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

What is methotrexate?

 

Methotrexate is a medication that has been prescribed to treat many conditions, including cancer and autoimmune conditions like rheumatoid arthritis https://mothertobaby.org/fact-sheets/rheumatoid-arthritis/, lupus https://mothertobaby.org/fact-sheets/lupus-pregnancy/ and psoriasis https://mothertobaby.org/fact-sheets/psoriasis-and-pregnancy/. Some brand names for methotrexate are: Otrexup®, Trexall®, Rheumatrex®, and Rasuvo®.  

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. 

The product label for methotrexate recommends women who are pregnant not use this medication unless it is being used for cancer treatment. However, the benefit of using methotrexate might outweigh possible risks. Your healthcare provider can talk with you about using methotrexate and what treatment is best for you.  

Methotrexate lowers the body’s ability to use folic acid. During pregnancy, folic acid is important for the growing fetus. If you have recently stopped taking methotrexate and are planning to get pregnant, talk with your healthcare provider about taking a folic acid supplement and what dose you should take. More information on folic acid can be found in our fact sheet here: https://mothertobaby.org/fact-sheets/folic-acid/.  

I am taking methotrexate, but I would like to stop taking it before getting pregnant. How long does the drug stay in my body?

 

The time it takes the body to metabolize (process) medication is not the same for everyone. In healthy non-pregnant adults, it takes up to 1 week, on average, for most of the methotrexate to be gone from the body. Certain medications might affect how long methotrexate takes to clear from the body. Also, having reduced kidney function or other conditions that lead to extra body fluid might cause methotrexate to clear more slowly from the body. 

How long do I need to wait to get pregnant after I stop taking methotrexate?

 

Some healthcare providers have suggested waiting 1 to 3 months after stopping methotrexate to make sure the medication has been cleared from the body. The drug label recommends waiting 3 to 6 months after stopping the medication. However, there are no reports of methotrexate-related birth defects in babies born to women who stopped taking methotrexate any time before conception (when the egg is fertilized by the sperm).  

I take methotrexate. Can it make it harder for me to get pregnant?

 

One study on women undergoing fertility treatment found that those who had been treated with methotrexate for ectopic pregnancy (when a fertilized egg implants and grows outside the uterus) within the last 6 months had a lower number of eggs. Those who were treated with methotrexate longer than 6 months ago did not have a lower number of eggs. This suggests that any effect of methotrexate on the number of eggs might be temporary. Other studies have not shown a higher chance of problems with fertility (ability to get pregnant) with the use of methotrexate.  

Does taking methotrexate increase the chance of miscarriage?  

 

Miscarriage is common and can occur in any pregnancy for many different reasons. Small studies looking at women who used methotrexate to treat rheumatic diseases have reported an increased chance of miscarriage.  

Does taking methotrexate 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 methotrexate, might increase the chance of birth defects in a pregnancy.  

Taking methotrexate in the first trimester could increase the chance of a specific pattern of birth defects of the head, face, limbs, and bones. It is not clear if methotrexate could cause other kinds of birth defects. Heart defects and oral clefts (cleft lip and/or cleft palate) have been reported in some infants exposed to methotrexate during pregnancy; however, there is not enough information to know if methotrexate could have caused these birth defects.  

Not all babies exposed to methotrexate during pregnancy will have birth defects. A published review of studies reported no increase in birth defects among infants born to 101 women with rheumatoid arthritis taking 5 to 25mg of methotrexate per week in the first trimester.  

Although birth defects could occur with exposure to methotrexate any time in the first trimester, limited evidence suggests that methotrexate-related birth defects are more likely to occur if a pregnancy is exposed to 10 mg or more of methotrexate per week between 6 and 8 weeks after conception (8 to 10 weeks after the first day of the last menstrual period).  

Does taking methotrexate in pregnancy increase the chance of other pregnancy-related problems?

 

Poor growth of the fetus (being smaller than expected for the weeks of pregnancy) has been reported in pregnancies affected by methotrexate-related birth defects.   

Does taking methotrexate in pregnancy affect future behavior or learning for the child?  

