This sheet is about having asthma in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is asthma? 

Asthma is a condition that causes inflammation (swelling and tightening) in the airways of the lungs. When an asthma attack happens, it is hard for air to pass through the lungs. This can lead to symptoms like wheezing, coughing, and trouble breathing. Asthma is often managed with medication in inhalers for fast symptom relief (when an attack happens) and/or with daily medication to help lower inflammation (to prevent attacks).  

Asthma is one of the most common chronic diseases among people of reproductive age. For some people, asthma attacks might be triggered by things like breathing in cold air, cold/flu viruses, heavy exercise, chemicals, smoke, and allergies. Avoiding triggers and having a good medical plan in place can lower the number of asthma attacks you have. Asthma that is not well controlled can increase the chance of problems in pregnancy, so it is important to talk with your healthcare provider about the best way to treat your asthma.  

I have asthma. What should I talk about with my healthcare team before I get pregnant? 

It is important to talk to your healthcare team about plans for treating your condition before and during pregnancy, during delivery, and after delivery. If possible, talk with your healthcare team before getting pregnant. If your pregnancy is unplanned, contact your healthcare providers as soon as you find out you are pregnant.  

Things to talk about with your healthcare team include: 

• Ways to monitor your pregnancy and your asthma symptoms, and ways to avoid triggers.  
• Any medications or vitamins you should take during pregnancy.  
• Getting any necessary vaccines before and during pregnancy. Many vaccines can be given in pregnancy. For more information, please see the MotherToBaby fact sheet on vaccines at https://mothertobaby.org/fact-sheets/vaccines-pregnancy/. 
• Any other questions or concerns you have.

Can having asthma make it harder for me to get pregnant? 

It is not known if having asthma can make it harder to get pregnant. Some studies have suggested that it might take longer for people with asthma to get pregnant, especially when asthma is not well controlled. Other studies have not shown that it is harder for people with asthma to get pregnant.      

Will pregnancy affect my asthma? 

It is hard to know how a person’s asthma will act during pregnancy. About one-third of people with asthma who are pregnant will have improvement in their symptoms, about one-third will stay the same, and about one-third will get worse. It appears that the more severe asthma is at the time of conception, the more likely it is that the symptoms will get worse during pregnancy. It is important that a person’s asthma is well controlled before getting pregnant or as soon as possible. 

Does having asthma increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. A few studies have suggested a small increased chance of miscarriage; however, these studies did not look at other factors that can cause miscarriage. Most studies have not shown an increased chance of miscarriage in people with asthma.

Does having asthma increase the chance of birth defects? 

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like asthma, might increase the chance of birth defects in a pregnancy.  

Some studies have suggested an increased chance of birth defects in people with asthma, while others have not. In these studies, it is hard to know if the birth defects found were due to asthma, the medications needed to control asthma, or other factors. Most people who are pregnant and have asthma have babies without birth defects. If there is an increased chance of birth defects from asthma itself, it is expected to be low. 

If a person who is pregnant has trouble breathing, they will take in less oxygen. This could lead to a lower amount of oxygen getting to the pregnancy, which could cause problems in organ development and other complications.  

Does having asthma increase the chance of other pregnancy-related problems?

Asthma that is not well controlled during pregnancy is linked to higher rates of pregnancy complications, such as preterm delivery (birth before week 37), low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth), higher rates of C-section, problems with the placenta, hemorrhage (blood loss), high blood pressure, and preeclampsia (high blood pressure and problems with organs, such as the kidneys). People with well-controlled asthma during pregnancy are not expected to have a greater chance for pregnancy-related problems than people without asthma.  

Does having asthma affect future behavior or learning for the child? 

It is not known if having asthma in pregnancy can increase the chance of behavior or learning issues for the child.  

Can taking medication for asthma during pregnancy increase the chance of birth defects or other pregnancy-related problems? 

Most asthma medications have not been shown to increase the chance of birth defects or other pregnancy-related problems. It is important that your asthma be as well controlled as possible before, during, and after pregnancy. Talk with your healthcare provider before making any changes to how you take your medication(s) and contact MotherToBaby with questions about your specific medications. For a list of MotherToBaby fact sheets related to asthma please see: https://mothertobaby.org/pregnancy-breastfeeding-exposures/asthma/.    

Breastfeeding while I have asthma:

Having asthma is not expected to affect a person’s ability to breastfeed.  

Can I breastfeed while taking my medications for asthma?

