Can You Have a Healthy Pregnancy with Chronic Illness?
- Complication-free pregnancies are possible for women with autoimmune diseases as well as chronic respiratory issues or heart conditions. Good medical care and practical support are essential — possibly even after delivery.
- Pregnancy may even cause a chronic illness to improve.
- Usually, the babies of chronically ill mothers are born healthy. Confirming which medication is safe to use is essential in early pregnancy.
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Pregnant with MS
Pregnant with Arthritis
Pregnant with Diabetes
Pregnant with Lupus (SLE)
Pregnant with Hypothyroidism (Hashimoto’s Thyroiditis)
Pregnant with Hyperthyroidism (Grave's Disease)
Pregnant with Allergies or Asthma
Surprise Pregnancy: Where Do I Go from Here?
Preparing for Pregnancy
Medication in Pregnancy
Pregnancy Medical Care
Birth Preparation & Delivery
Postnatal Support
I Am Still Wondering...
Common Chronic Health Conditions — Pregnancy Information for My Situation
Encountering a chronic illness, disability or recurring condition is usually exhausting and may restrict everyday life. The desire for a baby or an unexpected pregnancy may cause questions and concerns to arise: should I have kids if I am chronically ill? Is a successful pregnancy possible? How does my chronic disease affect pregnancy? Will I be able to take care of my baby?
According to research, 27% of pregnant women have a pre-existing illness. This relatively high percentage shows that many other women have also overcome health challenges in pregnancy. Maintaining a healthy pregnancy while chronically ill is usually possible. Ask your doctor when specific questions or concerns arise. They will decide whether to monitor your pregnancy more closely — so that you and the baby can thrive.
Click on each section for more information specific to a particular health condition.
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Anyone who has multiple sclerosis (MS) is familiar with the recurring relapses of the disease. You are probably worried that one or more of these relapses could occur during pregnancy and how this would affect you and the baby.
Medically, there is no reason to avoid pregnancy with multiple sclerosis. There is no increased risk for the baby. It has also been proven that pregnancy can have a positive effect on MS and reduce the frequency of relapses. If you have multiple sclerosis and desire a baby, talk to your doctor and educate yourself. Perhaps you will be able to pause your medical treatment during pregnancy.
MS attacks are especially unlikely in the later months of pregnancy (3rd trimester). This is due to the increase in hormones and antibodies.
Experiencing stress in the days leading up to delivery can increase the risk of flare-ups. Therefore, take it easy and rest as much as possible during that time.
In case of a flare-up, your neurologist will prescribe medication where little to none is passed on to the baby. Prepare for all eventualities by talking to your specialists (i.e. neurologist and gynaecologist) as soon as you learn about the pregnancy.
Breastfeeding can help prevent postnatal flare-ups. However, as breastfeeding is not always possible and can be physically exhausting, weigh up what is best for you. Your doctor will prescribe suitable medication if you experience a relapse during breastfeeding. If you are not breastfeeding, it is recommended that you restart your MS treatments soon after delivery.MS — Pregnancy and Parenting Support:
Worldwide
- Overcoming MS
- MS World
- MS Views and News
- Above MS
- Multiple Sclerosis International Federation
- Multiple Sclerosis Forums
UK
- muMS UK Facebook group
- Multiple Sclerosis Trust Medication Decisions
- MS Society
- Your community midwife will take care of you for the first three weeks. Apply for help through Homestart.
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Every pregnancy is unique, and this is, of course, also true for women who have arthritis. However, symptoms usually subside during pregnancy, sometimes allowing for the reduction of medication.
Arthritis has no negative impact on the baby's health, so medically speaking, pregnancy with arthritis is feasible.
If you require medication while pregnant or breastfeeding, consult your doctor, as some drugs are contraindicated for pregnancy. As long as your prescription does not affect the baby, breastfeeding is recommended, if reasonable for your situation.