 

Developmental delay, learning problems, and intellectual disability have been reported in some children who have birth defects related to methotrexate exposure 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, such as birth defects of the head, face, limbs, bones, heart, lips, and palate. Ultrasound can also be used to track 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 while taking methotrexate: 

 

Methotrexate passes into breast milk in small amounts. The product label for methotrexate recommends women not use this medication while breastfeeding. But the benefit of using methotrexate and breastfeeding might outweigh possible risks. Your healthcare providers can talk with you about using methotrexate and what treatment is best for you. Some healthcare providers recommend not breastfeeding while receiving high doses of methotrexate (such as those used to treat cancer) and for 1 week after receiving the last dose. 

Testing of breast milk samples from women exposed to methotrexate at lower doses found low levels of methotrexate in the milk. As a result, some experts suggest that weekly low-dose methotrexate is unlikely to cause problems for the breastfed infant. If a woman uses low-dose methotrexate while breastfeeding, it is suggested that the baby’s blood count be monitored. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

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

 

The product label for methotrexate states that men should use effective contraception (to prevent pregnancy) while on methotrexate and for 3 months after taking the final dose. Low sperm count has been seen in some men using methotrexate. Most of these men were using high doses of methotrexate to treat cancer, as well as other medications. Sperm levels returned to normal over time after the medication was stopped. Having low sperm count can affect a man’s fertility (ability to get a woman pregnant). Men who need to take methotrexate as part of cancer treatment can consider banking sperm before treatment. Studies looking at men taking lower doses of methotrexate to treat other health conditions have not agreed on whether these lower doses could affect a man’s fertility during the time of treatment.   

Studies have not found a higher chance of birth defects in the children of men taking methotrexate around the time of conception. In general, exposures that men 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 rheumatoid arthritis 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 providers.

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is a type of arthritis that mainly affects joints but can also affect other parts of the body. It is an autoimmune condition, meaning the immune system does not work the way it should, causing inflammation (swelling). Symptoms can include swelling, stiffness, discomfort, pain, and sometimes limited movement. Many people with RA might also have some symptoms that do not involve joints like fatigue, loss of appetite, and low-grade fevers (temperature above normal, but below 100.4).

I have rheumatoid arthritis and am thinking of getting pregnant. Is there anything I need to know?

Talk with your healthcare providers about getting pregnant and your condition. Many women with RA take medication to control the inflammation and prevent or reduce joint damage. It is important to talk with your healthcare providers about your medications and the best treatment options before trying to get pregnant. People with RA can have a higher chance of problems during pregnancy. If RA is well controlled for 3-6 months before getting pregnant, the chance for pregnancy complications is usually lower than in people with more active RA.

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

It might take longer for some women with RA to get pregnant. It is not clear if this is related to the RA itself, the severity of the disease, the medications used for treating RA, or other factors. In some studies, people with RA took longer to get pregnant than those without RA; however, many experts believe that the ability to conceive is not different from people without RA.

Will pregnancy affect my rheumatoid arthritis symptoms?

Studies suggest that up to 50% of pregnant people with RA experience symptom-relief over the course of pregnancy. It is unknown why some people experience relief and others do not.

Does having rheumatoid arthritis increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Most studies have found that rates of miscarriage for people with RA are similar to rates for people without RA.

Does having rheumatoid arthritis 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 RA, might increase the chance of birth defects in a pregnancy.

There is no evidence that having RA will increase the chance of having a baby with a birth defect. While most medications used to treat RA do not increase the chance of birth defects, some might. This is why it is best to review your medications with your prescribing healthcare provider before you get pregnant, if possible.

I just found out that I am pregnant. Should I stop taking my medication(s)?

Talk with your healthcare providers before making any changes to how you take your medication(s). Pregnancies are more successful when RA is well controlled, and it is important for your health and the health of the pregnancy. Because some medications (such as methotrexate or leflunomide) might be avoided during pregnancy, it is important to contact your healthcare provider as soon as possible to talk about what treatment is best for you.