Most asthma medications can be taken while breastfeeding. Contact MotherToBaby with questions about your specific medications. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

If a man has asthma, could it affect fertility or increase the chance of birth defects?

Studies have not been done to see if asthma could affect men’s fertility (ability to get a partner pregnant). Asthma in males is not expected to increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/. 

MotherToBaby is currently conducting a study looking at asthma and the medications used to treat asthma in pregnancy. If you would like to learn more, please call 1-877-311-8972 or visit https://mothertobaby.org/join-study/. 

Please click here for references.  

This sheet is about having anxiety in a pregnancy or while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare providers. 

What is anxiety? 

Anxiety is an excessive and uncontrollable worry. It is common to worry about your pregnancy or your baby’s health. Worrying becomes an anxiety disorder when the thoughts are frequent, time-consuming, intrusive, and irrational. Intrusive thoughts are unwelcome thoughts or images that are upsetting. Irrational worry means worrying about things that are unlikely to happen.  

Almost everyone can experience anxiety at some point in their life. It can be hard to tell the difference between what the usual pregnancy-related worry is and what excessive worry or anxiety disorder is. However, when anxiety interferes with everyday activities, it might be Generalized Anxiety Disorder (GAD), one type of anxiety disorder. GAD occurs in about 9 to 11 out of 100 (9% to 11%) women who are pregnant.  

What are the symptoms of anxiety? 

Anxiety can lead to difficulty sleeping, feeling tired, feeling irritated, and/or lacking focus. People with anxiety might also feel like their heart is pounding or beating fast. Some might start to sweat, tremble or shake, or feel short of breath. Anxiety might also cause diarrhea or constipation. During anxiety attacks (also known as panic attacks), people might have fears of passing out, dying, or of losing control or “going crazy.” 

I think I just worry too much. I don’t want to tell anyone. Should I tell my healthcare provider?  

Yes. If you think that you worry too much, or your partner, friends or family have told you that you are worrying too much, the best thing to do is to tell one of your healthcare providers. Many women with anxiety spend a lot of time worrying about seeking help which can delay treatment. Finding ways to lower your levels of anxiety can help you have a healthy pregnancy. Around half (50%) of individuals with anxiety disorder also have some symptoms of depression. Having anxiety during your pregnancy increases the chance of depression during pregnancy as well as having a mood disorder after the baby is born (postpartum mood disorder). Discussing anxiety with your healthcare providers can help during and after a pregnancy. For information on depression, please see that fact sheet at: https://mothertobaby.org/fact-sheets/depression-pregnancy/. 

I have been taking medication for anxiety, and I am trying to get pregnant. Should I stop my medication? 

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Stopping a medication that is working to treat your anxiety might cause symptoms to restart or to get worse. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

I have anxiety. Can it make it harder for me to become pregnant?  

It is not known if anxiety could make it harder to get pregnant.   

Does having anxiety increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. Some studies have reported that anxiety might increase the chance of miscarriage. 

Does having anxiety increase the chance of birth defects?  

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like anxiety, might increase the chance of birth defects in a pregnancy.  

Anxiety alone is unlikely to increase the chance of birth defects. However, since it is difficult to measure anxiety and people respond differently to stress, it is difficult to study the effects of anxiety on pregnancy. For information on stress, please see this fact sheet at: https://mothertobaby.org/fact-sheets/stress-pregnancy/.     

Does having anxiety in pregnancy increase the chance of other pregnancy related problems? 

Untreated anxiety might contribute to pregnancy related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). There have also been some studies that reported untreated anxiety in pregnancy might increase the chance for admission to the neonatal intensive care unit (NICU), poor physical growth, delayed gross-motor (large muscle) development, and asthma in early childhood.  

Does having anxiety in pregnancy affect future behavior or learning for the child? 

A few studies have found that poorly treated anxiety in pregnancy might affect early childhood development, including weakened social, emotional, and communication skills.  

Untreated anxiety can make it difficult to feel connected (bonded) with the baby both during pregnancy and after delivery. Having a mental health disorder can increase the chance of postpartum mood disorders, which can also interfere with bonding with the baby. Having frequent negative thoughts can lead to less involvement with your baby. Talk with your healthcare providers so that they can determine if you have an anxiety disorder (with or without depression) and can then discuss ways to manage it. 

What types of treatment are available for anxiety? 

