MS and Pregnancy
Mar 02, 2019 Cedars-Sinai Staff
Did you know multiple sclerosis (MS) is most commonly diagnosed in women between the ages of 20-40?
For many women, this is a time when they start planning for a family.
It wasn't all that long ago that doctors thought women with MS shouldn't get pregnant. Doctors feared that the disease would worsen and new moms could end up disabled from the autoimmune disease.
Fortunately for patients, doctors no longer have reason to think women with MS can't have healthy, successful pregnancies.
"There's no evidence to suggest that getting pregnant will make MS worse," says Dr. Nancy Sicotte, interim chair of Neurology and director of the Multiple Sclerosis and Neuroimmunology Center at Cedars-Sinai.
"Many patients may even see an improvement in their symptoms during pregnancy."
Good news for patients
For Dr. Sicotte's patient Michelle Buser, this was welcome news.
Michelle, who's had MS for 16 years, had been planning a family when she moved to Canada from LA. Her new doctors there were concerned that giving her an epidural could leave Michelle in a wheelchair and pushed her toward having a C-section under full anesthesia.
Dr. Sicotte worked with Michelle's new care team to create a birth plan so she could avoid an unwanted C-section. Michelle delivered healthy twin girls in 2018 with no surgery or complications.
"So many doctors don't know enough about MS, and sometimes even neurologists aren't MS specialists," says Michelle. "It's important to do your own research and be your own advocate before making a life-changing decision."
Getting pregnant when you have MS does have unique challenges and does require some planning.
"It's important to speak to your neurologist as soon as you start thinking about getting pregnant so we can make a plan," says Dr. Sicotte. "There are a lot of factors to consider."
Those factors include the medications you are taking as well as how well your MS is being controlled. Your doctor can help you decide when the time is right and make a plan to go off medication.
"It's important to do your own research and be your own advocate before making a life-changing decision."
Many of the longstanding worries about MS patients getting pregnant comes from the fact that relapse rates tend to increase in the first 6 months postpartum. A relapse refers to a new episode of symptoms.
"New episodes are common postpartum, but there's nothing special about those attacks," says Dr. Sicotte. "They're no different from previous relapses and they don't make for a worse prognosis in the long run."
Dr. Sicotte says that like all new moms, MS patients will need to weigh their options when it comes to breastfeeding. Medications cannot be taken while nursing, so it's important to discuss this with your doctor.