Pregnancy and parenting may feel especially challenging if you have multiple sclerosis (MS). Read on to learn more about pregnancy and raising kids when you have MS.
Common Pregnancy Concerns With MS
It's common to wonder whether you can still have a healthy pregnancy or be a good parent after getting diagnosed with MS.
You may worry that symptoms such as fatigue or difficulty walking could affect your ability to care for a child. You might wonder what other parents will think if they find out you have MS. Or you may fear it could be risky to get pregnant while treating your MS.
Can you pass MS to your children?
Some people with MS wonder whether they could pass MS on to their children. MS is caused by a variety of genetic and environmental factors.
If you have MS, your children have about a 2% risk of developing MS. In the general population, the likelihood of developing MS is about 0.1%.
So if you have MS, your children have a higher likelihood of having MS too. But as neurologist Robert Fox, MD, with the Cleveland Clinic Mellen Center for MS points out, they're still much more likely not to have MS than to have it.
"They are most, most likely not to have MS," Fox says. "It's just part of being a parent and the risk of having kids."
Pregnancy Planning With MS
If you have MS and want to have children, mention it to your doctor. Your doctor can help you get the right treatment options, necessary vaccinations, and plan the timing of your pregnancy around your medications.
MS treatments during pregnancy
Currently, there are no FDA-approved MS treatments for use during pregnancy or breastfeeding. But Fox says many neurologists these days choose to prescribe B-cell-depleting medications, such as ocrelizumab, for patients who plan to become pregnant within a few years.
B-cell-depleting treatments are believed to be safe for use until up to one month before getting pregnant. They also tend to have prolonged effects in the body that may help your MS even when you stop treatment while pregnant.
Ocrelizumab works especially well because you only need to get a new dose of the drug every six months. That means you have several months to try to get pregnant between doses.
MS and fertility
MS doesn't directly affect fertility or raise your risk of complications during pregnancy or childbirth. But some MS symptoms and medication side effects may affect your chances of getting pregnant.
Talk to your doctor about how to optimize your fertility and make use of your peak fertility periods each month. This can help you get pregnant faster and spend less time off MS treatment.
"I do recommend patients get together with their OB (obstetrician) to learn their cycle well and learn how to get pregnant as efficiently as they can," Fox says.
If your current MS treatment isn't safe for pregnancy, your doctor will likely switch you to a different treatment or help you plan a safe pregnancy with your current treatment plan.
If you get pregnant unexpectedly, talk to your doctor right away.
MS treatment during pregnancy
Once you're pregnant, you'll probably be advised to stop taking your MS medication. Pregnancy may offer a level of natural protection against MS.
MS After Birth
After birth, MS symptoms can quickly flare up again. Breastfeeding may lower the risk of MS relapses after birth. Make a plan with your doctor to decide when you can safely start treatment again after your child is born.
Some MS medications, such as ocrelizumab and rituximab, are considered safe to use while breastfeeding with mature milk. Only trace amounts of these medications pass into breast milk, so your baby's stomach won't absorb very much of it.
Parenting With MS
You can't predict MS, and it can change over time. Twenty years after diagnosis, half of the people with MS will transition from relapsing-remitting to secondary progressive MS. At that stage, you may have fewer symptom flare-ups but may still decline in your ability to function over time.
As a parent with MS, you may worry that current or future symptoms could affect your ability to care for your children. Fatigue may affect the amount of energy you have for childcare. Difficulty walking or muscle weakness could make it hard to play with your children or attend activities and school events.
Ways to manage
MS symptoms might make it hard to parent sometimes. But there are ways to manage your family's lifestyle.
If you have fatigue, talk with other parents about setting up a childcare or carpool routine where you can take turns. Be open with close friends and family if you may need help with childcare on days when your energy is low.
If MS makes getting around a challenge, plan ahead. Does the event or activity you plan to go to have accessible seating and an entry ramp? Could you park closer to the stadium to avoid too much walking in the parking lot? Little bits of prep can go a long way to help you get where you need to go so you can cheer your kids on.
"It's really just learning to adjust to the limitations, to the strengths and the weaknesses," Fox says. "It's an imperfect world."
Embrace Uncertainty
If you have MS, you can't be certain what your future holds. Your symptoms may come and go from day to day. Over time, you might need to adjust your lifestyle as your MS changes.
The same is true of parenting, whether or not you have MS. It's impossible to fully predict who your children will become or what your life together will look like as your kids grow older.
Know that your MS is only one part of who you are — as a person and parent. MS will play a role in your life and parenting strategies, but you have the power to decide how you move forward at every stage.
You can take control of your life and listen to your body when you need to make changes. Tell yourself: "I can do this."
"It turns out everyone's parent has some issues, has some challenges. Some are just more visible than others," Fox says. "No parent is perfect."
Talk to your doctor when you notice new or worsening symptoms. Continue your routine medical appointments. And recognize the ways you can be there for your children, even with MS. Little things, such as an evening storytime or outing to the neighborhood park, can all make a difference in your children's lives.
No parent is perfect, and you don't have to be either. You can make your family life work for you, MS and all, while still showing up for your kids.
