Crohn's Disease and Pregnancy: What You Need to Know About Risks, Medications, and Planning

When you have Crohn's disease, a chronic inflammatory bowel condition that affects the digestive tract. Also known as inflammatory bowel disease, it doesn’t mean you can’t have a baby—but it does mean planning matters. Many women with Crohn’s have healthy pregnancies and babies, especially when the disease is in remission before conception. The biggest risk isn’t the disease itself, but a flare-up during pregnancy, which can increase chances of preterm birth, low birth weight, or even miscarriage. That’s why controlling inflammation before you get pregnant is the single most important step.

Medications, the tools used to manage Crohn’s symptoms and prevent flares. Also known as IBD therapies, it’s not about stopping them—it’s about choosing the right ones. Drugs like mesalamine, azathioprine, and anti-TNF biologics (like adalimumab) are generally considered safe during pregnancy. But others, like methotrexate or certain steroids in high doses, aren’t. You need to talk to your gastroenterologist and OB-GYN together, not separately. Stopping meds on your own is riskier than keeping them. And if you’re planning to breastfeed, some meds pass into milk—so you’ll need to know which ones are safe for baby too.

Nutrition, the foundation for healing and supporting fetal growth. Also known as IBD dietary management, it’s not about special diets that cure Crohn’s, but about avoiding nutrient gaps. Many women with Crohn’s have trouble absorbing iron, folate, vitamin B12, and calcium—all critical for pregnancy. A simple blood test can show what you’re missing. Your doctor might recommend prenatal vitamins with extra iron or a liquid supplement if pills upset your stomach. Eating small, frequent meals helps when digestion is sensitive. And while no diet stops flares, cutting out trigger foods (like dairy or spicy stuff) can make a real difference in how you feel.

Some women worry about passing Crohn’s to their child. The truth? There’s a small genetic risk—about 5-10% if one parent has it—but it’s not a guarantee. Lifestyle, environment, and gut health all play roles too. The best thing you can do is get your disease under control, stay on your meds, eat well, and keep your care team in sync. You’re not alone. Thousands of women with Crohn’s have had healthy babies because they planned ahead.

What you’ll find below are real, practical guides from women and doctors who’ve walked this path. You’ll see how specific medications hold up during pregnancy, what symptom tracking looks like in real time, and how to talk to your doctor about switching or adjusting treatment. There’s no magic fix—but there’s plenty of proven advice to help you feel more in control, less anxious, and better prepared.