How to Successfully Manage Your Crohn's Pregnancy

You have Crohn's and find yourself pregnant, or you want to become pregnant. Thinking about a Crohn's pregnancy raises a lot of questions and concerns. A lot of the answers depend on you.

It is possible to have a safe Crohn's pregnancy and a healthy baby. It is wise to keep in mind that a Crohn's pregnancy has some special considerations and should be carefully monitored by your G.I. doctor in addition to your obstetrician.

A Crohn's Pregnancy: Doctor Consultations and Cooperation

If possible, talk to your doctors before becoming pregnant. Questions and answers regarding a Crohn's pregnancy will be individualized according to your health. Pregnancy is not a good idea if you are having frequent flare-ups and your Crohn's is not under control. However, if you have a mild to moderate case of Crohn's, and you have some success keeping the disease in remission you should be able to have a successful pregnancy.

The most important thing is not to disregard your Crohn's. As an autoimmune disease Crohn's is affected by all changes your body goes through. Crohn's can also affect certain changes in your body. Pregnancy can cause Crohn's to flare-up, but that doesn't mean that you can't have a successful pregnancy. It means that you must be wise and cautious during your pregnancy.

A Crohn's Pregnancy: Nutrition

As with a normal pregnancy, you need to eat a healthy well balanced diet during a Crohn's pregnancy. Frequent, small, healthy meals help stabilize your blood sugar, help you feel better, help manage weight gain, and keep you from becoming easily tired.

As a Crohn's mother-to-be you may have to exert more willpower to control food cravings. Stick to your Crohn's diet. Avoid the usual foods that tend to throw Crohn's into a flare-up or irritate your digestive system.

Nutritional supplements are taken by most expectant mothers, but with Crohn's you may need additional supplements because of your body's decreased ability to absorb certain nutrients. Also, because you are on a restricted Crohn's diet you may need supplements that aren't usually considered necessary during pregnancy.

Your obstetrician and G.I. doctor should consult during your Crohn's pregnancy to help you develop and monitor a diet and nutrition plan that will optimize your health, minimize your risk of a Crohn's flare-up, and ensure your baby's health.

A Crohn's Pregnancy: Safe Crohn's Medications

A huge concern during a Crohn's pregnancy is the safety of Crohn's medications. All pregnant women must monitor their medications to guard against harm to the unborn baby. The good news is that many Crohn's medications have proven safe to take during pregnancy.

Sulfasalizine, Asacol, Pentasa, Rowasa, and prednisone have proven safe during Crohn's pregnancies. Prednisone can cause high blood pressure, so be sure your blood pressure is carefully monitored throughout the pregnancy. Most doctors monitor your blood pressure under normal conditions. It's not a big deal to keep a check on if you take prednisone.

One caution to keep in mind is that high blood pressure during the third trimester can cause early delivery.

A Crohn's Pregnancy: Crohn's Medications to be Used with Caution

6-MP drugs (azathioprine, Imuran, 6-mercaptopurine, and purinethol) are known to cross the placenta and have been detected in the umbilical cord. There is no evidence that 6-MPs increase the risk of birth defects, and some doctors will use them if there is a serious Crohn's flare-up during your pregnancy. Just knowing these drugs can be passed to the baby is enough to keep many women from taking them during pregnancy. The risk associated with these drugs, and the need to take them should be discussed at length with your doctor.

Lialda appeared safe when tested on laboratory rats and rabbits. However, to date, there is no conclusive information about the safety of using Lialda during pregnancy.

A Crohn's Pregnancy: Crohn's Medications to Avoid during Pregnancy

Methotrexate, thalidomide, and Remicade should not be used during pregnancy. Immunonosupressive medications used for Crohn's are harmful and may be fatal to your unborn baby. Methotrexate has been known to cause miscarriages. Both Methotrexate and thalidomide are known to stunt skeletal development causing birth defects. Thalidomide also interferes with organ development. These Crohn's medications should be discontinued at least three months before you try to conceive.

Flagyl, an antibiotic frequently used for Crohn's patients, is not safe during the first trimester. If you are prescribed an antibiotic during your pregnancy discuss the safety and risks of the medication with your doctor and pharmacist.

A Crohn's Pregnancy: Additional Information and Decisions

Consult your G.I., OB-GYN, pharmacists, and drug manufacturer for more information about Crohn's medication safety and risks. One of the best places to investigate the safety of your Crohn's medications is the medication prescription insert or the manufacturer's website.

Most expectant mothers err on the side of caution. I'm overly cautious because I'm writing as a mother, not a doctor. My preference during a Crohn's pregnancy is lifestyle management using minimal medication. It isn't feasible for every Crohn's patient to give up medication during a Crohn's pregnancy.

Consult your doctors, remembering their opinion may differ from yours, but they are the experts. Read up on the medications. Then make a decision with which you are comfortable about managing your Crohn's pregnancy.

Be honest with your doctors about your decisions. Don't discontinue medications without letting them know. They will help you successfully manage your Crohn's pregnancy.

A Crohn's Pregnancy: The Importance of Rest

The best way to avoid many of the issues associated with Crohn's medications is to avoid a flare-up during pregnancy. Do not underestimate the importance of rest. As a Crohn's patient your immune system is already compromised. Allow yourself plenty of rest so your body has optimal time to repair and cope with the additional physical stress of pregnancy.

Anxiety and stress have to be kept at bay during a Crohn's pregnancy. Stress and anxiety can trigger a flare-up under normal conditions. This has to be avoided, if possible, during your Crohn's pregnancy.

Do not allow others to push you beyond a comfortable level of physical exertion. If you have small children at home, you may need help caring for them so that you do not stress or become overly fatigued.

Stress issues must be dealt with appropriately during a normal pregnancy; these become even more important during a Crohn's pregnancy. A flare-up creates a greater risk for miscarriage or premature birth.

Relax and get plenty of rest. Take care of yourself and your baby.

A Crohn's Pregnancy: Labor and Delivery

If you have had an uneventful Crohn's pregnancy, which is your objective, your labor and delivery should be normal. If you have had a sever flare-up, abscesses, or fistulas a Cesarean section may be advised.

This is one more reason that your obstetrician, gastroenterologist, and you must become partners managing your Crohn's pregnancy.

With careful attention to diet, medication, rest, and general health you can have a manageable pregnancy and successful delivery of a robust bundle of joy.

Sources:

LIALDA: Full Prescription Information

"Manage Crohn's Disease," Babyzone

"Pregnancy," Crohn's and Colitis Foundation of America

"Pregnancy and IBD," About IBD Crohn's

Remicade Rx Medication Guide