During the first year with your baby, you may experience a flare-up, which should be treated as quickly as usual.Arthritis — Pregnancy and Parenting Support:
Worldwide
UK
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Pregnancies with type 1 or 2 diabetes are closely monitored by medical professionals with the goal of keeping blood glucose levels within a target range. If you have diabetes and are hoping to conceive, try minimising blood sugar fluctuations as much as possible.
Place yourself under the care of your diabetologist and gynaecologist without delay if you are diabetic and pregnant.
Due to hormonal changes in pregnancy, keeping blood glucose within an optimal range is more difficult, but possible nonetheless. Therefore, the probability of a healthy pregnancy is high.
The best possible glucose levels can be maintained by:- Taking blood sugar readings more frequently
- Keeping tabs on your blood pressure
- Making meal plans with a dietician and sticking to them
- Staying active
- Asking your doctor whether ketone testing is right for you
- Taking folic acid and testing whether a higher dose is necessary due to your diabetes
- Taking insulin when prescribed
- Being prepared for the possibility of a premature delivery
What else do I need to consider?
Regular blood checks are essential for the following reasons: high blood sugar levels or extreme fluctuations can lead to foetal malformations. Having too much insulin in your system can lead to a high birth weight or underdeveloped lungs. Hypoglycaemia, on the other hand, can be dangerous for the pregnant woman. Especially after birth, insulin levels drop considerably. This will need to be closely monitored at the maternity ward.
Breastfeeding is recommended for at least six months to decrease the child’s likelihood of developing diabetes or obesity later in life. If breastfeeding is not for you, discuss alternatives with your care team.
ℹ️ Note: Type 1 and 2 diabetes are not the same as gestational diabetes, which may develop during pregnancy. For more information, go to High-Risk Pregnancy — Gestational Diabetes.
Diabetes — Pregnancy and Parenting Support:
Worldwide
UK
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Having a healthy pregnancy despite lupus is possible, but extra precautions are needed to ensure that you and your baby can thrive.
If you are dealing with Lupus, you are probably taking medication to keep the symptoms at bay. When planning a pregnancy, ask your doctor whether you need to switch to a drug that is safe in pregnancy. Should you have just found out about your pregnancy while on Lupus medication, refer to the stop list by Lupus UK. If your prescription is on that list, it is recommended that you discontinue this medication without delay and contact your doctor for a pregnancy-compatible drug.
Your pregnancy will be monitored more closely by a maternal-foetal medicine specialist to avoid serious complications. Your doctor will probably put you on a low dose of daily aspirin (baby aspirin) by the end of your first trimester.
Be prepared for the possibility of premature delivery by choosing a hospital with NICU (neonatal intensive care unit).
Lupus — Pregnancy and Parenting Support
Worldwide
UK
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Having a healthy pregnancy despite Hashimoto's disease is possible. However, if you have hypothyroidism, your body probably produces too few thyroid hormones necessary for the baby's development. Therefore, contacting your endocrinologist or gynaecologist is vital as soon as you find out you are pregnant. Your doctor will probably increase your thyroid medication for the duration of your pregnancy and check your thyroid levels regularly to ensure that you and the baby can thrive.
After birth, mothers commonly revert to their pre-pregnancy dosage. Most thyroid medication can be safely continued during breastfeeding. Check with your doctor whether your medication is contraindicated for breastfeeding.
Hashimoto's Support:
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If you have been diagnosed with an overactive thyroid, chances are that thyroid hormone production will increase in the first trimester of pregnancy if left untreated. Therefore, early and frequent antenatal check-ups are essential for you and your baby to thrive. Your care team may include an endocrinologist and a maternal-foetal medicine specialist who will carefully balance your possible need for medication with your baby's safe development. Thyroid hormone production usually slows to a more normal pace during the second half of pregnancy.
