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11 October 2021

MS and pregnancy: Pippa’s story

Pippa is a first time mother and wanted to share her story of pregnancy and motherhood after receiving a diagnosis of MS.

I’m a first-time mother to a baby boy and I also have RRMS. I wanted to have a child before I knew I had MS. When I was diagnosed with very active RRMS in January 2019 I had to decide what course of treatment to pursue; on the advice of my MS consultant I was offered Ocrevus or Copaxone, depending on whether I wanted to try for a child.

Deciding on a DMD

This choice was of course a difficult one for me, knowing that I wanted to try starting a family. Ocrevus was a recently approved DMT for RRMS in the UK by NICE (National Institute for Health and Care Excellence). It was very appealing with its effectiveness and mode of delivery – 1 infusion every 6 months – meaning that I only had a day of inconvenience and then I could just get on with my life until the next infusion. However, it came with the heavy caveat that it wasn’t compatible with trying for a baby. There was another option presented to me: Copaxone was less effective but compatible with trying for a baby.

After some deliberation, and chatting about it with my family, I made a very hard decision, and chose Ocrevus – I knew that time was of the essence in slowing or even preventing brain atrophy in MS.  I also knew that I could still try for a baby at some point, but I’d have to be off Ocrevus for at least a year, according to the advice.

I had my first two infusions and had started to get used to the process. Then the COVID-19 pandemic hit – with so many changes in the world, life became rather different. But obviously my body decided I needed a bit more excitement and gave me a wonderful surprise! By the time my third infusion was due, I found out unexpectedly that I was pregnant.

I was pleased, excited, but also nervous; I was worried about how Ocrevus was going to affect the baby. Fortunately, because it had been nearly six months since my last infusion, I was told that the drug was no longer having an effect on my immune system and therefore wouldn’t affect my developing baby. I was of course relieved, but still a little anxious about how the pregnancy would progress.

Following Overcoming MS during pregnancy

Being a vegan, I continued my diet during the pregnancy, which generally aligns with Overcoming MS diet guidelines, and it also meant that I didn’t have to worry about avoiding rare steaks, unpasteurised cheeses or other such things, because I already do! I also took a daily pregnancy supplement to give my developing baby the necessary nutrients.

I know that stress can be a trigger for my MS symptoms, so I took up pregnancy yoga classes to keep my mind and body healthy, and followed a pregnancy meditation course on the popular Headspace app as well as an online hypnobirthing course. All these classes helped to make me feel calmer about the prospect of giving birth. Of course, the COVID-19 pandemic played a part in causing anxiety, particularly as hospital visiting rules were in flux. Luckily, my husband was able to accompany me to all but one of my ultrasound scans.

Pregnancy and COVID

I had been asked to attend extra growth scans as a consequence of having MS, to check that the baby was developing as it should. It was one of these scans that my husband was not allowed to attend, but thankfully it showed that the baby was developing fine. I have sympathy for those mothers whose partners were not allowed to be with them at the pivotal 12- and 20-week scans. I can’t imagine how hard and unbearably sad it would be to receive devastating news without the support of a partner.

As I found out I was pregnant in August 2020, the advice about partners being able to attend scans was still changeable, so my husband and I decided to have an early private scan at 9 weeks so that we could both be there. It definitely put our minds at rest seeing the images of a healthy-looking fetus developing in my womb. We were both so overwhelmed with happiness and relief.

MS symptoms and pregnancy

Throughout my pregnancy, my MS symptoms went quiet and I felt well physically and mentally, barring some of the more common symptoms related to pregnancy: morning sickness (which is somewhat of a misnomer as it can occur at any time of the day!); an aversion to certain smells; swollen feet and ankles; and trouble getting a comfortable sleeping position. My husband and I also had the usual anxieties of becoming new parents, and I was anxious about the birth itself, although helped with this somewhat by doing the hypnobirthing course and meditations.

COVID vaccine

During my third trimester, I was invited to have the first dose of the COVID-19 vaccination. Obviously, being pregnant, I was unsure whether it was suitable for me to have, but having read about the virus potentially being worse in pregnant women, particularly those in the latter stages of pregnancy, I decided that I wanted to have the jab.

However, that decision caused a bit of a stir at my GP practice, where I had the jab, as I was the first pregnant woman that was being vaccinated there! A doctor had to check that I was happy to go ahead, but I was more than happy knowing that I was taking the first step to protect myself and my unborn child against this awful virus. I had a cold/flu-like reaction a few hours later, which I slept off but felt very tired and washed out the next day. After that, I felt fine. I was offered the second dose the day after my due date! I was again unsure whether to have it, but this time because it was so close to me giving birth. On a midwife’s advice, I decided to have it, and luckily didn’t suffer any adverse side effects. It would have made for a very uncomfortable labour if I had had to contend with cold/flu-like symptoms too!

DMT decisions post pregnancy

My little boy is now 5 months old. We’ve used a combination of bottle and breastfeeding, but now have to ask ourselves the questions about which DMT I should use – the benefits of Ocrevus are still there, and there is an increased chance that I might experience a relapse post-pregnancy (it’s apparently quite common for mothers with MS). However I would have to stop breastfeeding, and then I have to consider whether we would like to try for another baby; difficult questions with no easy answers. However, I’m grateful to my MS team for their support – whatever I decide I know that being pregnant with MS is something I don’t have to fear.