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

People with poorly controlled RA have a higher chance for preterm delivery (delivery before 37 weeks of pregnancy) and for babies to have low birth weight or be smaller than usual. Earlier delivery and lower birth weight increase the chances for health problems in a newborn. RA flares and inflammation can also increase the chance for pregnancy complications like preterm delivery and preeclampsia (a dangerous rise in blood pressure and increase of protein in the urine). C-sections have also been reported more often among women with moderate to high disease activity at time of delivery.

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

It is not known if having rheumatoid arthritis can affect future learning or behavior for the child. Some studies have suggested a possible association with neurodevelopmental disorders.

Breastfeeding while I have rheumatoid arthritis:

Many women with RA who want to breastfeed are generally able to do so. Many medications that are used to treat RA can be used when breastfeeding. It is important to find out about your specific medications. To find out more about specific medications, you can view MotherToBaby Fact Sheets at https://mothertobaby.org/fact-sheets-parent/ or contact a MotherToBaby specialist. Be sure to talk to your healthcare provider about all your breastfeeding questions.

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

Limited information has not found an increased chance of birth defects or miscarriages in pregnancies where men had been taking medications for RA. Some medications used to treat RA might affect men’s fertility (ability to get a woman pregnant). Many exposures a father or sperm donor 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 rheumatoid arthritis and the medications used to treat RA in pregnancy. If you are interested learning more about this study, please call 1-877-311-8972 or visit https://mothertobaby.org/join-study/.

Please click here for references.

Katie recently reached out to us; she told us that she has lupus and has been taking hydroxychloroquine for years to successfully manage her lupus symptoms. Her concern? “I just found out I am pregnant and my rheumatologist was not sure if I can continue taking hydroxychloroquine during pregnancy. I am worried for my baby but I am also worried about stopping my lupus medication since it helps my symptoms so much. I haven’t had a flare in over a year! I can suffer through the flares if I have to, but I don’t want to harm my baby. I don’t know what to do.’

Katie’s concerns about how to balance the management of her chronic health condition against her baby’s health during pregnancy are not uncommon. Generally, the healthier a woman is during pregnancy, the better it is for both them and their baby. When taking medication during pregnancy, the risks and benefits of taking or not taking the medication should be carefully considered. More specifically, could the untreated condition cause more problems than taking the medication?

What is lupus and how could it affect a pregnancy?

Lupus, also known as systemic lupus erythematosus (SLE), is an autoimmune disease that affects many different parts of the body. The symptoms are variable; however, the kidneys, joints, and skin are commonly affected.  It is very important for both the health of the pregnancy as well as the health of the woman who is pregnant to achieve optimal control of lupus and maintain that control without flares (relapses in symptoms) throughout the pregnancy. For those who are planning a pregnancy, it is generally advised that at least 6 months without flares reduces the chances of pregnancy-related problems.

Lupus, especially if not well controlled, can cause serious health complications for both the woman who is pregnant as well as the baby. These complications include nephritis (inflammation of the kidneys that causes difficulty filtering waste from the body) and blood conditions such as anemia (a condition in which you don’t have enough healthy red blood cells to carry adequate amounts of oxygen to your body’s tissues) and thrombocytopenia (a condition in which the blood does not clot as fast as it should, which can cause excess blood loss). Inflammation in the lungs, heart, or brain can also occur and cause serious health problems.

People who have lupus also have a higher chance to develop high blood pressure during pregnancy and preeclampsia (a pregnancy-related condition that has several symptoms including a dangerous rise in blood pressure). People with lupus, most often the ones who develop high blood pressure or other health problems, may also have a higher chance of having a baby with poor growth which can lead to late miscarriage and preterm delivery (delivery before week 37).

Rare complications for the baby may include being born with symptoms of lupus (called neonatal lupus erythematosus (NLE)). These may be temporary and often disappear by six months of age. NLE is mostly seen in children when the pregnant woman has anti-SSA and anti-SSB antibodies. The most serious complication of neonatal lupus is a heart rhythm problem called congenital heart block which can often be detected on ultrasound and may lead to health complications and death. If these antibodies are present, additional ultrasounds for the heart may be recommended.

Katie was surprised. ‘I thought if I stopped my medications my flares would be painful and uncomfortable, but I never thought it could seriously affect my health or the health of my baby. Can you tell me more what is known about taking my lupus medication during pregnancy?’