While breastfeeding is generally encouraged, your doctor may check your baby's thyroid if you are taking thyroid medication and nursing.Graves' Disease Support
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If you were dealing with allergies before getting pregnant, chances are that you will continue to have some symptoms during pregnancy. Symptoms may improve or worsen with pregnancy — depending on how one’s body responds to the hormonal changes.
After the pregnancy, the severity of an allergy will usually revert to pre-pregnancy conditions.Consult your doctor about how food intolerances, allergies or asthma might affect your pregnancy.
Treating respiratory allergies and asthma is vital in pregnancy to ensure an optimal oxygen level in the mother and baby. An allergic shock (e.g. caused by a food allergy) should be avoided at all costs.Check with your doctor whether to discontinue or alter your allergy medications during pregnancy and lactation. If you are undergoing immunotherapy, discuss how to proceed.
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Your health concerns may stem from an accident or a recent illness you are still recovering from. Perhaps you had intended to be completely healed up before becoming pregnant.
Physiologically, it can be assumed that if your body allows for conception and implantation, it is usually able to sustain the pregnancy. Sophisticated mechanisms must work together for a pregnancy to happen: if your body were not 'healthy enough,' your fertility level would probably be affected (which may be evidenced by the absence of menstruation). Conception would either not happen, or a very early miscarriage would take place, which would usually go unnoticed.
Nevertheless, it is understandable and responsible to consider what to look out for and what support may be beneficial.
Preparing for Pregnancy or Surprise Pregnancy: What Do I Do Next?
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You may have only recently learned about the pregnancy. Understandably, you may have been feeling upset and overwhelmed since then. Perhaps you are even debating whether to keep the baby.
Depending on the type of disease you are battling, you may want to see your doctor as soon as possible — especially if you take medications regularly. Your prescriptions may need to be changed as some medications should be avoided during pregnancy.
Frequently, women are asked by their doctors to discontinue taking certain medications before trying to conceive. Here, the desire is to keep the medication from entering the foetal bloodstream. Of course, this is only possible if the pregnancy is planned. However, unplanned pregnancies are common even while taking potentially harmful medications. If you find yourself in this situation, it is probably reassuring to know that embryos are not yet linked to their mother’s blood supply in early pregnancy.
Perhaps other circumstances are weighing on you, or the timing of the pregnancy is challenging. Take the time to consider your situation from all angles. What kind of support would you find helpful right now? If you are concerned about the practical aspects of raising a child, ask your doctor for advice, join a support group or contact a pregnancy resource centre.
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If you have a medical condition and desire to have a baby, gather as much information as possible to best prepare yourself.
Contact your specialist or family physician and ask them what you need to know regarding a future pregnancy — e.g. what medications may need to be discontinued. You may even be able to build your stamina in preparation for pregnancy.
Sometimes, women are told not to hope for it or are advised against getting pregnant. If this is your experience, it may be worth seeking a second professional opinion. You may also find it helpful to talk to a support group of mums diagnosed with the same or a similar medical condition.
Guilt is a common emotion among women who desire a baby while dealing with a chronic disease. 'Should I have a baby if I have…,' is the recurrent question that is asked because of certain social norms and expectations. They don't want to be a burden on others or have to ask for help.
Medication in Pregnancy
If you routinely take medications for a medical condition, you are probably wondering whether you can continue taking them during pregnancy.
This depends on the type of medical condition you are dealing with and the active ingredients in your medication. Most drugs have been categorised for use in pregnancy:
A — no risk
B — no evidence of risk
C — risk cannot be ruled out
D — evidence of risk
X — contraindicated in pregnancy
👍 Tip: Go to MotherToBaby to determine whether your medication could have adverse effects on the baby.
In addition, it is advisable to follow the most recent medical information. Advances in medical research continually bring new findings. Information received during a previous pregnancy may have become outdated. Therefore, it is important to consult one’s doctor anew.
ℹ️ Some drugs have no countra-indications but deplete the body of vital nutrients, such as folic acid, which are necessary for a healthy pregnancy. Ask your doctor to check your blood for vitamin and mineral deficiencies.