Specific types of talk therapy or counseling, relaxation techniques and mindfulness therapy can be effective for treating or managing mild to moderate symptoms of anxiety. Some people benefit from exercising. Some people benefit from medication. There may be other treatments available, as well. Talk to your healthcare provider to plan out the best treatment for your anxiety.  

If I take medication for anxiety during my pregnancy, will it harm the baby? 

There are many different medication options for treating anxiety in pregnancy. Generally, studies have not found an increased chance for birth defects for many of these medications. For more information about specific medications, please see our medication fact sheets at https://mothertobaby.org/fact-sheets-parent/ or contact MotherToBaby to speak with an information specialist about your specific medications. MotherToBaby also has a general information page on anxiety in pregnancy and breastfeeding, including links to fact sheets and other resources:  https://mothertobaby.org/pregnancy-breastfeeding-exposures/anxiety/.  

Breastfeeding if I have anxiety or need to take medication: 

Having anxiety does not need to keep you from breastfeeding. For some women, breastfeeding can feel overwhelming. Find supportive friends or family members who can help you. You can also talk to your healthcare provider about different treatment options, including therapy and medications. If you and your healthcare provider decide that medication is the best treatment for you, there are medications that can be used while breastfeeding. For more information about medications, please see our medication fact sheets at https://mothertobaby.org/fact-sheets-parent/ or contact MotherToBaby to speak with an information specialist about specific medications. Be sure to talk to your healthcare provider about all of your breastfeeding questions.  

If a man has anxiety, can it affect his fertility or increase the chance of birth defects? 

Some reports have found that men with anxiety might have lower fertility (ability to make healthy sperm). Anxiety (and depression) have been shown to lower semen volume and sperm density. A man’s emotional well-being is important, not only for their personal health, but also for the health and support of their partner and children. Men who have symptoms of anxiety should talk to their healthcare provider to plan out the best treatment for their anxiety. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here to view references. 

This sheet is about exposure to antiviral medications in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What are antiviral medications?  

Antiviral medications treat viral illnesses, such as influenza (the “flu”). Symptoms of the flu may include fever, headache, chills, muscle aches, coughing, congestion, runny nose, and sore throat. There can also be stomach upset with vomiting and diarrhea. For more information, see the MotherToBaby fact sheet on Seasonal Influenza (the Flu) at https://mothertobaby.org/fact-sheets/seasonal-influenza-the-flu-pregnancy/.   

What do antiviral medications do? 

Antiviral medications can lessen the symptoms of the flu and lower the risk of serious illness. Some may be used to help prevent a person from catching the flu. There are 4 antiviral medications approved by the U.S. Food and Drug Administration (FDA) to treat the flu: oseltamivir (Tamiflu®), peramivir (Rapivab®), zanamivir (Relenza®), and baloxavir (Xofluza®).  You need a prescription from your healthcare provider to get these medications.  

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

According to the Centers for Disease Control and Prevention (CDC), oral oseltamivir is the preferred treatment during pregnancy. Also, baloxavir is not recommended for the treatment of the flu during pregnancy or while breastfeeding, due to a lack of information. Your healthcare provider can discuss what treatment is best for you. 

Can I skip getting the flu vaccine and just take one of these medications if I get sick?  

Antiviral medications are not a substitute for the flu vaccine. Women who are pregnant have a higher chance of complications from the flu. Women who are pregnant or planning to get pregnant should get the injected form of the flu vaccine (flu shot). The nasal-spray form of the influenza vaccine has not been recommended during pregnancy. For more information, see the MotherToBaby fact sheet on the Seasonal Influenza Vaccine (Flu Shot) at https://mothertobaby.org/fact-sheets/seasonal-influenza-vaccine-flu-shot-pregnancy/.   

I take an antiviral medication. Can it make it harder for me to get pregnant? 

There are no human studies on the use of oseltamivir, peramivir, zanamivir, or baloxavir and female fertility (ability to get pregnant).  

Does taking an antiviral medication increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. Researchers have not found a higher chance of miscarriage after the use of oseltamivir. Limited information on zanamivir does not suggest an increased chance of miscarriage. Studies have not been done to see if exposure to baloxavir or peramivir in human pregnancy could increase the chance of miscarriage. 

Does taking antiviral medication increase the chance of birth defects?  

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like antiviral medications, might increase the chance of birth defects in a pregnancy. 

