The unpredictability of the course of MS is definitely the most challenging aspect of the disease. No one with MS can predict with certainty how they will be from one month to the next. So the decision about whether or not to have a baby may become even more difficult for a person with MS than it generally is.
MS and Pregnancy
The decision about whether or not to have a baby is always an important one. The future you hope your child will enjoy, the physical, emotional and financial security you as the parent can expect to plan for your child, the risks involved in pregnancy and childbirth – all these considerations and more must be thought about before you make the final decision. Many of these questions are unanswerable because, for all of us, the future comes with no guarantees.
Open, honest discussions with your partner are essential and the decision to have a child should be taken together – it really is a family matter.
Multiple Sclerosis (MS) compounds the decision-making process. A diagnosis of the disease does complicate a person's life, without doubt. MS is a puzzle to medical researchers, because as yet the cause and the cure remain elusive.
MS occurs most frequently amongst women who are in their prime childbearing years and it is no surprise that information on pregnancy and MS is frequently requested from health care professionals and MS Victoria. The best advice is: do not rush! – allow yourself plenty of time after the initial diagnosis of MS, so that you can work out your life's direction in its new light.
The following are some frequently-asked questions:
Q. Is MS a genetically inherited disease? Will I pass it on to my child?
A. Technically speaking, MS is not considered a genetically inherited disease, although it does tend to occur more frequently in some families than in the general population. About two children in one hundred children where one parent has MS will develop the disease. Research has not yet discovered which specific genes are responsible for MS susceptibility. There is still no blood test for MS, so you cannot determine if your child will inherit the susceptibility to MS.
Q. Does having MS affect my fertility?
A. No, neither male nor female fertility is adversely affected by MS. Some people, however, may experience orgasmic difficulties and some men may have erectile problems; these problems can be helped by health care professional advice.
Q. Does MS in the mother harm her foetus?
A. No, MS has no apparent effect on the course of the pregnancy. Note that it is essential to discuss with your doctor matters such as the drugs you are taking to manage your MS before you consider becoming pregnant. Some drugs must be discontinued if you are pregnant – immunotherapy drugs are among such drugs, and there may be other drugs you may be taking which your doctor will advise you to discontinue before and during pregnancy.
Q. Will having MS mean my pregnancy is worse than usual?
A. No, it is often quite the contrary: many women with MS say that during their pregnancy they felt much better than usual. However, women with MS do suffer greater fatigue than usual. Bowel and bladder problems can be troublesome (they are a problem in many pregnancies, anyhow). Towards the end of the pregnancy, many mothers with MS experience gait problems, again attributable often to MS.
Q. Will labour and delivery be normal?
A. Yes, MS does not create any real problems, except perhaps an increase in spasticity of the muscles and greater fatigue than usual during childbirth. The mother may need instrumental assistance during delivery.
Q. Is it alright to have anaesthetics during labour and delivery?
A. Yes, you can have local, spinal and general anaesthetics. You will need to discuss this with your doctor or midwife.
Q. I have heard that in the six months after the baby is born, the mother with MS can expect a worsening of her MS condition. Is this so?
A. A recent large European study, involving 254 women, showed that the overall impact of pregnancy was neutral in its effect on the MS relapse rate. The mother with MS may possibly suffer exacerbations within three months of birth; but this is counterbalanced by a reduction of relapses during the pregnancy. Commonsense dictates the mother must try to rest as much as possible and avoid heat, stress and infections. Now is the time to ask for, and accept, help with the baby and household tasks!
Q. If I have MS, can I breast feed my baby?
A. Yes, provided of course that you are not on immunotherapy drugs. If fatigue is an issue, plan practical ways of coping with night feeds. Some mothers express milk for the night feeds; some choose to feed the baby with formula – both these situations mean that someone else can actually manage the baby during the night, and the mother with MS can get a good sleep. If you choose to breast feed, check with your doctor about drugs you may be taking to manage your MS – you may need to discontinue these for the baby's sake.
The decision of whether or not to have a baby is one that each person and each couple will make taking into consideration their own particular situation in life. A chronic illness like MS imposes its own demands and must be taken into consideration. Pregnancy and child rearing may become a special challenge to the parent with MS, because when a parent has MS there are some areas where adjustments may have to be made and helpful support sought.
Don't forget to read our article on Parenting with MS in the Baby section of BellyBelly.
The information in this article was provided by the MS Society of Australia. You can visit their website for more information at http://www.msaustralia.org.au