What You Should Know About Endometriosis During PregnancyShare on Pinterest
Kristen Curette & Daemaine Hines/Stocksy United

Endometriosis is a disorder in which tissue similar to what normally lines the uterus, called the endometrium, grows outside of the uterine cavity. It can adhere to the outside of the uterus, the ovaries, and the fallopian tubes.

When any of these organs are damaged, blocked, or irritated by this endometrium-like tissue, it can become more difficult to get and stay pregnant. Your age, health, and the severity of your condition will also affect your chances of carrying a baby to term.

One 2014 study found that while 15 to 20 percent of fertile couples attempting to become pregnant will be successful each month, that number drops to 2­ to 10 percent for couples affected by endometriosis.

Pregnancy may temporarily halt the painful periods and heavy menstrual bleeding that are often characteristic of endometriosis. It might provide some other relief as well.

Some people benefit by the increased levels of progesterone during pregnancy. It’s thought that this hormone suppresses and perhaps even shrinks endometrial growths. In fact, progestin, a synthetic form of progesterone, is often used to treat those with endometriosis.

Other people, however, will find no improvement. You may even find that your symptoms worsen during pregnancy. That’s because, as the uterus expands to accommodate the growing fetus, it can pull and stretch misplaced tissue. That can cause discomfort. An increase in estrogen can also feed endometrial growths.

Your experience during pregnancy may be different from other pregnant people with endometriosis. The severity of your condition, your body’s hormone production, and the way your body responds to pregnancy will all affect how you feel.

Even if your symptoms do improve during pregnancy, they can resume after the birth of your baby. Breastfeeding may delay the return of symptoms, but once your period returns, your symptoms will likely return.

Endometriosis may increase your risk for pregnancy and delivery complications. This may be caused by the inflammation, structural damage to the uterus, and hormonal influences endometriosis causes.

Miscarriage

Several studies have documented that miscarriage rates are higher in those with endometriosis than in those without the condition. This holds true even for people with mild endometriosis.

One retrospective analysis from 2017 concluded that people with endometriosis had a 35.8 percent chance of miscarriage versus 22 percent in those without the disorder. More research is needed to determine if endometriosis is a significant risk factor for miscarriage.

There’s nothing you or your doctor can do to stop a miscarriage from happening, but it’s important to recognize the signs so you can seek medical and emotional help to properly recover.

If you’re fewer than 12 weeks pregnant, miscarriage symptoms resemble those of a menstrual period:

  • bleeding
  • cramping
  • low back pain

You might also notice the passage of some tissue.

Symptoms after 12 weeks are mostly the same, but bleeding, cramping, and tissue passage might be more severe.

Preterm birth

According to an analysis of studies, pregnant people with endometriosis are 1.5 times more likely than other expectant moms to deliver before 37 weeks of gestation. A baby is considered preterm if he or she is born before 37 weeks of gestation.

Babies born prematurely tend to have a low birth weight and are more likely to experience health and developmental problems. Symptoms of early labor include:

  • Regular contractions: Contractions are a tightening around your midsection, which may or may not hurt.
  • Change in vaginal discharge: It may become bloody or the consistency of mucus.
  • Pressure in your pelvis

If you’re experiencing any of these symptoms, speak with your doctor. Early labor can sometimes cause, or be a symptom of your baby being in distress, and should be investigated to see if medical intervention is needed.

Placenta previa

During pregnancy, a fetus and placenta will develop. The placenta supplies oxygen and nourishment to your growing fetus through your blood.

Most placentas attach to the uterine walls, away from the cervix. However, in some, the placenta may be close to or directly on the opening to the cervix. This is known as placenta previa.

Placenta previa can increase your risk for significant bleeding and placenta abruption — a premature and dangerous separation of the placenta from the uterus.

People with endometriosis may be at increased risk for this life-threatening condition. The main symptom is bright red vaginal bleeding. If the bleeding is minimal, you may be advised to limit your activities, including sex and exercise. If bleeding is heavy, you may need a blood transfusion and an emergency C-section.

Surgery and hormonal therapy, the standard treatments for endometriosis, are generally not recommended while pregnant.

Over-the-counter pain relievers may help reduce endometriosis discomfort, but it’s important to work with your doctor to determine which ones can be safely used during pregnancy, and for how long. Never take any medication, even over the counter, without consulting with your doctor first.

Some self-help measures include:

  • taking warm baths
  • eating fiber-rich foods to help reduce your risk for constipation
  • walking gently or doing prenatal yoga to stretch the back and relieve endometriosis-related back pain

Getting pregnant and having a healthy baby are possible and common with endometriosis.

Having endometriosis may make it more difficult to conceive, and may also increase your risk for serious pregnancy complications.

Pregnant people with the condition are considered higher risk. Depending on the severity, you could expect to have more frequent and careful monitoring throughout your pregnancies, so that your doctor can quickly identify complications if they do arise.