So what do we know about lupus medications and pregnancy?

Many medications used to treat lupus are not thought to increase risks to a pregnancy over background chances that all pregnant individuals have. Medications work differently for different people. It is very important to talk with your healthcare providers before making any changes to how you take your medication. It is important to consider (with help of a rheumatologist) which medication works best to treat you. Regarding Katie’s question, the Society of Maternal Fetal Medicine (SMFM) recommends continuing the use of hydroxychloroquine during pregnancy. This recommendation is based on studies which did NOT show an increased risk for pregnancy related problems when hydroxychloroquine is used. Additionally, the studies showed a lower chance of lupus related problems during pregnancy when hydroxychloroquine is used.

There are many other medications such as steroids and biologics that lower the body’s immune system (immunosuppressants) that can also be considered for use during pregnancy.  However, certain medications for lupus are not recommended for use during pregnancy because they can increase the chance for birth defects and other pregnancy-related problems. SMFM recommends that methotrexate should be stopped 1-3 months before pregnancy and mycophenolate mofetil/mycophenolic acid should be stopped at least 6 weeks before attempting pregnancy. NSAIDs (non-steroidal anti-inflammatory drugs), such as ibuprofen, high dose aspirin, etc. are not recommended for use during pregnancy.

For information on specific medications make sure you talk with your healthcare provider or contact MotherToBaby and see our medication fact sheets at https://mothertobaby.org/fact-sheets/ . It is very important to talk with your healthcare providers before making any changes to how you take your medication. 

Katie summarized the information she was given very well, ‘It seems like making sure my lupus is well controlled will set both me and my baby up for the highest chance of being healthy. I feel much more comfortable continuing my medication knowing that with my own health, I am helping my baby to be healthy as well. I will talk with my healthcare providers to plan for monitoring both me and the pregnancy. Is there anything else I should know?’

Other info to know about lupus and pregnancy

It’s not uncommon for new medications to be developed for the treatment of lupus. If there is one thing that these new medications have in common, it’s that they very rarely have adequate, real-world data that describes whether the medication is safe to take during pregnancy. Pregnancy registries are the types of studies that give us this information, which is what allows us to provide risk assessments to people like Katie. That’s why we suggest to any pregnant woman with lupus that they consider joining the pregnancy registry for the medication(s) they are taking if one exists. The U.S. Food and Drug Administration (FDA) maintains a list of ongoing pregnancy registry studies on their website. If you’re planning a pregnancy or are already pregnant, now is a great time to find out more about the benefits of joining a lupus pregnancy study.

Women who are pregnant and have lupus will require some additional monitoring during pregnancy. They should be followed by their rheumatologist to make sure their symptoms are well controlled. Additional monitoring during pregnancy such as blood pressure checks, additional lab tests and additional ultrasounds may be recommended. Make sure you talk with your healthcare provider to discuss the management plan for your pregnancy.

Katie returned to MotherToBaby a few weeks later and told us she has been working together with her rheumatologist as well as her obstetric team including a high-risk pregnancy provider (also called Maternal Fetal Medicine (MFM) specialist) to make sure both her and her baby are as healthy as they possibly can be. ‘I felt empowered by being informed, having all my healthcare providers in my corner and knowing that by taking care of myself, I am taking care of my baby too. Thank you, MotherToBaby!’.

For more information about lupus and pregnancy, including links to lupus-related MotherToBaby Fact Sheets, visit our lupus resources page at https://mothertobaby.org/pregnancy-breastfeeding-exposures/lupus/. You can also contact one of our information specialists for a no-cost risk assessment by visiting https://mothertobaby.org/contact/.

If you are pregnant and taking belimumab (Benlysta®) to treat SLE or lupus nephritis, please consider enrolling into our observational study. This study will give women with lupus better answers about how lupus and its management can affect a pregnancy and a developing baby. You will not be asked to take or change any medications, and you can participate from the comfort of your home.

Tanya called in on a Monday morning. “I’m getting married in a few months and we want to start trying to get pregnant right away. What should I be doing now to have the best chance of a healthy baby?”

