Ulcerative Colitis and Pregnancy: What You Need to Know

When you have ulcerative colitis, a chronic inflammatory bowel disease that causes ulcers and swelling in the colon and rectum. Also known as ulcerative colitis, it affects how your body digests food and manages inflammation. Many women with this condition wonder if they can safely get pregnant — and the answer is yes, but it takes planning. The key isn’t avoiding pregnancy, but managing your disease before and during it. Flare-ups during pregnancy can increase risks like preterm birth or low birth weight, but keeping your condition in remission greatly improves outcomes for both you and your baby.

Medications used to treat ulcerative colitis, including 5-ASAs, corticosteroids, and certain biologics. Also known as IBD medications, they play a critical role in maintaining control are often safe to continue while pregnant. Drugs like mesalamine and sulfasalazine are well-studied and rarely harm the fetus. Steroids like prednisone are used cautiously, only when needed. Newer biologics like infliximab and adalimumab cross the placenta in the third trimester, so timing your last dose matters. Never stop your meds without talking to your doctor — going off them increases the chance of a flare more than the meds themselves.

What about diet and stress? Both can trigger symptoms, but they don’t cause ulcerative colitis. Still, eating small, frequent meals, avoiding dairy or spicy foods if they bother you, and staying hydrated helps. Stress won’t cure or cause your disease, but it can make symptoms worse. Simple routines — walking, breathing exercises, talking to a counselor — make a real difference. Many women find that staying active and connected to their care team reduces anxiety and improves their pregnancy experience.

Some people confuse ulcerative colitis with Crohn’s disease, another type of inflammatory bowel disease that can affect any part of the digestive tract. Also known as Crohn's, it behaves differently and sometimes needs different treatment. While both are IBD, ulcerative colitis only affects the colon and rectum, and surgery can cure it. Crohn’s can’t be cured with surgery, and flare-ups may continue through pregnancy. Knowing which one you have helps shape your plan.

What you’ll find in the posts below isn’t just a list of articles — it’s a practical toolkit. You’ll see how medications like metronidazole and corticosteroids affect pregnancy, what to watch for with drug interactions, how to manage side effects without risking your baby, and how to talk to your doctor about switching or stopping treatments. There’s no one-size-fits-all approach, but with the right information, you can take control — not just of your disease, but of your pregnancy journey too.