Preparing for pregnancy with Crohn's disease

If you have Crohn's disease and you would like to become pregnant, do not despair! Many women with moderate to severe Crohn's disease have healthy pregnancies and healthy babies. Here are some tips to keep in mind if you have Crohn's and you are planning on becoming pregnant:

1. If possible, plan ahead. Given the delicate balance of maintaining health for those with a chronic disease, it is best to try to plan before making major life changes (such as having a baby.) If possible, ave a general idea of what point in life you would like to have a baby and then work towards that and start managing your health, lifestyle and personal calendar to help acheive that. Planning ahead can help to alleviate stress, but make sure that your plan is fluid (allow for it to change as your circumstances change). You do not want to create additional life stress by trying to stick to a rigid plan that is not happening as you wanted.
2. Talk to your doctor ahead of time. Let all your doctors, especially your gastroenterologist, know that you are planning on becoming pregnant. Your gastro may want to run tests to assess the state of your disease. Many tests require radiation, such as small bowel barium; and they cannot be performed if you are pregnant. Your doctor may also want to get a baseline reading of blood levels, etc.
3. Take advantage of being in remission. If you are fortunate enough to go into remission, consider taking advantage of that time to get pregnant. Health at the time of getting pregnant is the best predictor for the health of the pregnancy. Be aware that the timing of remission may not coincide with the planned timing (as laid out in Step #1). If this is the case, consider that a healthy pregnancy might be more important than timing the pregnancy perfectly.
4. Evaluate medications. If you are in remission, consider going off all medications during pregnancy. While there are many Crohn's medications that are approved for pregnancy (such as prednisone and asulfazaline), it is preferable to be drug-free. Make a plan with your doctor about which medications you will take (if necessary) if you do flare during pregnancy.
5. Get your weight up. Since a flare up is possible while pregnant, it is good to have a few extra pounds in store prior to getting pregnant.
6. Monitor your nutrient level. All pregnant women, whether they have Crohn's or not, are prone to a drop in certain vitamins and minerals. Those with Crohn's are often already prone to lower iron, albumin, calcium, B12 and folic acid levels. Try to get these levels up as high as possible prior to getting pregnant and be conscious about trying to maintain them while pregnant.
7. Prepare for a possible post-delivery flare up. It is not uncommon for women to experience a flare up shortly after delivering the baby. It is suspected that this is due to the change in hormonal levels. If possible, plan for this with your partner and others. Alert friends and family that you made need their help in home and baby care in the event that you do flare up and need your sleep.
8. Minimize stress. Studies have proven that stress can exacerbate the symptoms of Crohn's disease. Since it is particularly important to keep the Crohn's activity to a minimum while pregnant, try to set up your life so that you can eliminate all forms of stress while pregnant.
9. Keep a positive attitude throughout! If possible, try not to get too wound up or worried about your health or the pregnancy. Emotional stress will make things worse. Try to keep reality in check. It is not the end of the world if you are not able to have your own baby.