Several studies that looked at the use of oseltamivir and zanamivir during pregnancy did not find an increased chance of birth defects. Studies have not been done in humans to see if exposure to baloxavir or peramivir could increase the chance of birth defects. 

Does taking an antiviral medication in pregnancy increase the chance of other-pregnancy related problems?  

Several studies have not found a higher chance of pregnancy complications with oseltamivir or zanamivir use during pregnancy. Studies have not been done in humans to see if exposure to baloxavir or peramivir could increase the chance of preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2,500 grams] at birth). 

Does taking an antiviral medication in pregnancy affect future behavior or learning for the child?   

Studies have not been done to see if oseltamivir, peramivir, zanamivir, or baloxavir can increase the chance of behavior or learning issues in a child.   

I am pregnant and think I may have the flu. What should I do?   

Talk to your healthcare provider as soon as possible. Women who are pregnant have a greater chance of complications from the flu. Taking an antiviral medication within 48 hours (the earlier the better) of your first symptoms can lower the chance of severe complications from the flu. The medications may still be helpful when they are started later than this, so talk to your healthcare provider even if you have already been sick for more than 2 days.  

I am pregnant and my partner has the flu. Should I take an antiviral medication so that I don’t get sick?  

Talk with your healthcare provider if you have been in close contact with someone who has the flu. Because women who are pregnant are at an increased risk of complications from the flu, some may benefit from taking antiviral medications. Your healthcare provider can help you decide whether taking an antiviral medication for flu prevention is best for you.  

Be sure that you and others around you are doing the following to help prevent spread of the flu:  

• Wash your hands with soap and water frequently 
• Avoid touching your eyes, nose, or mouth 
• Try to avoid close contact with sick people 
• Cover your nose and mouth when you cough or sneeze 
• Stay home and avoid close contact with others if you are sick 
• Get your flu shot every year

Breastfeeding while taking antiviral medication: 

Oseltamivir passes into breast milk in small amounts and has not been shown to cause side effects in nursing babies. Zanamivir is given by inhalation, which limits the amount of medication that gets into the bloodstream. For this reason, zanamivir is unlikely to enter breast milk in high amounts. Studies have not been done on the use of peramivir during breastfeeding. Because peramivir does not get absorbed well from the gut, it is unlikely that any medication that passes into the breast milk would enter the baby’s system. Studies have not been done on the use of baloxavir during breastfeeding. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

If a man takes an antiviral medication, could it affect his fertility or increase the chance of birth defects?  

Studies have not been done in humans to see if oseltamivir, peramivir, zanamivir, or baloxavir could affect male fertility (ability to make healthy sperm) or increase the chance of birth defects. Illnesses that cause fever, such as the flu, might cause a temporary reduction in the movement or number of sperm which could make it harder to conceive a pregnancy during that time. Close contact may not be recommended when you have the flu to try to avoid passing the flu to your partner. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet on Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/. 

Please click here for references.  

This sheet is about having lupus in pregnancy or while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is lupus?  

Lupus, also known as systemic lupus erythematosus (SLE), is an autoimmune disease where the body’s immune system attacks its own cells or organs. Lupus can cause problems with the skin, kidneys, joints, heart, lungs, blood vessels, and nervous system. Symptoms can be mild to severe, and they can come (referred to as high disease activity or a flare) and go (called remission).  

I have lupus. What should I talk about with my healthcare team before I get pregnant? 

It is important to talk to your healthcare team (including your obstetrician, anesthesiologist, hematologist, and lupus disease specialist) about plans for treating your condition before and during pregnancy, during delivery, and after delivery. If possible, talk with your healthcare team before getting pregnant. If your pregnancy is unplanned, contact your healthcare providers as soon as you find out you are pregnant.  

Women with lupus can have a healthy pregnancy. However, women with lupus have a higher chance of complications during pregnancy including a higher chance for nephropathy (kidney disease), thrombocytopenia (low blood cell counts), thrombosis (blood clotting), and neurological issues like headaches, seizures, and mood disorders. It is not clear if pregnancy increases the number of lupus flares or new symptoms of lupus, but disease activity might increase right after delivery (postpartum). The chance for symptom flares during pregnancy and pregnancy complications might be lower if lupus is in remission for at least six months before getting pregnant.  

I take medication for lupus. Can I take my medication during pregnancy?  

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Having lupus can cause pregnancy complications, so it is important to keep your condition controlled as much as possible. Stopping some lupus medications during pregnancy might cause lupus symptoms to get worse, which could increase the chance for complications. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

There are a variety of medications used to treat lupus. For information on specific medications contact MotherToBaby and see our medication fact sheets at https://mothertobaby.org/fact-sheets/. 

