Things to Know When Planning for Pregnancy with MS, with Riley Bove, M.D., M.Sc.

In an interview with The Educated Patient, Riley Bove, M.D., M.Sc., associate professor at University of California, San Francisco (UCSF) Weill Institute for Neurosciences, emphasizes that most women with multiple sclerosis (MS) can plan for families as they would otherwise, with coordinated care between neurology and obstetrics teams ensuring a smooth experience. Obstetric guidelines typically dictate pregnancy and delivery management, with anesthesia and fertility treatments considered safe. The key is to time MS medications appropriately.

Over the years, research has greatly improved understanding of MS therapies’ safety during pregnancy and breastfeeding. Bove explains that updated data provide valuable insights into how these treatments affect both mother and baby. Breastfeeding not only offers general health benefits but may also help lower the risk of MS relapses postpartum.

Comprehensive postpartum care is crucial, including monitoring for mood changes and early referrals to mental health and rehabilitation specialists, such as physical and pelvic floor therapists. These interventions support recovery and overall well-being in new mothers with MS.

For women preventing pregnancy, there are no MS-specific restrictions on contraceptive choices. However, long-acting, reversible contraceptives are often recommended for their effectiveness. Additionally, some MS medications can impact gynecological health, potentially affecting human papillomavirus (HPV) status, cervical health and vaginal inflammation. Regular screenings and consideration of immunomodulatory therapy effects are advised to maintain reproductive health.

Bove’s insights underscore the importance of proactive, multidisciplinary care in managing MS throughout family planning, pregnancy and postpartum recovery.

4 Things to Know When Planning for Pregnancy with MS:

• Most women with MS can have families: With proper planning and coordinated care between neurology and obstetrics teams, women with MS can successfully have children.
• Comprehensive postpartum care is essential: New mothers with MS should be monitored for mood changes and have access to mental health support, physical therapy and pelvic floor rehabilitation as needed.
• Some MS medications may impact gynecological health: Regular screenings and discussions with a health care provider are crucial.
• Prepregnancy planning is key: Work with your neurology and obstetrics teams early to adjust medications, monitor health and ensure the best outcomes for you and your baby.