What Doctors Say about MS and Pregnancy
Women with Multiple Sclerosis who are pregnant or who plan to get pregnant should know about how doctors feel about this situation and how they manage it. A new reports sheds some light on this topic of pregnancy for women with multiple sclerosis.
Women with MS (multiple sclerosis) and who are either pregnant or planning to get pregnant have some important questions to discuss with their doctors. A recent study reviewed what doctors are talking about with their MS patients. Let’s see what they are discussing and how it compares with your experiences.
MS and pregnancy
First of all, the general consensus is that pregnancy is safe for women who have MS and for their infants. That said, each new mother-to-be who has MS has unique medical and personal needs that must be taken into consideration.
In the study, 28 healthcare providers from around the United States answered questions about how they manage women with MS during pregnancy. An investigative team from the University of Washington asked the providers about their recommendations regarding the following:
- Use of disease-modifying therapies during pregnancy and breastfeeding
- General recommendations about MS and pregnancy
- Where they got their information about how to manage women with MS
Now here’s a breakdown of the authors’ findings from the 28 doctors. If you are a woman with MS who is pregnant or who has been pregnant, how do these findings correspond with your experience? If you are planning to get pregnant, this information may help you when you are ready to discuss pregnancy with your doctor.
- Only 13 providers (46%) encouraged pregnancy if a woman wanted it, while all but one (97%) said they would not discourage a woman from getting pregnancy because she had MS
- Only 5 (18%) of the providers said that their recommendations concerning pregnancy might be influenced by the woman’s clinical course of MS
- Regarding the use of disease-modifying drugs, 16 (57%) said they always initiate a discuss with their patients about family planning when women of childbearing age begin to take these drugs
- An additional 8 providers (29%) reported that they sometimes make the first move in discussing family planning with these women
- 61% (17) providers said they always recommend women stop taking disease-modifying drugs before they become pregnant, while 36% (10) said they recommend women stop using the drugs as soon as they learn they are pregnant
- 5 providers noted that they took into account a woman’s clinical course of MS before they would or would not recommend the use of disease-modifying drugs
- 10 (36%) said they had had an MS patient who got pregnant while taking a disease-modifying drug they considered to be potentially damaging to the fetus
- 15 providers (54%) said they discuss the risks and benefits of breastfeeding with their patients
- Most of the providers (17; 75%) tell their patients that disease-modifying drugs are not recommended while breastfeeding
- 19 (68%) of the providers do not encourage their patients to breastfeed for a prolonged time, probably because they want to reduce the amount of time the women are not taking their disease-modifying drugs
- 17 (61%) noted that they tell their patients about the increased risk of MS relapse during the post-partum period
- Most of the respondents said they got the majority of their information about how to manage MS during pregnancy and breastfeeding from Food and Drug Administration product labeling, case reports, and from their colleagues. A healthcare provider’s personal experience also played a significant role.
- Most of the healthcare providers also commented on the lack of evidence-based guidelines to help them in the management of women with MS during pregnancy and breastfeeding
The findings of this study reveal the need for improved guidelines for doctors so they can better assist women with MS who are planning to get pregnant or who are already pregnant. It also indicates that women with MS may encounter a variety of opinions when looking for a doctor to help them manage their pregnancy and that they should find a healthcare provider who is well versed in handling MS patients.
Wundes A et al. What do healthcare providers advise women with multiple sclerosis regarding pregnancy? Multiple Sclerosis International 2014; article 819216