Planning For Pregnancy | Decision to Delivery to Parenthood With MS

We all imagine parenthood through our own lens – based on childhood experiences, memories of our parents and how they parented us, and how social media and influencers describe parenthood today. The truth is that each person’s passage into parenthood is unique – formed by both wishes and realities.  

Depending on your age at the time of your (or your partner’s) MS diagnosis, your path to parenthood might be somewhat different than you expected. While other aspiring parents are focusing primarily on when, what sex baby they hope for, the color of the baby’s room, and other fun details, you may have a few additional hurdles to jump. But the important thing to remember is that a multiple sclerosis pregnancy can be just like any other pregnancy. Women and men with MS can ​have happy, healthy babies just like everyone else and provide a loving and supportive environment in which their child(ren) can thrive. There’s nothing about conception, pregnancy, or delivery that will have a negative impact ​on​ a mom’s MS. So, let’s look at what your journey to parenthood might look like.

Making The Decision

Well before the moment when you stop birth control and start planning for pregnancy, have an open and honest conversation with your partner. Here are some topics you might want to talk about: 

• Are we emotionally and financially ready for this change? 

• Is our partnership strong enough and flexible enough to take on the joys and challenges of bringing another person into the world? 

• Are we so reliant on two incomes that we would struggle if one of us couldn’t or didn’t want to return to work? 

• Are we flexible enough in our gender roles that we would both happily manage diapers, feedings, cooking, cleaning, shopping, or anything else that needed doing? 

• Are we confident in our ability to navigate the unpredictability of multiple sclerosis during pregnancy or parenting? 

• Do we have a support system in place? 

Being open and honest with each other now will save you a lot of stress and resentment later. Give each other space and time to respond to these questions, and avoid the temptation to say, “We’ll deal with that when we have to.”  

Involving Your MS Care Provider

Chances are that one of you is taking a disease-modifying therapy (DMT) for your MS as well as symptom-management medications. None of these are approved by the U.S. Food and Drug Administration (FDA) for use during pregnancy or breastfeeding. This means that they need to be out of a woman’s system before she tries to conceive. ​Some medications need to be stopped two years before conceiving or require the use of another medication to clear it from the body more quickly. So, schedule a sit-down with your MS care provider to let them know that you’re ready to start planning for pregnancy. During this conversation,​ you should ask several questions about your multiple sclerosis pregnancy: 

• When should I stop taking my medications? 

• What is likely to happen with my MS if I’m not taking my DMT? 

• How long will I need to stay off my medication? 

• Will I be able to have anesthesia during delivery if I want/need it? 

• How will I know whether to nurse my baby or go back on my medication? 

• How will we manage my symptoms during pregnancy? 

• How would we manage a relapse during my pregnancy? 

• I’ve experienced depression with my MS. Does that make me at higher risk for postpartum depression?  

Involving Your Obstetrician and Anesthesiologist

While multiple sclerosis pregnancies are not generally considered to be “high risk,” your obstetrician and anesthesiologist may have different perspectives. So, meet with them early, find out about any concerns they may have, and make sure they are the clinicians you want to have working with you. It is safe for a woman to have any anesthesia she prefers, so it’s important to make sure the anesthesiologist is on board.  

Involving Your Rehab

Physical and occupational therapists have a lot to offer prospective parents.  

• A physical therapist can recommend stretching, balance, ​and aerobic exercises for multiple sclerosis pregnancies to​​ ​help with fatigue, instability, and comfort. (​​And they’ll also help you create a plan for postpartum recovery). 

• An occupational therapist can offer fatigue management strategies and​ invaluable tips for making your living space and the baby’s room easier to ​navigate. If either parent is dealing with weakness or balance issues, having a well-designed space will help relieve your concerns about your or your baby’s safety.  

Bringing Your Baby Home

You’ll be thrilled, excited, a little bit scared, and more than a little bit exhausted – just like every other new parent but maybe a little more so. All new parents face some unknowns, but you are likely facing a few extra ones:  

• Will I have a relapse? How will we manage if that happens? 

• Will I have enough energy to breastfeed,​ care for my​​ ​baby, ​and ​tend to my partner and other children?  

• If I decide to breastfeed, will my partner or other ​​family member be willing and able to support me throughout?  

• If I decide not to breastfeed because of fatigue or medication issues, ​​will I/we feel OK about that? How will we cope with our feelings about it? 

• Will we get the help and support we need? If my MS gets worse, how can I ensure that I’m the kind of parent I want to be? ​     ​ 

Communication is as important now as it was when you were planning for pregnancy. Make time to pat each other back, check in with each other, problem-solve when you need to, reach out to your healthcare team for answers, and engage with your support network to provide specific suggestions about ways they can help you. 

Prepping for Parenthood

It comes faster than you think!

Once again, your rehabilitation team will come in handy. Babies become active toddlers before you know it. Ask your physical therapist about mobility aids to conserve energy or help with your balance as you toddle after your toddler. Ask your occupational therapist about strategies for making your environment safe for a fast-moving toddler and easier for you to access without​​ using up all your energy. ​  

Remember that there are many ways to love, support, and entertain an active child. If lots of physically active pastimes aren’t possible for you​ (at least not all the time), divvy up activities with your partner or another family member or friend. One of you can run around the park while the other one specializes in reading and cuddle time, play dough and fingerpainting, and other less strenuous activities. This is where parental tag-teaming comes in handy.  

The journey from decision to delivery to doting parent is an exciting, challenging, and fulfilling one. If you occasionally feel anxious or self-doubt, give yourself grace – every new parent feels the same.