Moms-to-be with IBD Can Have Safe Pregnancies

Crohn’s disease and ulcerative colitis are two forms of inflammatory bowel disease (IBD) which involve a dysregulated immune system, and unpleasant, often debilitating gastrointestinal symptoms such as abdominal pain, diarrhea, and impaired nutrient absorption.

People tend to be diagnosed with Crohn’s or ulcerative colitis during their peak reproductive years — typically between the ages of 15 and 30 — which can be especially challenging for women who wish to have children. “Unfortunately it’s a chronic illness, so they carry that diagnosis for their whole lives,” says Dr. Yvette Leung, MD and Associate Clinical Professor at the University of British Columbia.

Navigating the pregnancy conversation

In the past, women taking medication for IBD were advised against pregnancy and breastfeeding. “There were a lot of myths and misconceptions about fertility and the ability to become pregnant, stay pregnant,

and have healthy children while on IBD medication,” says Dr. Leung.

It’s critical that women diagnosed with IBD speak with their gastroenterologist about medication options prior to becoming pregnant and how those medications might impact the safety of their pregnancy.

Recent evidence shows that the majority of IBD medications are considered safe for pregnancy and nursing. “Looking at large studies with appropriate control groups, there doesn’t seem to be any risk to the pregnancy itself or the health of the newborn from these medications,” says Dr. Leung.

While some women still have concerns, Dr. Leung points out that it’s important for future moms to have frank, one-on-one conversations with their health care providers about the potential risks of continuing the medication versus the potential risks of stopping it. “Women have options and we want them to feel comfortable with their own decisions, but we also want them to be educated decisions,” says Dr. Leung. Fortunately, there are now many centres in Canada that specialize in IBD and pregnancy, which can help women living with IBD feel supported and confident in their own health care decisions.