Postpartum Planning Is a Must If You Have MS

Be on alert for signs of relapse, depression, fatigue

Women with MS are more likely to suffer from depression than the general population, meaning they also may be at greater risk of the condition after they have a baby.

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They need to plan ahead with their doctors and watch for mood swings during and after pregnancy, since these can affect care for self and baby. Antidepressant medications should be used with caution while you’re pregnant – and after the baby comes.

Leaning on faith

Faith has gotten Dion W. through her 15-year journey with multiple sclerosis, and it’s what she leans on now in the final days before the delivery of her firstborn.

Dion, of Northeast Ohio, is due to give birth in early June at Hillcrest Hospital. She is hopeful she won’t have to deal with postpartum depression. “But if I do, I have to remember to stay in prayer,” she says. “That’s the No. 1 thing. It helps me continue to have the strength. I ask every day for the strength to keep on going.”

Balancing baby and medication

Dion has yet to get medication recommendations from her doctors for the postpartum period. She’s done without her MS medications since she first conceived.

Normally, doctors put moms who need immune-system-modifying meds prior to pregnancy back on them once breastfeeding ends.

There’s no formula to determine disease management postpartum, says OB-GYN Jonathan Emery, MD. “Each patient’s course will be different based on what their symptoms were like before delivery,” he says.

Planning for life after the birth

Dr. Emery describes an ongoing triangle of communication that needs to occur among patient, neurologist and obstetrician to prepare for life after the birth. “The hormonal shift, the lack of sleep and, depending how stressful the delivery is, sometimes that can precipitate an MS flare. … You want to be able to plan for that before delivery,” he says.

Experts say there’s an increased risk of MS attacks in the first three to six months after delivery. Because of this, patients may want to move up their first postpartum appointment, Dr. Emery says. “Normally, we see patients at six weeks,” he says. “Maybe an MS patient should be scheduled for a visit three to four weeks postpartum to see how she’s doing.”

If new symptoms show up or symptoms worsen, a call to the doctor is in order, Dr. Emery says.

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But planning and preparation – and help from family and friends – set most new mothers with MS up for success. “Most of them do really well,” he says.

Getting the help you need

Fatigue is a common symptom of MS, as is the type of tiredness that comes with sleeplessness when caring for a newborn. MS patients likely will notice the drain more than healthy moms, and it may take them longer to recover from it, Dr. Emery says.

To help offset the fatigue factor, Dr. Emery advises new moms with MS to be sure to plan for extra help once they arrive home. “Tell friends and family, ‘Hey, I’ll need to lean on you a little bit more,’ ” he says. “Plan for the worst and hope for the best.”

Dion says she will depend on her mother, a retiree living about 15 minutes away, and other family for support in the days following delivery.

Meanwhile, she dreams about being able to fit into her favorite clothes again. “I used to wear these pants two weeks ago and can’t wear them now. It’s discouraging,” she says. “But I think your faith is what keeps you going.”

To hear more of Dion’s story, please go to this post.

 

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