This sheet talks about multiple sclerosis during pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.

What is multiple sclerosis?

Multiple sclerosis (MS) is a condition that causes nerve damage that interferes with how the brain communicates with the rest of the body. Because the nerve damage can happen at any part of the brain or spinal cord, the symptoms of MS can vary. Some of the symptoms of MS are loss of balance, numbness, constipation, double vision, muscle spasms (involuntary muscle contraction), depression and fatigue. The severity of symptoms or how quickly symptoms progress also varies among individuals.

Will I have a harder time becoming pregnant because of MS?

In general, women with MS are as likely to become pregnant as women without MS. Some women with MS might experience sexual dysfunction, such as a decreased desire to have sex or increased vaginal dryness. These symptoms may make it harder to become pregnant.

How will pregnancy affect MS?

Women with MS will report different experiences, but many women find that their MS symptoms get better during pregnancy, especially in the third trimester. The risk of having a relapse (attack or flare) is thought to be lower in pregnancy, especially in the third trimester, than before the pregnancy. However, doctors cannot predict for any one woman whether symptoms will get better, worse, or stay the same during pregnancy.

After pregnancy, about 15% – 30% of women will experience a relapse within 3 months of delivery. After about 12 months following the delivery, the risk of relapse goes back down to what it was before the pregnancy.

Some long term follow up studies have suggested that pregnancies may have some protective effects, in that women with MS who have been pregnant appear to have a longer time before gaining disabilities (lower disability scores).

Does having MS make it more likely for me to have a miscarriage, a baby with a birth defect, or other pregnancy complications?

In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This is called her background risk. Studies have shown that women with MS are not at a higher risk than women without MS to have a poor pregnancy outcome. The rates of miscarriage, birth defects, and pregnancy complications (like giving birth before 37 weeks gestation) are similar to those expected in the general population. Studies have also shown that anesthesia, including spinal anesthesia, can be given to a woman with MS during delivery.

Rarely, a woman with significant disability may require additional help during delivery if she is too weak to push through contractions. However, most women require no additional help.

I am prescribed medication for MS. Can I take my medication during pregnancy?

There are a variety of medications that are used to treat MS. For information on specific agents, see our medication fact sheets at https://mothertobaby.org/fact-sheets-parent/ or contact MotherToBaby..

It is important that you discuss treatment options with your healthcare providers when planning pregnancy, or as soon as you learn that you are pregnant. Talk with your healthcare providers before stopping any medication.

Can I breastfeed if I have MS?

MS does not appear to affect a woman’s ability to breastfeed. Many of the medications used to treat MS have not been well studied while nursing, but some may still be considered low risk. For information on specific medications, look for a fact sheets at https://mothertobaby.org/fact-sheets-parent/ or contact MotherToBaby.

Because the risk of relapse increases after delivery, be sure to discuss options of treating MS while breastfeeding with your health care provider.

What if the father of the baby has MS?

Due to the symptoms of MS, it is possible that a man with MS may have fertility problems. This can be caused by sexual dysfunction or lower quality of sperm as a result of hormonal changes in MS. However, there is no evidence to suggest that a father’s MS or the medications he uses to treat MS cause birth defects. In general, a father’s exposure is unlikely to increase the risk to a pregnancy. For more information, please see our Paternal Exposures fact sheet at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/pdf/.

MotherToBaby is currently conducting a study looking at multiple sclerosis and the medications used to treat MS in pregnancy. If you are interested in taking part in this study, please call 1-877-311-8972 or visit https://mothertobaby.org/join-study/.

Please click here for references.