Ulcerative Colitis and Pregnancy: What You Need to Know

When you have ulcerative colitis, a chronic inflammatory bowel disease that affects the colon and rectum. It's not just about stomach pain—it's a condition that can shape your life choices, including whether and when to have a baby. Many women with ulcerative colitis worry: Can I get pregnant? Will my flare-ups get worse? Is my medication safe for the baby? The good news is, most women with well-managed ulcerative colitis have healthy pregnancies and babies. But it takes planning, the right care team, and knowing which drugs are safe.

Ulcerative colitis doesn’t make you infertile, but active disease can make it harder to conceive. If you’re in remission when you get pregnant, your chances of a smooth pregnancy go up dramatically. Flares during pregnancy? They’re more common in the first trimester or right after delivery. That’s why keeping your condition under control before you try to conceive is key. Your doctor might adjust your meds—some, like mesalamine and sulfasalazine, are considered safe. Others, like certain immunosuppressants or biologics, need careful review. prenatal care for women with IBD isn’t the same as for everyone else. You’ll likely see a high-risk OB and a gastroenterologist together. And yes, you can breastfeed while on most ulcerative colitis meds, but you’ll want to confirm which ones pass into milk and in what amounts.

There’s a lot of misinformation out there. Some women stop their meds cold when they find out they’re pregnant—big mistake. Uncontrolled inflammation is riskier for the baby than most medications. Others think they’ll be fine without any treatment—until a flare hits at 30 weeks and lands them in the hospital. The truth? You don’t have to choose between being healthy and having a baby. You just need the right plan. Below, you’ll find real, practical advice from posts that cover everything from how to talk to your doctor about switching meds, to how lifestyle changes can help reduce flares, to what to expect when you’re on biologics during pregnancy. These aren’t theoretical tips—they’re what real women and their doctors are using right now.