I have lupus. Can it make it harder for me to get pregnant?  

Some women with high disease activity have reported missing periods, which might make it harder to get pregnant. Women with lupus might have fertility problems and problems with how their ovaries work. Some medications used to treat lupus can affect how the ovaries work and might make it harder to get pregnant. Women with kidney problems due to lupus might also have a harder time getting pregnant.  

Does having lupus increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. Lupus might increase the chance of miscarriage, especially in women with high disease activity, kidney disease, and the presence of certain antibodies (such as antiphospholipid). 

Does having lupus increase the chance of birth defects? 

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like lupus, might increase the chance of birth defects in a pregnancy.  

There are rare cases of babies born to women with lupus who have a condition called chondrodysplasia punctata that causes problems with bone and face development. Most babies born to women with lupus do not have this condition. Babies born to women with lupus might have a higher chance of having heart defects.  

Would having lupus increase the chance of other pregnancy related problems? 

Women with lupus have a higher chance of developing preeclampsia (high blood pressure and problems with organs, such as the kidneys), which can lead to seizures (called eclampsia). Women with lupus also might have a higher chance of preterm delivery (delivery before week 37), and poor growth of the fetus. Having flares during conception and early in pregnancy, having kidney disease, having other lupus complications, and having high blood pressure before pregnancy can also increase the chance of these complications. Women with lupus might have a higher chance of gestational diabetes. 

What is neonatal lupus erythematosus? 

If a woman who is pregnant has lupus, her child can have symptoms of lupus right after delivery. This is called neonatal lupus erythematosus (NLE). NLE is seen mostly in children who were exposed to certain antibodies (anti-Ro and/or anti-La) during pregnancy. Signs of neonatal lupus include rash, blood abnormalities that only show up on a blood test, and liver problems. Pneumonia in the infant is possible. These are usually temporary and often go away by six months of age. The most serious complication of NLE is a heart rhythm problem called congenital heart block. Congenital heart block can cause death in up to 30% of infants. Most babies born to women with lupus do not have heart block.  

Does having lupus in pregnancy affect future behavior or learning for the child?  

A few small studies reported that having lupus in pregnancy might increase the chance of learning problems and developmental delays. Another study, looking at approximately 100 women with lupus, did not see an increased chance for developmental problems. As there can be many things that affect future behavior and learning for a child, it is hard to know if lupus, pregnancy complications (such as preterm delivery), medications used to treat lupus, or other factors are the cause of these problems. 

What screenings or tests are available to see if my pregnancy has birth defects or other issues?

Prenatal ultrasounds can be used to screen for some birth defects and to monitor the growth of the pregnancy. Your healthcare provider might do a special ultrasound of the fetal heart called a fetal echocardiogram. This type of ultrasound is usually done between 18-24 weeks of pregnancy to look at the function and structure of the fetal heart and look for signs of congenital heart block. Talk with your healthcare provider about any prenatal screenings or testing that are available to you. There are no tests available during pregnancy that can tell how much effect there could be on future behavior or learning. 

Breastfeeding while I have lupus:  

Lupus does not appear to affect a woman’s ability to breastfeed. Lupus antibodies are not passed through breastmilk. For information on specific medications while breastfeeding, look for a fact sheet at https://mothertobaby.org/fact-sheets/ or contact MotherToBaby. Be sure to talk with your healthcare provider about all your breastfeeding questions. 

If a man has lupus, can it affect his fertility or increase the chance of birth defects?   

Studies have suggested that lupus and certain medications used to treat lupus might affect male fertility (ability to get a woman pregnant). In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/. 

 Please click here for references.  

This sheet is about exposure to chemotherapy in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is chemotherapy?

Chemotherapy (also called chemo) is a term that describes the use of medications given orally (by mouth) or intravenously (through a vein) to treat or control cancer by killing cancer cells. Chemotherapy is one of the most widely used methods to treat cancer, along with surgery, immunotherapy, hormonal therapy, targeted therapy, and radiation treatment (radiotherapy). 

Other conditions, such as lupus and rheumatoid arthritis, can be treated with chemotherapeutic drugs. MotherToBaby has fact sheets on these conditions here https://mothertobaby.org/fact-sheets/lupus-pregnancy/ and here https://mothertobaby.org/fact-sheets/multiple-sclerosis/. 

