Pregnancy and IBD Part 1 Conception and Effects

If you have Inflammatory Bowel Disease (IBD) and are thinking of having a baby, you may be concerned about how your condition might affect your pregnancy. You may also be worrying about whether having a baby could affect your IBD. The good news is that the great majority of women with Ulcerative Colitis (UC) or Crohn’s Disease (the two most common forms of IBD) can expect a normal pregnancy and a healthy baby. Also, for most women, having a baby does not make their IBD worse. 

However, it is important to discuss your pregnancy with your IBD team. You may need to take special care with some aspects of your pregnancy - or perhaps change your treatment slightly. 


Is it better to conceive while my IBD is under control? 

Definitely. If you are well when your pregnancy begins, you are more likely to have an uncomplicated pregnancy. If you remain in remission your chances of a normal pregnancy and of delivering a healthy baby are about the same as those for a woman without IBD. You are also more likely to remain well yourself during your pregnancy if your symptoms are under control when you conceive.

This is why most doctors will advise women with IBD who are thinking of getting pregnant to try and get their IBD under control first.


What if I have a flare-up while I am pregnant?

If your disease is active when you conceive, or you have flares during your pregnancy, you may be more likely to give birth early or have a baby with a low birth weight. But, your doctor should be able to help you bring your symptoms under control - and many women who conceived while their IBD was in an active phase have gone on to have successful pregnancies and healthy babies. Severe active Crohn’s Disease or a very severe flare-up of Ulcerative Colitis may put the baby at greater risk. So, if your IBD symptoms begin to get worse, consult your doctor or IBD team as soon as possible.


Will pregnancy make my Ulcerative Colitis or Crohn’s Disease worse? 

For most women, having a baby does not lead to a worsening of their IBD. Some research has even suggested that it may have a positive effect on the disease process in the longer term. For example, several studies have found that women with IBD had fewer relapses per year after having children than before they got pregnant. 

How your IBD is likely to behave while you are pregnant appears to depend at least partly on how active your disease was when you started the pregnancy. If you conceive when your IBD is in remission (inactive) you have a good chance of staying in remission. Studies have shown that about one in three women with UC who conceive while their disease is inactive will have a flare up during their pregnancy. This is a very similar rate of relapse to that for non-pregnant women with UC over nine months. The rates for women with Crohn’s Disease are also very similar.

If you conceive while your disease is active you may find that your symptoms remain  troublesome during your pregnancy. For some women, flare ups may become more acute, especially during the first three months. Others may find that their symptoms improve as their pregnancy progresses. 

What will happen in future pregnancies is also difficult to predict. If your IBD becomes active during a pregnancy there is no evidence to suggest that it will do so again in future pregnancies. Similarly, if you do not have a flare up during your pregnancy, unfortunately this is no assurance that the disease will remain inactive in later pregnancies.

In Part 2 Pregnancy and IBD Medicines