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During the Health Woman podcast, “Ulcerative Colitis, Part Two: Before, During, and After Pregnancy,” Dr. Nathan Fox speaks with Dr. Asher Kornbuth, a clinical professor of medicine in gastroenterology at Mount Sinai, about Crohn’s Disease and Ulcerative Colitis during pregnancy.

Pre-pregnancy

Before your pregnancy, it is essential to consult with a doctor to determine which medications you can take during pregnancy and which medications you need to stop beforehand. Patients need to stop methotrexate three months before pregnancy aggressively. Halting medication can be challenging to predict. In most cases, the medicines given nowadays are safe. However, discussing this with your doctor and receiving a second opinion is important. If the patient has a flareup during pregnancy, this can put the fetus at risk. Dr. Kornbluth states, “But your biologics, the anti-TNF drugs, Remicade, Humira typically, Entyvio, Stelara, we emphatically say stay on them.”

Pregnancy

Pregnancy can be unpredictable for women with Crohn’s disease or ulcerative colitis. Some may experience improvement due to the natural immunosuppressive effects of pregnancy, similar to taking medication. Others may worsen due to hormonal changes or mechanical issues, such as the movement of organs like the intestines. However, some may not see significant changes in their condition during pregnancy. “Some patients will say, and I could almost mouth the words with them because I could see it come. They say the best I’ve ever felt is during pregnancy. If I could always stay pregnant, I’d be great.”

Flare-Ups and Pregnancy

If someone is having a flareup during pregnancy, health measures can still be delivered to ensure the mother’s health. Your doctor can perform a colonoscopy or provide specific medications to help you.

Birth Options

In terms of delivery for women with Crohn’s disease or ulcerative colitis, the primary focus lies on ensuring the safety and health of both the mother and the baby. Generally, vaginal deliveries are encouraged unless there are specific medical reasons to opt for a c-section. Instances, where vaginal delivery might be discouraged, include if the patient has undergone recent or severe perianal disease or has had surgeries that could increase the risk of complications. The decision regarding the mode of delivery is typically made in consultation with the gastroenterologist and obstetrician, ensuring a comprehensive approach to maternal health during childbirth.

Postpartum Care

Additionally, postpartum care involves closely monitoring the mother’s condition, maintaining or adjusting medication schedules as necessary, and addressing any concerns or complications that may arise following delivery.

Learn More

Listen to part one of the Healthful Woman podcast with Dr. Nathan Fox and Dr. Asher Kornbuth to learn more about Crohn’s disease or Ulcerative Colitis and pregnancy.

Carnegie Imaging for Women blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!