also cause neural tube defects. These defects can lead to malformation or diseases such as spina bifida (a spinal disorder) and anencephaly (a brain disorder). Consult with your healthcare team about getting the proper dosage of folate.
Women with Crohn’s are capable of vaginal delivery, unless they’re experiencing active perianal disease symptoms. In this case, a cesarean delivery is recommended.
Cesarean delivery is the best option for women with an ileal pouch-anal anastomosis (J pouch), or bowel resection. It will help you avert future incontinence issues and protect your sphincter functionality.
The Genetic Factor of Crohn’s
Genetics play a role in developing Crohn’s disease. Ashkenazi Jewish populations are three to eight times more likely than non-Jewish populations to develop Crohn’s. But so far, there is no test that can predict who will get it.
The highest incidences of Crohn’s are reported in Europe and North America. Australia, Japan, and the tip of South America follow. There are higher incidences of Crohn’s disease in urban populations than in rural populations, which suggests an environmental link.
Cigarette smoking is connected to Crohn’s flare-ups, and can make the disease worse to the point of needing surgery. Expectant mothers with Crohn’s who smoke should quit immediately.