7 questions to ask your doctor when pregnant with IBD
After sharing my first and second-trimester pregnancy updates, I thought today I would focus on dealing with your medical team whilst pregnant with IBD. As I'm in the UK, I appreciate my experience of being under the NHS could be different compared to other countries. But I thought I'd share how I've navigated them so far and questions to ask that might help you make the most of your gastro appointments. Here are the most important questions to ask your doctor when pregnant with Inflammatory Bowel Disease...
1. What can I expect from you throughout my pregnancy?
I actually only got to see my IBD team after about 4 months of pregnancy. Frustratingly, I found out I should have been seeing my gastro doctor monthly, but this wasn't communicated to me at all! So my first question would be to try to get a real feel for your gastro doctors role. Will he see you more often? (I'm now being seen each month). Will they be in touch with the antenatal team or is that separate? (I'm actually planning to give birth in a different hospital in a different district but the gastro and my consultant will communicate regularly by email). Will you require extra testing?
2. What is the plan regarding medication?
I will be hopefully stopping my Humira at the 24-week mark so it's important to ask your doctor the plan regarding medication. Will it need to be stopped and altered? If so, what is the plan to ensure you don't flare-up? Steriods are my backup plan. Check what general medication is safe to be taken during pregnancy (such as Imodium and painkillers). I've been told that Imodium isn't safe for pregnancy which I was quite shocked by!
3. How will IBD affect my baby?
I know this sounds a bit of a silly question but I am a worrier, so my doctor explained how my condition and a flare-up could impact the baby. He told me inflammation couldn't harm the baby but obviously, malnutrition and dehydration could. I've taken extra precautions with my antenatal team to check my nutrition levels (Vitamin D, Iron, Folic Acid etc) much more regularly so I can ensure the baby is not missing out on anything. Obviously, I don't want to flare but I did find lots of reassuring stories of mums to be flaring and the baby is fine! So it reassured me somewhat.
4. What extra tests will I be entitled to?
Leading on to point 3, my doctor explained I was entitled to extra growth scans which I'll be having from 26 weeks. This might be standard in lots of countries but make sure you ask what extra tests and other things you might be entitled to with IBD. Although it's a pain, being closely watched can only be a positive thing!
5. Will IBD impact my birthing plan?
Many women with IBD have completely uneventful births but it is important to ask about how the condition might impact your birth plan and if you need to make adaptations. A small minority with perianal activity (including me!) are better off with Caesareans in case a natural birth could cause trauma to the perianal area. It could also be worth asking your consultant if you're in the UK whether the NHS can make special adaptations for your condition. Such as a private room or a partner being able to stay with you. I appreciate these are standard with many countries' healthcare systems but they're not in the UK.
6. What's the plan after the baby's birth?
A baby's arrival is an incredibly exciting time but some moms can flare-up due to the surge of hormones. Therefore talk to your doctor and plan for this in advance. Some women put off surgery during pregnancy and have it immediately after birth. Others go straight back on the drugs they've stopped. Some might see how it goes. However, it always helps to know your options-we all know how quickly things can change!
7. What pregnancy vitamins should I take?
It's worth remembering that sometimes those of with IBD can struggle to digest our supplements properly. Ask your doctor for recommendations. Sometimes a pregnancy vitamin in liquid form is best-or he/she might be able to arrange infusions of specific vitamins. Also, run past any other supplements you're taking too. Most will be fine but I hadn't realized turmeric supplements shouldn't be taken in pregnancy for example!
I hope these questions helped. I'm still a little new to this so I'd love to hear from you any other questions you think I should be asking!
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