Sometimes when people find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

I have had chemotherapy. Can it make it harder for me to get pregnant?

Chemotherapeutic medications affect the division of cancer cells and normal cells, including those in the organs needed for pregnancy (reproductive system). This could affect a woman’s ability to get pregnant. For some people, the ability to get pregnant (reproductive function) can return to what it used to be within months after chemotherapy has stopped. For others, it can take several years or might not happen at all. After chemotherapy, the ability to get pregnant is based on different factors, including age and the exact chemotherapeutic medication(s) used. 

Talk with your healthcare provider about your future ability to have a pregnancy (fertility preservation) before starting chemotherapy or other treatments for cancer. They might refer you to meet with a reproductive endocrinologist, someone who specializes in fertility and reproduction.  

Does having chemotherapy increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Chemotherapy has been associated with an increased chance of miscarriage in multiple studies, especially when given in the first trimester. 

Does having chemotherapy during pregnancy increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like chemotherapy, might increase the chance of birth defects in a pregnancy. Exposure to chemotherapy early in pregnancy has been associated with an increased chance of birth defects. There have also been case reports of babies born without birth defects after exposure to chemotherapy during the first trimester of pregnancy.  

When possible, chemotherapy is usually avoided during the first trimester of pregnancy. The chance for birth defects is less when chemotherapy is given in the second or third trimester. Most of the fetal organ systems are developed by the beginning of the second trimester. The brain and reproductive system might still be sensitive to some medications after the first trimester. 

Some chemotherapeutic medications show a stronger link to an increased chance of birth defects than others. Different factors, such as the number of medications used during pregnancy, how often they are taken, how long the medications are used, and the trimester in which they are used can also affect the outcome. Contact MotherToBaby at 1-866-626-6847 to speak with an information specialist about your specific treatments. 

I had chemotherapy as a child. Could this increase the chance of birth defects in my pregnancy?

Exposure to chemotherapy in childhood is not expected to increase the chance of birth defects in future children. 

Does having chemotherapy in pregnancy increase the chance of other pregnancy-related problems?

Exposure to chemotherapeutic medications in the second and third trimesters has been associated with a greater chance of preterm delivery (birth before week 37), low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth), admission to the neonatal intensive care unit (NICU), stillbirth, or a temporary reduction in some of the baby’s blood cells (low blood counts). It is unclear if the effects reported in some studies are due to a medication, other factors, or a combination of factors. 

Chemotherapy after week 35 of pregnancy is generally not recommended to allow the bone marrow of both the person who is pregnant and the fetus to recover before delivery. 

Does having chemotherapy in pregnancy affect future behavior or learning for the child?

Studies have followed a total of 194 children who were exposed to chemotherapy during pregnancy. These children were reported to have typical development, typical performances at school, and were not more likely to have learning or behavioral problems as compared to children who were not exposed to chemotherapy during pregnancy. 

What screenings or tests are available to see if my pregnancy has birth defects or other issues?

Prenatal ultrasounds can be used to screen for some birth defects. Ultrasound can also be used to monitor the growth of the pregnancy. Talk with your healthcare provider about any prenatal screenings or testing that are available to you. There are no tests available during pregnancy that can tell how much effect there could be on future behavior or learning. 

Breastfeeding during chemotherapy:

For most chemotherapeutic medications, there is limited information about use in breastfeeding. Generally, breastfeeding is not recommended while receiving chemotherapy. There could be serious side effects in the nursing infant. For example, some medications might  lower the baby’s ability to fight infections (suppression of the immune system). Be sure to talk to your healthcare provider about all your breastfeeding questions. 

If a man has chemotherapy, could it affect fertility or increase the chance of birth defects?

A man’s ability to make sperm (sperm production) is often affected by cancer treatment. Sperm production might return to what it used to be after chemotherapy, but it is not guaranteed. Also, damage to the structure of chromosomes in sperm might happen (although most of the damage is not thought to be permanent). Some studies have found higher levels of abnormal sperm for years after the end of chemotherapy. These issues could affect men’s fertility (ability to get a partner pregnant). Men who need cancer treatments might consider sperm banking (freezing and storing) before treatment. 

 While information is limited, if sperm production restarts, it appears that a man’s treatment with chemotherapeutic medications before conception does not increase the chance of birth defects in future children. For more general information about paternal exposures, please see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/ . 

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