Family Planning and Pregnancy With Multiple Sclerosis
Preventing Pregnancy With MS
Getting Pregnant With Multiple Sclerosis
MS Medications (DMTs) and Family Planning
Galati et al., 2022) because they don’t cross the placenta to the fetus until week 20 of pregnancy. At this point, the medicines should be out of your blood. These therapies have long-lasting effects and may help your MS during pregnancy even when treatment is stopped before getting pregnant." c-nmssatomrichtext_nmssatomrichtext-host=""> Studies show B cell depleting therapies are safe to use until 1-3 months before getting pregnant (Galati et al., 2022) because they don’t cross the placenta to the fetus until week 20 of pregnancy. At this point, the medicines should be out of your blood. These therapies have long-lasting effects and may help your MS during pregnancy even when treatment is stopped before getting pregnant.- These therapies provide a longer period of MS stability after you stop taking them. You should wait 6 months after your last dose to try and get pregnant. After that, you could go for 3 years or more without MS treatment while you are trying to get pregnant or during pregnancy.
Coyle, 2016)." c-nmssatomrichtext_nmssatomrichtext-host=""> Studies show these are safe to use while trying to get pregnant and during early pregnancy (the first trimester) (Coyle, 2016).Graham, et al., 2024). Stopping fingolimod and natalizumab may lead to relapses. Your doctor may advise you to: - Switch to another treatment such as a B cell depleting therapy (Graham et al., 2024)
- Stay on natalizumab until week 34 of pregnancy with doses every 6-8 weeks. Doctors will need to check your baby’s cord blood when they are born to make sure the blood counts are normal (Bast et al., 2025).
These medicines may cause harm to your baby. They need to be stopped early and carefully (Graham, et al., 2024). Stopping fingolimod and natalizumab may lead to relapses. Your doctor may advise you to:- Switch to another treatment such as a B cell depleting therapy (Graham et al., 2024)
- Stay on natalizumab until week 34 of pregnancy with doses every 6-8 weeks. Doctors will need to check your baby’s cord blood when they are born to make sure the blood counts are normal (Bast et al., 2025).
Pregnancy and MS
bladder and bowel issues, balance issues, and fatigue may get worse, especially later in pregnancy. Physical therapy can help with these changes.Some medications for muscle stiffness and bladder control may not be safe to use during pregnancy. You might want to explore other options like rehab therapy to help manage symptoms.Your mental health also matters. If you are taking an antidepressant or have mood changes before or during pregnancy, talk to your OB-GYN about medicines that are safe to use while pregnant.Your doctor can help you figure out if and what changes need to be made to manage your symptoms during pregnancy." c-nmssatomrichtext_nmssatomrichtext-host=""> Many people find that their MS feels better during pregnancy. But some symptoms, like bladder and bowel issues, balance issues, and fatigue may get worse, especially later in pregnancy. Physical therapy can help with these changes.Some medications for muscle stiffness and bladder control may not be safe to use during pregnancy. You might want to explore other options like rehab therapy to help manage symptoms.Your mental health also matters. If you are taking an antidepressant or have mood changes before or during pregnancy, talk to your OB-GYN about medicines that are safe to use while pregnant.Your doctor can help you figure out if and what changes need to be made to manage your symptoms during pregnancy.relapse during pregnancy is typically low. Changes in the immune system during pregnancy help protect the fetus. These changes are thought to contribute to less inflammation, less MS activity and fewer relapses.If you do have a bad relapse during your pregnancy, your doctor may give you a short course of steroids. In very severe cases, plasma exchange may be used (Coyle et al., 2019)." c-nmssatomrichtext_nmssatomrichtext-host=""> The risk of relapse during pregnancy is typically low. Changes in the immune system during pregnancy help protect the fetus. These changes are thought to contribute to less inflammation, less MS activity and fewer relapses.If you do have a bad relapse during your pregnancy, your doctor may give you a short course of steroids. In very severe cases, plasma exchange may be used (Coyle et al., 2019).Kaplan et al., 2019; Landi et al., 2018), especially if your MS was more active before pregnancy (Landi et al., 2018). If this happens, talk with your care team about emotional support and next steps in your treatment plan." c-nmssatomrichtext_nmssatomrichtext-host=""> Relapses can be more likely after a miscarriage or other pregnancy loss (Kaplan et al., 2019; Landi et al., 2018), especially if your MS was more active before pregnancy (Landi et al., 2018). If this happens, talk with your care team about emotional support and next steps in your treatment plan.
Delivery, Breastfeeding and Postpartum Care With MS
- Most people with MS do not need special care during labor and birth. Epidurals and other pain management for labor are safe for people living with MS.Depending on your symptoms, your doctor may suggest certain positions, medicines or other aids to make you more comfortable. Make sure to talk with both your MS doctor and OB-GYN team about your symptoms and birth plan.
Krysko et al., 2020).When deciding whether to breastfeed, make sure to think about how much support you have, your energy levels and your baby’s health needs.Once your mature milk comes in at 2 weeks after giving birth, it is safe to use these MS medicines: - Interferons
- Glatiramer acetate
- Ocrelizumab
- Ofatumumab
- Rituximab
Breastfeeding can lower your risk of having a relapse after birth, especially if you only breastfeed and don't also use formula (Krysko et al., 2020).When deciding whether to breastfeed, make sure to think about how much support you have, your energy levels and your baby’s health needs.Once your mature milk comes in at 2 weeks after giving birth, it is safe to use these MS medicines:- Interferons
- Glatiramer acetate
- Ocrelizumab
- Ofatumumab
- Rituximab
- Your MS team should support you in all areas after birth. This could include:
- Help with mood or energy levels
- Pelvic floor therapy
- Physical therapy
- MRIs
- Restarting your MS treatment
