Ask an Expert: multiple sclerosis and pregnancy

Providence Multiple Sclerosis Center cares for more MS patients than any other facility in Oregon. A team of MS experts, including neurologists, nurses, therapists and researchers, offers comprehensive and coordinated therapy for patients. The care and support of each patient is designed specifically to address that person’s needs and preferences. For women, especially those who are considering pregnancy or are already pregnant, individualized treatment is especially important. Our experienced providers can help women at any stage in their lives navigate the right MS care for their needs.

If a woman has MS, is it OK to get pregnant? Are there risks for the mom and baby?

Answered by Elisabeth Lucassen, M.D., neurologist at Providence Multiple Sclerosis Center, a part of Providence Brain and Spine Institute

Is it OK if a woman with MS has a baby?

Women with MS can have babies. Normal, healthy babies are born to MS patients all the time. It used to be thought that women with MS should not have babies, but we’ve learned over time that during pregnancy, MS relapse rates are actually reduced. Patients just need more time for planning before and after to make sure that things remain quiet.

What should a woman with MS consider, before getting pregnant?

We treat MS patients with disease-modifying therapies, which are medications that help to reduce the risk of relapse and disability progression. A lot of these medications can potentially have an effect on a baby so planning is very important – we want to make sure that we stop the medication at the right time prior to pregnancy to make sure it’s safe.

What are some of the issues MS may cause during a pregnancy?

Certain things we see in pregnancy, like fatigue and having to urinate a lot, can sometimes be symptoms we see with MS as well. So, having the two conditions together may just make those symptoms more likely.

How does MS treatment change, for patients who are pregnant?

MS is actually quieter during pregnancy, which means that the risk of relapse is reduced. That’s particularly true in the third trimester and that’s when the hormones are usually the most protective. But as the hormones shift after the delivery of the baby, we typically see an increased risk of relapse, so that’s something that we need to consider and plan for. We always want to be sure we’re monitoring appropriately and choosing a plan after delivery to make sure that the patient gets back on track.

How else is care different for pregnant patients?

I think it’s important to have a team approach to treating MS patients who are thinking about having babies. It’s really important to have the neurologist as well as the obstetrician part of the decision-making process, and the best case scenario is to collaborate to find the best treatment plan for the patient and their baby.

Are there any risks to the baby?

There are potential risks to the baby if the woman becomes pregnant while she’s taking one of the disease-modifying therapies. So we always want to plan when to discontinue the medication. This is part of a conversation I have with any young woman who has a diagnosis of MS, even if they’re only 17 or 18 years old, because a lot of pregnancies are unplanned. We want to make sure to plan appropriately to make the best decisions for the patient and the baby.

What is one piece of advice you would give to patients with MS?

I emphasize to my patients that we are a team in their care, and that what I can do for them is only part of the care plan. I emphasize the need to exercise, eat healthy, and to take care of their general health. My patients who do this seem to have always done better. To schedule an appointment with Dr. Lucassen, call 503 216-1150.