Pregnancy

1,2Inflammatory bowel disease (IBD), including both Crohn’s disease (CD) and ulcerative colitis (UC)(UC), causes chronic inflammation of the digestive tract. Common symptoms include diarrhea, abdominal pain, nausea, and fatigue. People living with IBD usually have a lot of questions about living with and managing IBD. One concern many women have is how having IBD may affect pregnancy.

How will inflammatory bowel disease affect conception?

Women who wish to become pregnant may be concerned with how their IBD will affect their ability to conceive. In general, most women with IBD are able to become pregnant just as easily as women without IBD in their relative age bracket. This is true specifically for women whose symptoms are currently in remission.1,2

The potential to conceive tends to be lower during flare ups of IBD symptoms. Healthcare practitioners typically discourage women from trying to conceive during symptom flare ups. Women who conceive during remission will work with their healthcare provider to maintain remission with the use of certain medications.1

What happens if I conceive during a time of IBD symptom flare ups?

Women are generally discouraged from becoming pregnant during a flare up of IBD. The main reason for this is because if they become pregnant during this time, the disease is more likely to remain active throughout the pregnancy. This could lead to greater pregnancy risks such as miscarriage or premature delivery. If conception occurs during a flare of symptoms, the woman should talk to her doctor about how to reduce these risks.1,2

What affect will IBD medications have on pregnancy?

Many IBD medications are considered low risk for pregnancy and will be continued throughout the pregnancy. Since a IBD flare up could be more detrimental to a pregnancy than many medications, maintaining a state of remission through medication is often advised. Most IBD patients continue to take their scheduled medications throughout their pregnancy, although some dosages may be changed. Some medications do have serious negative side effects of pregnancy. It is extremely important to notify your doctor immediately if you become pregnant or wish to become pregnant.1,2

How will IBD-related surgeries affect pregnancy?

Women have had successful pregnancies after undergoing a variety of IBD-related surgeries. Bowel resection surgeries have not been seen to have any negative effects on pregnancy. Women who have undergone colectomies with ileostomies or J pouches may have slightly decreased fertility rates. Women who have developed fistulas or abscesses around the rectum and vagina, as a result of IBD, will most likely have to deliver via Cesarean section. Most abdominal surgeries and invasive diagnostic procedures can be safely preformed during pregnancy.1,2

Will IBD affect breastfeeding?

Most women with IBD are encouraged to breastfeed. However, there are certain medications that are not to recommended to be taken during breastfeeding, as they can cause potential negative side effects. Talk with your healthcare provider before continuing medication if you plan to breastfeed.1,2

Due to the inherent risks of a potential symptom flare up during pregnancy, women with IBD will most likely be considered high-risk OB patients. Many women with IBD have had successful pregnancies. If you are considering conceiving, it is very important to talk with your healthcare provider and develop a plan to help ensure a healthy and successful pregnancy.

Written by: Anna Nicholson and Emily Downward | Last Reviewed: January 2018.
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