New website helps standardize care for pregnant women with IBD

February 2, 2019

Planning a family can be difficult for anyone. But if you're one of more than 800,000 women in the United States with inflammatory bowel disease (IBD), such as Crohn's disease or ulcerative colitis, this can be particularly intimidating.

You may be wondering: is it safe to take my IBD medication during pregnancy? Will I need a Caesarean section or can I have a natural childbirth? Can I badfeed while taking my medication? Will I be good enough to take care of a child? Can I even have children? In fact, a woman of the American Gastroenterological Association (AGA) is three times more likely to remain voluntarily childless than the general population. The fear of the disease and the safety of the fetal drugs are the basis of the decision.

But a new online resource, the IBD Parenthood project, aims to empower patients and give hope.

"Pregnancy is a scary time, but you can have a health problem and a baby," says Christopher Robinson, MD, a physician in maternal and fetal medicine in Charleston, South Carolina, and spokesperson for the AGA IBD Parenthood project. .

Led by the AGM and the Society for Materno-Fetal Medicine, the Crohn's & Colitis Foundation and the Girls with Guts Patient Support Network, the IBD Parenthood Project is an online resource for women of childbearing age with IBD. to their health care providers. It corrects misconceptions about IBD and pregnancy that even health care providers may have, and that can be harmful to women's health, such as: Women with IBD should stop taking their medications during pregnancy. pregnancy.

On the contrary, "drugs can be used during pregnancy to keep women healthy," says Uma Mahadevan, MD, a professor of medicine at the University of California at San Francisco and chair of the IBD Parenthood project. In fact, poorly controlled IBD can lead to design difficulties, increased miscarriage rates, premature birth, and an adverse outcome of pregnancy.

Guidance for health care providers

The IBD Parenthood project also offers a clinical care pathway – explicit instructions for treating and managing women with IBD at all stages of family planning – for physicians of different specialties and other health care providers who treat pregnant women.

Among the recommendations, the care chain suggests that the care of pregnant women with IBD and those undergoing planning is coordinated through a maternal fetal medicine (MMF) subspecialist. . This person can help determine the type of monitoring required by a gastroenterologist and the frequency of prenatal visits with an obstetric provider.

Since not all women can have access to an MFM subspecialist, the care pathway is designed so that any gastroenterologist, gynecologist, physician badistant, nurse practitioner or midwife can follow.

Be a proactive patient

If your health care providers are not aware of these evidence-based treatment guidelines, you can download them through the online patient toolbox and present them at your next appointment to help you receive the best care. possible.

"The goal of the IBD Parenthood project is to inspire hope and guide women to the healthiest pregnancy for themselves and their baby," said Dr. Robinson. "The more independent patients are, the more these treatment recommendations will be disseminated to medical specialists."