Inflammatory bowel disease and pregnancy

Inflammatory bowel disease (also called IBD) is a group of conditions that affect the intestines and, sometimes, other parts of the digestive system. 

The two main types of IBD are Crohn’s disease and ulcerative colitis. Both conditions cause inflammation (redness, pain and swelling) in the intestines. 

Most women with IBD can have a healthy pregnancy and a healthy baby. If you have IBD and are pregnant or trying to get pregnant, talk to your health care provider. You want to make sure any medicine you take for IBD is safe to take during pregnancy and that you get pregnant at a time when you’re not having serious IBD symptoms. This can help prevent complications for you and your baby. 

About 1.4 million people in the United States have IBD. Symptoms often start between ages 15 and 30, so it can affect many pregnant women and women who can become pregnant. 

How does IBD affect pregnancy?

IBD usually doesn’t affect your ability to get pregnant. But if you’ve had certain types of surgery for IBD, you may have trouble getting pregnant. If you have IBD, try to get pregnant when you’re not having any IBD symptoms. This is called being in remission. Talk to your provider about how long to be in remission before you try to get pregnant. 

Most medicines used to treat IBD are safe to take during pregnancy. If your medicine isn’t safe, your provider can switch you to a safer one before you get pregnant. If you have IBD, talk to your health care provider before you get pregnant to make sure any treatment you get is safe for both you and your baby. 

Don’t stop taking your medicine without talking to your provider first. Stopping some medicines may cause health conditions that may be harmful to you and your baby. 

If you have IBD, you may be more likely to have these pregnancy complications:

  • A low-birthweight baby. This means your baby is born weighing less than 5 pounds, 8 ounces.
  • Premature birth. This is birth that happens too early, before 37 weeks of pregnancy.
  • Preterm premature rupture of the membranes (also called PPROM). This is when the sac around the baby breaks before 37 weeks of pregnancy. PPROM can lead to premature birth. 
  • Miscarriage. This is when a baby dies in the womb before 20 weeks of pregnancy.

These complications may be more likely if you have serious IBD symptoms around the time you get pregnant or if you have symptoms during pregnancy. This is why it’s so important to start pregnancy when you’re in remission.

Many women with IBD can have a vaginal birth. But IBD — especially Crohn’s disease — makes it more likely for you to need a cesarean birth (also called c-section). This is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus (womb). If you have Crohn’s disease, your provider may recommend a c-section if you’ve had certain types of surgery or if your symptoms are active and involve the anal area. If you have Crohn’s disease, talk to your provider about the safest way to have your baby. 

Is your baby at risk for IBD?

If one parent has IBD, your baby has about a 2 to 5 percent chance (2 to 5 out of 100) of having IBD. If both parents have IBD, your baby has about a 33 percent chance (1 in 3) of having IBD. 

We don’t know exactly what causes IBD. In IBD, the immune system that usually protects your body from infection attacks cells in the intestines. This triggers inflammation and IBD symptoms. It may happen because of genes that are passed to you from your parents. Or it may have something to do with your environment (how and where you live) or other problems with your immune system. Or it may be a combination of these. 

What are symptoms of IBD?

Symptoms of IBD can be mild or severe. Your symptoms may come and go, and you may have long periods of time when you’re in remission and have no symptoms. Common symptoms of IBD include: 

  • Belly cramps and pain
  • Bleeding from the rectum or blood in your stool
  • Diarrhea
  • Fatigue (feeling very tired)
  • Loss of appetite
  • Weight loss

If you have symptoms when you get pregnant, you’re likely to have symptoms during pregnancy. Being pregnant doesn’t seem to make IBD symptoms worse. If your symptoms do get worse during pregnancy, tell your provider right away. You may need to see a special doctor called a high-risk obstetrician who has experience treating pregnant women with IBD. This doctor can treat you with medicine to help control your symptoms.

How is IBD diagnosed and treated? 

If you have IBD symptoms, tell your provider. He can give you some blood tests and a physical exam to find out if you have IBD. He may want you to have other specialized tests, like an X-ray or a colonoscopy, to look at different parts of the intestines.

If you do have IBD, your provider can prescribe medicines to help control your symptoms and help your intestines heal. Medicines also can help prevent your symptoms from coming back so you’re in remission longer. If medicines don’t work or if you have complications from IBD, you may need surgery. 

Last reviewed: August, 2014