Crohn's Disease and Pregnancy: What You Need to Know About Managing Flares and Medications

When you have Crohn's disease, a chronic inflammatory bowel condition that causes gut inflammation, abdominal pain, and diarrhea. Also known as inflammatory bowel disease, it doesn’t go away when you get pregnant—but it doesn’t have to derail your plans either. Many women with Crohn’s have healthy pregnancies and babies, but it takes smart planning. The biggest risk isn’t the disease itself—it’s letting flares go untreated. Uncontrolled inflammation can lead to preterm birth, low birth weight, or even miscarriage. That’s why staying in remission before and during pregnancy isn’t optional—it’s essential.

IBD medications, the drugs used to control Crohn’s symptoms like azathioprine, 6-mercaptopurine, and certain biologics, are often safe to keep taking. Studies show that stopping them increases flare risk more than continuing them. For example, anti-TNF drugs like Humira and Remicade cross the placenta mostly in the third trimester, so doctors often adjust timing to reduce baby exposure. Steroids like prednisone are used sparingly—they work fast but aren’t ideal for long-term use. On the flip side, drugs like methotrexate and tofacitinib are strictly off-limits during pregnancy. Your gastroenterologist and OB-GYN need to talk to each other. If they’re not, ask them to. There’s no such thing as too much coordination when your baby’s health is on the line.

And it’s not just about pills. Diet, stress, and sleep all play roles. Some women find their symptoms improve in pregnancy—others get worse. No one can predict it. That’s why tracking your symptoms daily helps. Keep a journal: what you ate, how you felt, any new pain or diarrhea. Bring it to every appointment. Fetal monitoring, ultrasounds, and blood tests become more frequent, but they’re not just routine—they’re your early warning system. You’re not just managing a disease. You’re protecting a growing life.

There’s also the emotional side. Worrying about whether your meds are safe, whether you’ll be able to care for a newborn during a flare, whether your body will hold up—it’s a lot. You’re not alone. Thousands of women walk this path. What they all have in common? They didn’t wait until they were pregnant to get help. They planned ahead. They asked questions. They trusted their medical team. And they kept moving forward, one day at a time.

Below, you’ll find real-world guides on how specific drugs behave during pregnancy, what symptoms to watch for, how to talk to your doctor about switching meds safely, and what to expect after delivery—especially if you’re breastfeeding. These aren’t theory pieces. They’re written by people who’ve been there, with facts that actually help.