Preconception health and pregnancy planning present a terrific opportunity to assess a wide range of factors that can give your baby the best start. This blog will outline the things to consider, as I relayed to Tanya:

Your Personal Health

Are you generally healthy? If you already get headaches or have acid reflux, know that pregnancy can make these more frequent. Ask your doctor if the way you treat these common conditions should change once you are pregnant. Ask about your current exercise routine and if you need to alter it during pregnancy. Get checked for sexually transmitted infections because some may not show symptoms. Also discuss your medications – some should be stopped before you start trying to conceive, such as Valproic acid, leflunomide (e.g. Arava®), teriflunomide (Aubagio®), methotrexate, and isotretinoin (e.g. Accutane®) to name just a few. For others, you’ll want to weigh the risks vs. the benefits with your health provider before you conceive. Talk with your doctors now to make a plan.

Caffeine

Do you drink caffeinated coffee, tea, or soda? What about energy drinks, protein powders, or Kombucha? MotherToBaby’s fact sheet on caffeine may put your mind at ease and encourage you to think about all your beverage options.

Body Weight

Is your weight a concern? One of the best things you can do before conception is to get to a healthy weight. Women who are overweight or obese have increased risks for miscarriage, birth defects, gestational diabetes, high blood pressure and preeclampsia, and unplanned cesarean birth. Now is a good time to meet with a nutritionist or go on a sensible diet to get to a healthy weight in anticipation of pregnancy. Once you are pregnant, continue to watch what you eat but don’t try to lose weight. Weight gain is inevitable during pregnancy but guidelines from the American College of Obstetricians and Gynecologists (or ACOG, the leading professional society for OB/GYNs) advise women to gain anywhere from 11-40 pounds, depending on your pre-pregnancy weight. It’s a myth that you need to “eat for two,” so don’t set yourself up for postpartum weight gain by eating more than you should. After delivery of an average 7-8 lb. baby, you may lose 2 lbs. in amniotic fluid, 1.5 lbs. of placenta, 5-7 lbs. in blood volume, and 2 lbs. as the uterus returns to its normal size. That could still leave you with 10 pounds of excess weight, or more if you gained more weight during the pregnancy. Some women never take off those extra pounds, and their weight creeps up with successive pregnancies and age, which can lead to pregnancy complications and chronic health problems later on. See our exercise fact sheet for more information.

Chronic Health Conditions

Do you have chronic health conditions like diabetes, high blood pressure, migraines, asthma, high cholesterol, heart conditions, varicose veins, or anemia? Do you have an autoimmune disease like Crohn’s or ulcerative colitis, lupus, rheumatoid arthritis, ankylosing spondylitis, multiple sclerosis, psoriasis or psoriatic arthritis? Meet with your obstetrician for a “preconception” appointment to discuss how a pregnancy might impact your health, and how your health might affect a future pregnancy. Your specialist can provide an important opinion too. A maternal-fetal medicine specialist (MFM) is a doctor who specializes in high-risk pregnancies, and consulting with a MFM once you are pregnant could help you learn how to optimize your and your baby’s health.

Mental Health

What about your mental health? If you have a history of anxiety or depression, ADHD or other conditions, ask your psychiatrist and OB about treatment, and don’t make changes before you do. Many medications can be continued during pregnancy and while breastfeeding. In fact, mental health is incredibly important – for example, when a woman doesn’t treat her mood disorder or inadequately treats it, some studies suggest risks for miscarriage, premature birth, low birth weight, and preeclampsia. Talk therapy is vitally important too. And if you struggle with mental health concerns during the pregnancy, you are at risk for postpartum depression. Let’s face it – pregnancy and caring for a new baby is stressful, so now is the time to marshal your helpers – friends, relatives, therapists and doctors – to ensure you have enough support. Your obstetrician should ask about mental health but if not, speak up. Your doctor can be your ally here, helping you get treatment and addressing concerns related to pregnancy and postpartum mental health. And MotherToBaby can give you an overview of the research related to any prescriptions you might choose to take.

Dental Health

Have you seen a dentist lately? Oral health can impact a pregnancy, meaning that if you have swollen or bleeding gums, a toothache or an infection, it can increase risks to the pregnancy. If you need to have a dental x-ray, take antibiotics, or have local anesthesia for a dental procedure, these are generally acceptable during pregnancy, but best to complete before you get pregnant. Contact MotherToBaby for more details.

