Your guide to MS and pregnancy

Multiple Sclerosis (MS) is usually diagnosed between the ages of 20-40, which is when many women are thinking of having a baby. Thankfully, MS doesn’t harm your chances of getting pregnant and you are likely to have a healthy pregnancy and baby.

However, combining the condition with having a baby does mean you need to get advice and plan carefully. Here’s some of the things you need to think about in regards to MS and pregnancy...

What is MS?

Multiple sclerosis (MS) is a condition that can affect the brain and/or spinal cord, causing a range of potential symptoms. These include problems with vision, arm or leg movement, sensation, and balance. Women are about two to three times more likely than men to develop MS.

It is a lifelong condition that causes a range of symptoms and disability which can vary from mild to more serious.

What are the MS pregnancy risks?

It can be daunting considering pregnancy when you have a condition such as MS. However, having MS does not significantly increase the risk of problems in pregnancy. Recent research in mums with MS found nothing to suggest a link between MS and pregnancy complications, apart from a slightly higher risk of low birth weight and caesarean section.

Are there risks around MS medication and pregnancy?

Some disease modifying drugs (DMDs) used to treat MS can harm unborn babies and shouldn’t be taken if you’re expecting a baby. But you should not delay or suddenly stop taking DMDs because you’re trying for a baby, as this could affect your long-term health. So, if you’re planning for a baby you should meet with your MS team to discuss your options. An option might be to change the DMD to one which is considered safer in pregnancy.

If you become pregnant while taking MS medication it is important to contact your MS nurse or neurologist as soon as possible to discuss how best to proceed.

Other drugs used to treat pain and muscle spasms may not be recommended in pregnancy. Reducing these drugs gradually may be advised and it is important not to stop drugs suddenly without the advice of your MS team. Steroids, used to manage a relapse, can be taken safely during all stages of pregnancy.

Will MS and pregnancy affect my relapse rate?

During pregnancy the risk of having a relapse of MS is actually reduced- particularly in the last 12 weeks of pregnancy. Relapse risk does rise again in the three months after birth, but there is no evidence that your MS will deteriorate long term as a result of having a baby. Breastfeeding has been shown by one recent study, to be protective against relapses of MS in the postnatal period, although further studies are required. Added to the multiple other benefits of breastfeeding to your baby’s and your own health it is  recommended that you exclusively breastfeed for the first 6 months of your baby’s life.

Will my child get MS?

The majority of people who have MS have no one in their family with the condition as MS is not directly inherited. However, if you have MS your child has a higher risk of the condition, although that risk is still low. Around 1 in 330 people in the UK develop MS in their lifetime while 1 in 50 people who have a parent, brother or sister with MS will develop the condition.

Do I need specialist MS help during pregnancy?

Because MS does not lead to pregnancy complications, you don’t need specialist support simply because you have the condition. But some maternity services may offer specialist clinics for women with neurological conditions, so you should ask if one is available where you are.

MS does not usually affect labour or delivery, but it’s worth meeting with your midwife, MS nurse and anaesthetist to make a plan for pain relief. Women with MS can have most types of pain relief during labour, including an epidural, but the doctors who help you on the day may not be familiar with MS guidelines. So, it’s good to be prepared and have everything written down in advance.

Can I still breastfeed with MS?

MS cannot be passed on to your baby through breast milk, so having the condition is not an issue. And there are great benefits to breastfeeding your baby exclusively for the first 6 months of life. Taking some medicines for MS may not be recommended while breastfeeding so it is important to discuss your feeding choice with your MS nurse or neurologist.

Do I need support after I have given birth?

MS leads to an increased risk of relapse after giving birth and for the next 6-9 months, and there is also an increased risk of post-natal depression amongst mums with MS. Having plenty of support and enlisting friends and family who can help if needed is a good plan. Ways they can help include making meals, caring for older children and doing household chores. Do speak to your health visitor or social worker if you need help and support, especially if you don’t have friends and family nearby.