How do I Manage Crohn's During Pregnancy?

Crohn's disease is a chronic digestive inflammation that affects both men and women. There are concerns for people with Crohn's during pregnancy, including contraindications of some medications with the labor and birth process. Conception can also be affected by the presence of the illness in either parent; some doctors recommend that conception should only be attempted if the condition is in remission.

Managing Crohn's during pregnancy may be different for each person. Medical opinions vary widely about how the drugs commonly prescribed for the disease will be tolerated during a pregnancy. While certain drugs, such as some immunomodulators like methotrexate, are never permitted during pregnancy, others are frequently considered safe to use. Commonly, expectant mothers experiencing Crohn's during pregnancy can keep taking aminosalicylate or 5-ASA drugs that include sulfasalazine and mesalamine. Prescription steroids may be allowed, but they can increase the chance of premature delivery.

It is important to note that expert opinion about how to treat Crohn's during pregnancy does vary widely. Some doctors do recommend avoiding prescription drugs of any kind, but others feel that active Crohn's during pregnancy is far more dangerous than taking drugs to prevent a flare-up of the disease. It is important to discuss all options and risks with a competent physician who has experience at handling Crohn's during pregnancy.

Interestingly, many women experience total remission during pregnancy and a reduction in Crohn's flare-ups following birth. This may be related to the production of hormones during pregnancy that prevent uterine contractions. The increased production of hormones along with the natural immune-suppressant reaction of the body to pregnancy can actual cause a material change in quality of health for the mother.

Women with active Crohn's during pregnancy are at a much higher risk for stillbirth, miscarriage, and pre-term delivery than women in remission or women without the disease. Any sign of a flare-up should be met with immediate medical care. Overall, the risk for miscarriage is considered to be slightly higher for women with Crohn's in remission than for healthy women. Some doctors may also recommend birth by Cesarean section, particularly if the mother has evidence of fistulas, which are canals and abscesses that form between organs and may cause serious infection if ruptured.

Some women who experience Crohn's during pregnancy may be concerned about passing the condition on to their babies. Some evidence suggests that Crohn's disease is genetic in nature, but passing on the illness is by no means an absolute. According to some studies, children with one parent that has Crohn's have less than a 10% chance of developing the same condition. If both parents have Crohn's, the risk is somewhat higher.