The effects of pregnancy on MS symptoms
Just as the symptoms of MS are very different for each individual, so is the effect of pregnancy on MS symptoms. Although most women feel very well at this time, it is important to realise that certain symptoms can worsen for example; fatigue, bladder problems (due to pressure from the pregnant uterus). It is important for women to discuss their symptoms with their GP, neurologist or MS nurse.Medications and pregnancy
Medications used to reduce relapse rate in MS (Beta Interferon and Glatiramer Acetate) are not recommended in pregnancy, and should be discontinued (with advice from the neurologist) at least three months before becoming pregnant. Similarly, many of the treatments for MS symptoms should be discontinued before becoming pregnant eg Carbemazepine, Amitriptyline. Steroids (which are used to speed up recovery from relapses) are best avoided, particularly in the first three months. If a pregnant woman experiences a severe relapse then steroids are occasionally used on the advice of the neurologist. For any woman, advice on medication should be sought from their GP, neurologist or MS nurse prior to becoming pregnant.MS and labour
There is no need for women with MS to be treated any differently during labour, as there is no increased risk from MS for either mother or baby. The caesarean section rate is no higher in women with MS, and should not be advised solely on the grounds of MS, as recovery afterwards takes much longer than from a normal vaginal birth. Depending on the individual’s symptoms, some women with MS may find it difficult to remain mobile in labour, get into certain birthing positions, or may become fatigued. These issues should be discussed with the midwife during pregnancy, when various options such as alternative positions can be explored.Women with MS can safely use all of the usual forms of labour pain relief (pethidine, entonox, TENS machine, epidural anaesthesia). A recent study has confirmed that there is no increased risk of relapse from epidurals
Coping after the birth
Being a new mother is always demanding, and this may be especially true for women with MS who have to cope with extra physical demands. It is wise to plan ahead, and accept all offers of help from friends and family. As explained, there is an increased risk of relapse after childbirth, and if couples are aware of this then they can make contingency plans and seek early treatment. It may be possible to have formal help arranged through social services and/or health visitor if necessary.Women with MS are often unsure whether to breastfeed, because of anxieties that it may be too tiring. MS cannot be passed on through breast feeding, in fact, the health benefits for mother and baby are great, and once established, breastfeeding is quicker and more convenient than bottle feeding. It has also been suggested that breastfeeding may have a beneficial effect in suppressing MS disease activity, although this has not yet been studied in large enough numbers of women to be conclusive .
Women with MS symptoms or disabilities often worry about coping practically with a baby. There are many pieces of equipment available e.g. sleepsuits with Velcro fastenings, speaking thermometers etc. An occupational therapist will be able to offer advice and contacts.
Support, more information and contacts
It is easy for women with MS to feel isolated when pregnant or caring for a small baby. Many women find it helpful to speak to others in a similar situation, and an MS nurse or neurologist may be able to put you in touch with other women locally. Alternatively, there are several organisations offering such support and information.Conclusion
Having MS need not prevent people from having children, but it is important that prospective parents are armed with the facts in order to carefully weigh up options. Planning ahead, seeking information and advice, and accepting help can minimise or solve some of the problems that can arise.(published with permission in writing from:http://www.mstrust.org.uk)
