Pregnancy and Multiple Sclerosis

In the past, women who had Multiple sclerosis (MS) were cautioned not to become pregnant. Today, that advise is generally not an accepted one among physicians. Pregnancy has been shown to have little if any impact on MS. It has even been shown to have a temporary protection against relapses during the time of pregnancy because pregnancy is an immunosuppressed state, and MS is an autoimmune disease, so this realization of temporary protection is not surprising to those who understand MS.

It is however important that the disease stage and the woman's ability to handle her symptoms be taken into consideration when deciding to become pregnant or not. It is important to think about the level of disease the woman is at, what her average energy level is, and how well she will be able to handle caring for an infant (whether or not she will have support). She will need to discuss pregnancy with her physician and how it will respond to her symptoms of MS. There does tend to be more attacks of MS during the post-partum period, especially between 3 and 6 months post delivery. During the pregnancy itself it is common to experience fewer exacerbations of the disease. Usually there is no change in the occurrence of attacks or the severity associated with being pregnant.

Immunomodulating therapy is not used during pregnancy but may be resumed shortly after delivery (3 months is recommended). These medications are not used during pregnancy because there is no conclusive evidence that they are safe to take during pregnancy.

The woman with MS should definitely have a pre-conception appointment with her gynecologist as well as to mention her intention to become pregnant with her neurologist.

Pregnancy is a very personal decision as well as a couple decision and careful thought should be given beforehand with any woman considering becoming pregnant but especially so when a woman has any long term medical condition.

Medical care is important for any pregnant woman but more so for women who have chronic diseases such as MS. It is important to monitor symptoms and for the woman to take good care of her including adequate exercise, good sleep patterns and proper nutrition.

There are several ways women with MS can take good care of their bodies during pregnancy. They can get adequate amounts of sleep. They can eat nutritious meals and snacks. They can start taking folic acid before becoming pregnant and continue taking a prenatal vitamin that contains folic acid throughout their pregnancy.

One dilemma any pregnant woman faces who has a chronic disease is that of continuing or changing treatment plans because of her pregnancy. She must go over with her doctor the medications she is taking for MS as well as any other medications to decide if any of them may be harmful to her developing fetus. The risks must be weighted between the benefits of the medication against the harmful affects that the medication may have on the fetus. Some medications may not have any reliable statistics in which to make an informed decision regarding if they are harmful or not. In this case the doctor must provide any information and give the best medical recommendation possible.