The dream of becoming a mother shouldn’t feel impossible because you have IBD. Yet for so many women in our community, the questions and fears about pregnancy feel overwhelming. Will my medications hurt my baby? Can I even get pregnant? What if I flare during pregnancy? These anxieties keep many of us awake at night, wondering if motherhood is truly possible with Crohn’s disease or ulcerative colitis.

The good news is that new expert guidance is here to offer the clarity and reassurance we’ve been seeking. Recent recommendations from leading gastroenterology experts are reshaping how we think about IBD and pregnancy, and the message is overwhelmingly hopeful.

Summary of the original source

The American Gastroenterological Association has released updated recommendations for managing IBD in women who are pregnant or planning pregnancy. These guidelines address the most common concerns about fertility, medication safety, and pregnancy outcomes for women with Crohn’s disease and ulcerative colitis.

Key findings include that most women with IBD can have healthy pregnancies and deliver healthy babies. The guidance emphasizes that keeping IBD in remission before and during pregnancy is crucial for positive outcomes, while active disease increases risks of complications like preterm birth and low birth weight.

Regarding fertility, the guidelines clarify that IBD generally doesn’t significantly impact a woman’s ability to conceive, except for those who’ve had certain surgeries like ileal pouch-anal anastomosis (IPAA). Most IBD medications, including biologics and immunosuppressants, are safe to continue during pregnancy and breastfeeding, with only a few exceptions like methotrexate and tofacitinib.

This post summarizes reporting from the original source. Our analysis represents IBD Movement’s perspective and is intended to help patients understand how this news may affect them. Read the original article for complete details.

What This Means for the IBD Community

These updated guidelines represent a seismic shift in how we approach family planning with IBD. For too long, women in our community have been told to “wait and see” or given conflicting advice about pregnancy safety. This new guidance provides the evidence-based reassurance that many of us have desperately needed.

Let’s talk about what this really means for your daily life with IBD. If you’re currently managing your condition well and dreaming of starting a family, these guidelines confirm that your dreams are not only valid but achievable. The key insight here is that your IBD doesn’t define your fertility potential – your disease management does.

This guidance also validates something many of us have suspected but couldn’t prove: that stopping our medications “just to be safe” during pregnancy is actually more dangerous than continuing them. How many women have suffered through devastating flares because they were afraid their biologics would harm their babies? This new evidence shows that for most medications, the opposite is true – maintaining remission protects both mother and child.

The emphasis on preconception planning is particularly important for our community. Unlike couples without chronic conditions, we need to think strategically about timing. This means having honest conversations with both your gastroenterologist and gynecologist about your disease activity, current medications, and family planning timeline. It’s not just about getting pregnant – it’s about setting yourself up for the healthiest possible pregnancy.

Questions to Discuss with Your Healthcare Team

These guidelines open up important conversations you should have with your doctors:

• What does my current disease activity mean for my fertility and pregnancy risks?
• Which of my current medications are pregnancy-safe, and what adjustments might be needed?
• If I’ve had IBD surgery, how does that impact my fertility or delivery options?
• What’s my ideal timeline for achieving remission before trying to conceive?
• How will we monitor my IBD during pregnancy, and what’s the plan if I flare?
• What genetic counseling resources are available to help me understand my child’s IBD risk?

The recommendation for multidisciplinary care is especially crucial for our community. Finding an obstetrician who understands IBD can make the difference between a pregnancy filled with anxiety and one where you feel supported and informed. Don’t be afraid to advocate for yourself in finding providers who are knowledgeable about your condition.

Connecting to Broader IBD Trends

These pregnancy guidelines reflect a broader evolution in IBD care toward more personalized, evidence-based treatment approaches. We’re moving away from the one-size-fits-all mentality that has historically left women feeling like they had to choose between managing their IBD and growing their families.

This shift also highlights the growing recognition that IBD affects women differently than men, not just in pregnancy but throughout our reproductive years. From menstrual cycle impacts to menopause considerations, the medical community is finally acknowledging that women’s IBD experiences deserve specialized attention and research.

The guidelines also reflect improved safety data on newer IBD medications. As biologics and advanced therapies have been available longer, we now have real-world evidence about their safety in pregnancy – data that simply didn’t exist when many of these medications were first approved.

Perhaps most importantly, these recommendations represent a cultural shift away from fear-based counseling toward hope-based, evidence-informed guidance. Instead of focusing on everything that could go wrong, healthcare providers now have clear direction to help women understand how to optimize their chances for healthy pregnancies and babies.

For women who may have delayed family planning due to IBD concerns, this guidance offers a path forward. It’s never too late to have these conversations with your healthcare team, whether you’re 25 or 35 or considering a second child after years of managing your condition.

The bottom line is empowering: Your IBD doesn’t have to derail your dreams of motherhood. With proper planning, ongoing medical support, and evidence-based care, the vast majority of women with IBD can have healthy pregnancies and welcome healthy babies into their families. These new guidelines aren’t just changing medical practice – they’re changing lives and giving hope to countless women who thought motherhood might be beyond their reach.

IBD Movement provides information for educational purposes only. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.