If you have Crohn’s disease and want to get pregnant, you probably have many questions and concerns. Knowing how the disease will run during any one woman’s pregnancy is variable and hard to predict. However, here’s a brief overview of what you should know.

Getting pregnant

Doctors encourage women to conceive while in remission, if possible. This improves the likelihood of having a normal pregnancy and delivering a healthy baby. It’s also easier to become pregnant during remission. If you’ve had an ileostomy, however, you may have a slightly lower fertility rate.

Studies show that pregnant women with Crohn’s are at higher risks for C-section deliveries (especially if they have fistulas or abscesses), venous thromboembolism (blood clots in a vein), and are more likely to suffer from malnutrition. They’re also more likely to have a spontaneous abortion or stillbirth, especially if they have a relapse during pregnancy. Doctors believe this is caused by inflammation-creating proteins that develop because of Crohn’s.

Will my baby be okay?

Babies born to moms with Crohn’s are more likely to be born early and weigh less. A study published in the American Journal of Gastroenterology reported an average gestation of 35 weeks for women with Crohn’s, almost four weeks less than the average for healthy women. Seventy percent of the babies in this study weighed less than average at birth.

Since Crohn’s disease does have a strong genetic component, parents are understandably concerned about passing it onto their children. If one parent has Crohn’s, there’s only a nine percent chance their child will get the disease. However, if both parents have Crohn’s, this risk increases to 35 percent.

Studies have shown that it’s safe to breastfeed, even while taking certain medications. Although sulfasalazine is considered safe during pregnancy, doctors recommend that women avoid this drug at the start of pregnancy, and that they get sufficient folic acid while pregnant.

Other common Crohn’s medications such as Infliximab, aminosalicyclates, immunomodulators and biologics, are also considered safe during. In a study of Infliximab, for example, the drug did not transfer to the baby during breastfeeding.

Will pregnancy make my disease worse?

Unfortunately, in some cases, Crohn’s symptoms do get worse during pregnancy, but they can generally be controlled with corticosterioids and sulfasalazine. Pregnant women have the same risks of Crohn’s-related complications as those who are not.

For some women, symptoms actually improve during pregnancy. Medical experts believe this occurs because the body naturally suppresses the immune system during pregnancy to prevent your body from rejecting the baby. This may trigger remission and help prevent against future flare-ups.

If you are, or are planning to become, pregnant, avoid high doses of vitamin A and the herbs cat’s claw and tumeric. Don’t smoke, and don’t take methotrexate before or during pregnancy. In breast milk, this drug is toxic. You should also avoid antibiotics and thalidomide.

Don’t let Crohn’s prevent you from having children. Discuss your plans with your physician and begin planning before you become pregnant so you can take appropriate steps to have a safe pregnancy and a healthy baby.