Your Workplace

Where do you work? MotherToBaby can give you information to minimize exposures in a veterinarian office, dry cleaners, salon, laboratory/hospital, imaging center, pest control service, or other business. Your occupational safety department can recommend personal protective equipment (PPE) and tell you about ventilation that may be in place to ensure workplace safety. Safety data sheets (SDS) give an overview of chemicals used in industry and are available online or at work.

Food Safety

Read up on food safety and learn how to minimize your exposure to foods that have commonly been associated with foodborne illness such as E. coli or listeria. Get in the habit of washing your fresh fruits and vegetables well. Check out other blogs on our website too.

Vitamins and Supplements

Have you started taking a prenatal vitamin? Are you getting enough folic acid? ACOG recommends that women take at least 400 mcg of folic acid before getting pregnant and at least 600-800 mcg/day once they are pregnant. This can help prevent birth defects of the brain and spinal cord. Call MotherToBaby if you want to learn the recommended daily intake for specific vitamins or minerals. In general, taking more than what is recommended is not advisable – we haven’t studied how mega-doses of vitamins may impact a pregnancy. Other supplements beyond taking a prenatal vitamin are not advisable either – the Food & Drug Administration (FDA) doesn’t supervise their manufacturing plants and past surveys have shown some supplements actually contain contaminants. Furthermore, we’ve seen instances where the label didn’t match the contents of the bottle and could cause ill effects. Pregnant and breastfeeding women should avoid herbal supplements unless specifically recommended by your doctor.

Alcohol, Cannabis, and Tobacco

Do you smoke cigarettes? Do you use cannabis for medicinal or recreational purposes? Do you drink alcohol? Recent research has demonstrated that marijuana use very early in pregnancy causes changes in brain development, which could result in behavioral or learning challenges we see later in the child’s life. Cigarettes increase risks for pregnancy loss, among other things. And alcohol is known to cause a variety of birth defects known as fetal alcohol spectrum disorder (FASD). We don’t believe that there is a “safe” amount of alcohol which when consumed doesn’t cause issues for a developing child. Now is the time to quit smoking, drinking, and using cannabis – your baby will be heathier for it. MotherToBaby can provide resources, or check with your doctor.

Vaccinations

Are you up to date on all your vaccines? Did you get a flu shot this past season? You don’t want a vaccine-preventable illness to have an impact on your pregnancy. Flu infection can increase risks for more severe symptoms, longer-lasting illness, pregnancy loss and premature delivery, which can have a lifelong impact on your baby. Flu vaccine helps prevent infection. Another benefit to vaccinating during pregnancy? Studies show the protection extends to your baby, and gives them a little extra immunity from birth until they can receive vaccines. Also good to know: some vaccines can be given and are recommended during pregnancy, like a flu shot or TDAP, but others are best given before you conceive to avoid a small risk of spreading the illness to the fetus (e.g. the measles, mumps, and rubella (MMR) vaccine, as well as the Varicella (chicken pox) vaccine) – so try to get these done at least a month before trying to conceive. Check your medical records to see the last time you received any of these vaccinations. If you don’t know if you were previously vaccinated, your doctor can draw blood to check if you have immunity.

Your Pets

Do you have a cat? There is some concern in pregnancy about an infection called toxoplasmosis, which is caused by a parasite that can be found in cat feces. Read our blog for more info on what you can do to prevent this infection if you have a fur baby at home.

Other Illnesses

Do your upcoming travel plans involve travel to a warm tropical place? Check out our Zika fact sheet to learn more before you book nonrefundable tickets. In general, women will want to wait to try to conceive for eight weeks from the time of your return home; the wait time is three months if your male partner travels with you. COVID-19 is also spreading around the globe and our fact sheet can give you the latest information on whether and how it could affect a pregnancy.

Finally, your obstetrician or primary care doctor would be glad to see you for a Preconception consultation. Make an appointment to discuss your personal history and health. It’s a great way to get you and your baby off to the best start.