Women with irritable bowel diseases like ulcerative colitis (UC) can have healthy, happy pregnancies. You just need to keep a few important things in mind so that you and your baby can be well nourished during your pregnancy.
Ulcerative colitis during pregnancy
In an ideal world, you would become pregnant during a period of disease inactivity or remission. Your body would also remain flare-free for the nine months that you’re pregnant. However, that’s not always how it works.
The physical and chemical changes that take place during pregnancy can greatly affect your UC. If you find out that you’re pregnant during a flare, immediately notify your doctor. They will need to make sure that any medicines you’re taking do not have the potential to harm the developing fetus.
It’s not necessary to stop all your colitis treatments if you find out you’re pregnant. In many cases, the medicines are perfectly safe for both you and your baby. Stopping treatment may in fact make your condition worse.
According to the Crohn’s and Colitis Foundation of America, if a woman stops her treatment regimen and then her UC flares, she may not be able to easily control her condition again. This may lead to additional health problems, including some that can harm the baby.
Most women with UC carry their babies to term without complication. However, women with the disease are more likely than women of the same age without the disease to experience a miscarriage, premature delivery, and labor and delivery complications. Approximately half of women with UC will experience a flare during their pregnancy according to the University of Maryland Medical Center. This flare most commonly occurs during the first trimester or immediately following delivery. For that reason, your obstetrician may classify you as a high-risk pregnancy.
Feed your body properly during pregnancy
The large intestine of a person with UC may not be able to absorb nutrients, vitamins, and minerals as easily as it would if UC wasn’t present. That’s why proper nutrition is extremely important if you are pregnant and have UC.
You will receive prenatal vitamins which include nutrients like folic acid. This is especially important for women with UC, because some UC treatments lower your folic acid levels.
Ask your gastroenterologist or obstetrician about making an appointment with a dietitian. During this important time in your life, you may want expert help with making a diet that works for your condition. Your doctor can help ensure you’ll have a proper, balanced meal plan, and you can rest easy knowing you’re giving your body—and your child’s body—all the nutrition it needs.
Safe treatments during pregnancy
If you experience a flare while you are pregnant, or are experiencing a flare when you find out that you’re pregnant, your doctor may need to reevaluate your treatments. Many medications used for treating the signs and symptoms of UC are safe for pregnant women. These include:
- aminosalicylates and 5-ASA compounds: Both appear to be safe for developing fetuses, and women taking a 5-ASA compound are able to breastfeed.
- corticosteroids: These hormone injections, such as prednisone, are considered low-risk treatments for most pregnant and nursing women.
- immunomodulators and immunosuppressants: Most medicines in both classes are considered low-risk during pregnancy. If you’re taking methotrexate to treat your bowel symptoms, it’s important that you explain to your doctor your plans to become pregnant. Methotrexate is potentially toxic to developing fetuses and newborns that are breastfed.
- biologics: Biologic compounds are considered low-risk for early-trimester pregnancy. They can also be prescribed to women who are nursing.
Passing ulcerative colitis to your child
UC is genetic, and you can pass it to your child. If you have UC but your partner does not, the risk that your child will have the disease is less than 10 percent.
Work with your doctors
No two people experience UC in the same way. Some women with the disease have normal, healthy pregnancies. Others with the disease have a more difficult time. The truth is, you can’t gauge your prospects of conception and pregnancy by another woman’s experience. Instead, it’s important to work with your gastroenterologist and obstetrician. They can help make sure you have the best chances of conceiving and carrying to term without complications or setbacks.