In the best-case scenario, a team of doctors will collaborate to develop an appropriate medication protocol. Your team of doctors will likely include the specialist treating your chronic condition, your obstetrician or midwife, and a maternal-foetal medicine doctor.
In the case of epilepsy during pregnancy, finding suitable anti-epileptic drugs can be a challenge. Go to The North American Antiepileptic Drug Pregnancy Registry for more guidance.
Pregnancy Medical Care
Most health conditions place the pregnancy in a high-risk category. This is merely a precautionary measure as it allows for closer monitoring, ensuring the prevention or early detection of possible complications.
In addition to your pregnancy check-ups, you will probably have appointments with your specialist. This is where to address concerns regarding your health condition and pregnancy, such as physical exercise or nutrition.
You may also be in medical or physical therapy, which would need to be adapted to your pregnancy. This could present an opportunity to ask for tips on lifestyle changes. Use your pregnancy as a catalyst for better self-care and overall health.
If you are employed, ask your doctor about workplace accommodations and when to take sick leave.
Birth Preparation & Delivery
🏥 If your condition could affect your pregnancy or possibly lead to a pre-term delivery, choose a hospital with a neonatal intensive care unit (NICU). Here, a pre-term baby would receive the best care possible, should your baby be born early.
Pregnancy Care Tailored to Your Chronic Condition
Your hospital care team can access your medical records, including vital medication information and other care needs. Your care plan, including the type of pain meds or possible anaesthesia, would be adjusted to suit your current medication protocol. Additionally, many mothers make a birth plan, which they bring to the hospital, providing their care staff with details of additional needs and desires. This plan could be discussed with your gynaecologist beforehand.
Vaginal Birth or Caesarean?
A (chronic) illness is not in and of itself a reason for a caesarean. Even though caesarean sections are more common, the choice always depends on the specific situation. Your gynaecologist will discuss the pros and cons and guide you through this decision.
Some illnesses, such as MS, can cause muscle weakness or chronic fatigue, making a prolonged birth process too strenuous.
Ask your medical provider for tips on birthing positions that best suit your needs, for example, when dealing with arthritis.
Postnatal Support
Your search may have led you to this page because you are concerned about the day-to-day life of raising a child while having a chronic illness. Perhaps you are wondering how to manage everyday life with a baby, how to prepare and what support might be available.
What could provide you with relief and make this change as easy as possible for you?
- Childcare while at medical appointments or therapies?
- Practical support in taking care of the newborn?
- A cleaning service?
- Meals?
- Transportation?
- Talking with other mums who have a similar medical condition?
Where Can I Find Support?
Organisations that focus on a specific disease often provide support groups and financial resources. Refer to our health condition chart for details.
You can also find help at:
- Living with Postnatal Chronic Illness Support Group
- Support Groups by the Center for Chronic Illness
- 🙌 Support Near Me
- 💰 Help with Money
- Family Rights Group
I Am Still Wondering...
Perhaps your pre-existing condition was not listed here, or you still have other questions that were not addressed. Maybe you are still waiting for a specific diagnosis. Or you may not have anyone to confide in right now.
Pregnancy may exacerbate these or other concerns.
In our experience, however, pregnancy can also be an opportunity to gain a new perspective. Rather than focusing on hardships, it may allow you to see the good that could result from it.
It is not uncommon for some symptoms to improve with pregnancy. This may be due in part to the hormonal changes.
You may also be considering an abortion because of the challenging situation you are in. Allow us to be your sounding board as you discern the path you want to follow.
Don't stay alone with your concerns!
- ⚖️ Should I get an abortion? Take the Abortion Test.
- 🤔 Could my symptoms be early signs of pregnancy? Test
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Disclaimer: While this page provides essential information and resources regarding chronic diseases and pregnancy, this information does not replace the need for instructions from a medical doctor.