Key takeaways

  • Most people with ulcerative colitis (UC) have healthy pregnancies, although they may be classified as high-risk due to the potential complications and extra monitoring you may need.
  • Close collaboration with your medical team, which may include a gastroenterologist, obstetrician, and dietitian, is crucial for managing symptoms and ensuring proper nutrition during pregnancy.
  • Many ulcerative colitis treatments are safe to continue during pregnancy, but it is important to consult a doctor as soon as possible to make sure, ideally before conceiving.

You can have a healthy pregnancy with UC. However, you’ll need to keep a few important things in mind so that you and the fetus are well-nourished during your pregnancy.

It’s important to work with your doctor and a dietitian throughout your pregnancy. They’ll be able to help you find the best and safest way to manage your symptoms and flare-ups.

Here’s more information about UC and pregnancy.

Most people with UC carry their babies to term without complications.

However, people with UC may be more likely than others to experience certain complications, such as:

In an ideal world, you would become pregnant during a period of disease inactivity or remission, when the symptoms are well-controlled. Your body would also remain flare-free for the duration of your pregnancy.

But this may not always be the case. As a result, doctors will aim to help people who want to get pregnant manage their UC before conception or, if conception has already occurred, reduce the risk of flare-ups throughout.

For that reason, your obstetrician may classify your pregnancy as high risk – but it’s important to remember that most people with UC will give birth to a healthy baby.

UC can affect how well the large intestine absorbs nutrients. That’s why proper nutrition is extremely important if you’re pregnant and have UC.

A doctor may recommend taking prenatal vitamins containing folate, iron, and vitamin D. Folate is especially important for people with UC, as some UC treatments can lower folate levels.

If you need additional help getting enough nutrients or experience a flare-up, you can also use nutritional treatments, such as enteral nutrition via a feeding tube, during pregnancy.

Ask your gastroenterologist or obstetrician about making an appointment with a dietitian. During this important time in your life, you may want expert help with creating a diet that works for your condition.

Your doctor can help ensure that you’ll have a balanced meal plan, and you can rest easy knowing that you’re giving your body — and your baby-to-be’s — all the needed nutrition.

It’s not necessary to stop all your treatments if you’re pregnant. In many cases, the medications are safe.

Medications that can be safe during pregnancy include:

  • Aminosalicylates and 5-ASA compounds: Both appear to be safe for developing babies, and when taking a 5-ASA compound, you’re able to breastfeed or chestfeed. However, it’s recommended that you supplement with 2 milligrams (mg) of folic acid daily while taking sulfasalazine. Folic acid supplementation is not necessary for people taking mesalamine, a 5-ASA compound.
  • Corticosteroids: These medications are generally considered low risk treatments during pregnancy and when nursing. However, you shouldn’t take corticosteroids for longer than necessary, and if possible, doctors should not prescribe them at the beginning of the pregnancy.
  • Immunomodulators and immunosuppressants: Most medications in both classes are considered low risk during pregnancy. However, methotrexate cannot be taken during pregnancy. If you’re taking methotrexate to treat your bowel symptoms, it’s important that you talk with your doctor before trying to conceive.
  • Biologics: A 2019 review says that some biologic drugs are suitable for use in early pregnancy and while nursing, but others are not. Your doctor will review your treatment plan and recommend a suitable option.

If you have UC, let your doctor know as soon as possible if you’re pregnant or planning to become pregnant.

It’s also important to consult your doctor before stopping any treatments, including medication. Stopping treatment may worsen your condition.

If you experience a flare while you’re pregnant, or are experiencing a flare when you find out that you’re pregnant, your doctor may need to re-evaluate your treatment plan.

Below are some answers to common questions about pregnancy and UC.

Most people with UC can give birth vaginally, but there may be some situations where doctors recommend a C-section instead, such as if you have a fistula or have had pouch surgery.

There is a higher risk of a child having UC if their parent has it, but it isn’t guaranteed. Crohn’s and Colitis UK estimates that 3 in every 100 children might develop UC if one parent has the condition.

No two people experience UC in the same way. Some people with the condition have typical, healthy pregnancies. Others have a more difficult time.

If you’re pregnant or thinking about becoming pregnant, it’s important to talk with and work with your gastroenterologist and obstetrician as early on as possible.

They can help ensure you have the best chance of conceiving and carrying to term without complications or setbacks.