Articles on Medical Diseases and Conditions

Tag: Childbirth

  • Childbirth

    Miscarriage and relapse

    Women with Multiple Sclerosis run an increased risk of a relapse after a miscarriage as well as after delivery of a baby at the expected time. Miscarriage occurs quite commonly (about a third of all pregnancies miscarry), although many of these miscarriages occur so early in pregnancy that you may not realize what has happened. There is, however, no evidence that a larger number of pregnancies – or a large number of miscarriages – result in any worse outcome as far as MS is concerned.

    Delivery problems

    Some women with MS who have muscular weakness in their legs or lower bodies, or who may have spasms, might need some assistance with childbirth – perhaps an epidural anaesthesia, for example, or the use of forceps or even a caesarean. However, there is little evidence that MS causes major additional changes in the way that babies are delivered compared to those of women without MS.
    The general experience in relation to women with MS is that their pat- tern of delivery is no different from that of other women. The overall advice for women with MS in relation to preparing for the birth is the same for all women. Prenatal classes, run by your local midwives, and often also by the National Childbirth Trust, would be useful both for you and your partner if you have one, so that you can be taken through the stages of labour and how best to manage them. It may also be worth dis- cussing techniques of pain relief with your midwife and the obstetrician.
    There is one other point that you may need to know. If you have been taking steroids over the past few months, such as Prednisone (generic name prednisolone) – and this is one of the drugs that pregnant women have taken safely – then it is possible during the delivery that you will need an extra dose of this drug. This is because during labour the adrenal gland may be ‘overloaded’, if you have taken steroid drugs over the preceding months, and an additional dose, a ‘boost’, is needed. This issue ought to be raised with your midwife, and with the obstetrician before the delivery itself, so that they are aware of the situation.

    Breastfeeding

    If you decide not to breastfeed your baby, you can start taking your drugs again shortly after the delivery of the baby. If you decide to breastfeed, then you do need to seek your doctor’s advice – for drugs may be passed to the baby in breast milk.
    Breastfeeding is generally recognized as giving the baby the best possible food in the first few months. Of course breastfeeding is only a part of an often exhausting experience that all women have in caring for a newborn baby. If you can, arrange for someone else to help you in the first few weeks after the birth, and whilst it is important – if you wish to continue breastfeeding – to undertake all the feeding yourself in the first
    2 or 3 weeks, someone else could help with the particularly exhausting night-time feeds with previously expressed breast milk, or with a relevant formula feed.
    Just to reiterate, it is important to be very careful about drugs you are taking during breastfeeding, for they may be passed to the baby through breast milk. With the newer interferon-based drugs and copolymer (Copaxone), you must seek your doctor’s advice and you may have to consider not breastfeeding your baby, if you take these drugs.

  • Pregnancy, childbirth and the menopause

    Issues concerning pregnancy and childbirth often worry people with MS and their partners, as many will have recently embarked on relationships in which they will be considering the possibility of having children. Bringing up children is also another area that concerns both people with Multiple Sclerosis and those close to them. We also discuss problems older women might encounter.

  • Related problems

    For most younger people (those in their 50s and below), the urinary symptoms caused by Multiple Sclerosis will probably be far more significant than those arising from other causes, and thus the focus should mainly be on these. However, there are some circumstances that may be associated with an increased likelihood of urinary problems.

    Men and prostate problems
    As men get older, some have problems from prostate gland enlargement. This gland surrounds the neck of the bladder and the beginning of the urethra. By the age of 60, it is enlarged in some 60% of men, and the proportion increases even more with age. Very often, the symptoms of an enlarged prostate develop slowly, but as they can echo some urinary symptoms caused by MS – particularly increased urinary frequency, urgency and nocturia – it may be difficult to separate the causes without investigation. As with other symptoms, it is important that specific causes are found, if possible, so that they can be appropriately managed. As the life expectancy of people with MS increases, more men may find that an enlarged prostate gland makes some of their urinary symptoms worse.

    Childbirth
    Recent research has also shown that urinary problems may occur earlier in life for some women following a difficult or problematic childbirth. The control of urination is a frequent minor problem following childbirth. It is not clear how such problems interact with
    those of MS. However, many techniques of management indicated in this section can be used, although it would be wise for women who feel their pregnancy and childbirth has affected their bladder control to seek professional help and advice.