Fertility and Pregnancy
Approximately three times as many women as men have MS. Most women are diagnosed in their mid thirties at exactly the time when they may be thinking about starting a family. The issue of pregnancy and MS is therefore an important one. In addition, women who have been diagnosed with MS may have concerns about how the disease will affect their ability to have children and how pregnancy and delivery may exacerbate their MS.
When is the best time to have a baby?
The major factors in the decision to have children are the same for people with MS as they are for other people. The decision whether to have a family and when to start is a very personal one and needs to be made with attention to current and future emotional, financial and medical considerations.
Is MS inherited?
Although we still do not understand what causes MS, research suggests that there is a genetic component in a person’s susceptibility to developing the disease. Children who have a parent with MS have an approximate 3% (3 out of 100) chance of developing MS themselves. The risk in the general population is approximately 0.3% (that is, 3 children out of 1000 will get MS). So although having a parent with MS increases the risk, it is important to remember that the risk remains quite small.
Does MS affect fertility?
While MS does not affect a woman’s fertility, men who experience MS related problems with ejaculation may need medical intervention to assist with fertility. Since the majority of couples will not experience any reduction in fertility, you will be faced with the same decisions about birth control as any other couple. You are free to use any form of birth control that you find manageable and comfortable. It is important to consult your general practitioner (GP) when you and your partner are deciding on the most suitable form of contraception.
How does MS affect pregnancy and childbirth?
Couples do not need to be concerned that a woman’s MS will affect her ability to have a normal, healthy baby. MS has not been found to affect the course of pregnancy and labour. Neither does it increase the risk of miscarriages, complications during labour or delivery, foetal malformations or stillbirths. Epidural anaesthesia is considered safe to use for pain relief during labour and has been found to be beneficial for women who experience spasticity. Either general or epidural anaesthesia is recommended for women requiring caesarean section.
What medications are safe during pregnancy?
As a general rule, the use of any medications during pregnancy and breast-feeding (including ones bought over the counter) should be done cautiously and under the supervision of your GP. If you are able to talk to your GP before you start trying to conceive, they will be able to advise you on which of your current medications are safe to keep taking, and which you should stop. This is applicable for both women and men.
If you are on a disease modifying treatment (DMT) for MS, contact your MS nurse or neurology clinic to plan how to manage these medications during and after your pregnancy.
Can mothers who have MS breast-feed their babies?
Any mother who wishes to breast-feed is encouraged to do so. As long as you are not taking any medications that could be unsafe for the
baby, you can choose to breastfeed. Your medical team will be able to help you decide which medications are safe to take while breastfeeding, and help you weigh up your desire to breastfeed with the importance of re-starting any medications you’ve temporarily stopped.
Research indicates exclusive breastfeeding may reduce the risk of relapse postpartum. However, due to fatigue being a prevalent symptom of MS, it may have an impact on milk production for new mothers. It is, therefore, crucial to prioritise adequate nutrition, get sufficient rest, and have support available at home, if feasible.
Will having a baby make my MS worse?
During pregnancy, MS is highly likely to remain stable, and certain studies have even suggested that relapses are less common
during pregnancy. Although MS is typically stable during pregnancy, there is an increased risk of relapse in the few months following the birth of the baby, whether the pregnancy goes to term or not. Studies have shown that this risk of relapse can range from 20% to 75%.
Given the increased chance of a relapse, it may be beneficial to arrange for some additional short-term assistance at home. This support may include help from family and friends. Community Support Staff from your local MS Society can also provide information on services available in the community. As time passes, the risk of relapse after pregnancy will gradually decrease until it returns to the baseline level you had before becoming pregnant.
Additionally, studies have found that pregnancy has no long-term effects on a woman’s disease course or disability level. This means that you can confidently make decisions about having children, knowing that becoming pregnant is unlikely to have any lasting impact on your MS.
Further info:
Webinars & videos
MS & Pregnancy – Webinar – Multiple Sclerosis Research Trust with Dr. Vilija. G. Jokubaitis
MS & Pregnancy – Short video with Neurologist Jennifer Pereira, Auckland DHB
Pregnancy & MS Treatments – Short video with Neurologist Jennifer Pereira, Auckland DHB
Looking to the future – Short video with Neurologist Jennifer Pereira, Auckland DHB
It takes a village – Short video with Neurologist Jennifer Pereira, Auckland DHB
Happy Mummy, Happy Baby – Short video with Neurologist Jennifer Pereira, Auckland DHB
Balancing life with a newborn – Short video with Neurologist Jennifer Pereira, Auckland DHB
Life with MS
MS & Pregnancy
Jennifer Pereira, Neurologist
MS & Pregnancy Webinar
NZ Research Trust & Dr Vilija G. Jokubaitis
It Takes a Village
Happy Mummy, Happy Baby
Pregnancy & MS Treatments
Looking to the Future
Balancing Life with a Newborn