When it comes to conversation killers, bowels, especially those that don’t function properly, top the list. That’s why many of the 270,000 Canadians with inflammatory bowel disease, or IBD, suffer in silence.

Crohn’s disease and ulcerative colitis — the two main forms of IBD — both involve an abnormal response of the body’s immune system. Crohn’s disease may affect any part of the gastrointestinal tract. Ulcerative colitis, by contrast, affects only portions of the large intestine.

Both diseases disrupt the body’s ability to properly digest food, absorb nutrients, and eliminate waste and sufferers may experience bouts of abdominal pain, cramps, and diarrhea.

Since most IBD symptoms present themselves during prime childbearing years, it’s critical for women diagnosed with IBD to consider the implications the disease could have on future pregnancies and the ability to breastfeed.

The myth of the IBD-affected baby

For a long time, women with IBD were not encouraged to have children. In fact, it was believed that women with Crohn’s disease would experience premature births or defects in newborns, and would see a worsening of their IBD conditions. 

“These myths persist,” says Dr. Vivian Huang, a gastroenterologist and Director of the Preconception and Pregnancy in IBD clinical research program at Mount Sinai Hospital. “That’s why some women with IBD, thinking that their chances of having a healthy baby are low or that they might pass on their disease to a child, have delayed having children or are choosing not to have children.”

But their choices could have been different had they spoken to their doctors, explains Dr. Huang. Knowing how IBD treatment affects reproductive health provides the greatest advantage of having a healthy pregnancy.

The best time to get pregnant

It’s generally recommended that women with IBD avoid getting pregnant until at least three months after their last flare-up, as active disease is associated with increased risk of adverse outcomes.

“Women who experience an IBD flare-up during pregnancy will still need treatment to avoid complications,” says Dr. Huang. “Stopping medication is not really an option as a significant flare-up can put the pregnancy at risk.”

Overall, most studies show that if a woman conceives when her disease is in remission, she is as likely to have a normal pregnancy as a woman who does not have IBD. A flare-free pregnancy gives the best chance for a healthy outcome for both mother and baby.

Taking medication while pregnant or breastfeeding

Good control of Crohn’s disease or ulcerative colitis is essential to a healthy pregnancy and a healthy baby, and a woman’s medication contributes to that healthy state.

Among the various medications for IBD, there are different levels of data related to pregnancy outcomes and breastfeeding. Some medications are contraindicated for pregnancy, meaning they should not be taken while pregnant.

However, there are certain medications with evidence that suggests they can be taken safely during pregnancy and while breastfeeding.

It’s critical that women diagnosed with IBD speak with their gastroenterologist about medication options, and how those medications might affect their ability to become pregnant or breastfeed in the future.

Women living with IBD can indeed become pregnant and breastfeed. It’s not only possible, it can be safe as well.