Focus on Future – Having a Child and Multiple Sclerosis

Tick, tock, tick, tock. When the biological clock starts ticking, women think about their own wish to have children. Besides, women with multiple sclerosis (MS) often have to deal with many fears and doubts. However, this mustn't be at all.

01/06/2011

Women with MS can fulfill their
wish to have a child; © Laura
Boese/panthermedia.net

Between milk and ketchup they stand in the fridge – the vials with the attack-debilitating drug. The disease belongs to the everyday life of the family, but anyhow also not. Since the children don't know that their mother has MS.

„MS isn't the centre of my life. This would limit me too much,“ tells Sabine Pfeiffer*. The mother of three children is of the opinion that she leads quite a normal life. Although or maybe just because both girls and the boy know nothing about her disease.

About one year ago Sabine Pfeiffer could not walk properly any more. That’s why she got infusions at home. She only explained to her children that mummy can't just walk well and therefore needs some drugs. She did not mention the words multiple sclerosis. „As long as I feel so well as I do at the moment, I would not want my children to worry. I want to protect them as long as possible.“ She doesn't know, when she will tell them. However, she answers all questions of her children. „I will conceal nothing from them if they ask me, but I do not want them scare them too much.“

Neurologist and gynaecologist should advise together

Fears – an important headword. With MS patients with the wish to have children fears play a big role. Often they result from the lack of knowledge about the progress of the disease and the consequences for the child. Besides, the biggest fear that the illness could be inheritable is widely unfounded. „MS is no direct hereditary disease. Indeed, there is a certain familiar accumulation,“ knows Kerstin Hellwig, neurologist at the university hospital of Bochum. „If both parents are healthy, the risk lies at about 0.1 percent. If one parent is ill, the risk for the child to fall ill with MS as well, rises on about three percent.“ Therefore there is a likelyhood that the child does not fall ill with MS of about 97 percent.

During their pregnancy MS patients should not only confer with their gynaecologist regularly, but also include the treating neurologist in an active way; © Zsolt Nyulaszi/panthermedia.net

As well as the gynaecologist the treating neurologist should also be consulted. With the help of the state of health he can estimate best how advisable it is for the respective patient to become pregnant. And then only in arrangement with the neurologist can be decided, when which drug should be discontinued. Since this can again affect the health constitution of the patient, for example if an attack-debilitating drug is discontinued.

„If an attack appears during pregnancy, cortisone can be given any time,“ explains Hellwig. „Basically I advise to treat lighter attacks not with drugs, but to observe them intensively.“ Nevertheless, the neurologist points out to the fact that in the first third of pregnancy special caution is needed, because there is a rare however possible teratogenic risk.

During pregnancy the attack rate continuously decreases. In the last third of pregnancy it is nearly zero. „During the first three months after the birth the attack rate rises again. Then, however, the exclusive breast-feeding can affect the child positively. It reduces the attack risk around a fourfold,“ says the neurologist.

Exclusive breast-feeding minimises
the attack risk around a fourfold;
© Anja Roesnick/panthermedia.net

Also Daniela Wendt can confirm this from own experience. The mother of a ten month-old son suckled him for four months. When she stopped, she had an attack which has been treated with cortisone then. In this time she was particularly to her husband very thankful for his support. „And if only he got up to look after him. This already helped me a lot,“ remembers Wendt.

Thinking about the future

A stable environment and a good health constitution form a good basis for planning a family. Mostly, women are already free of attacks for a longer time and show only few symptoms, when a pregnancy is planned actively. Like all future parents, one should ask oneself if there are any people, friends or family, who can help caring for the child if ones state of health should get worse.

Back then, Sabine Pfeiffer asked herself how her life could look like in eight years. „When thinking this through, I have only relied on myself,“ remembers the mother of three. „I have tried to make clear to myself whether and how I will be able to get along with a child on my own.“ Based on her quite good and stable state of health at that time she was optimistic. And today everything works out the way she planned. „If then still the granny or the best friend lives nearby, it is of course even more easy in critical phases,“ says the 41-year-old.

Climbing and rollicking - mummy
has not to be around everywhere;
© Marco Kalbe/panthermedia.net

There were no problems during the pregnancies of Sabine Pfeiffer and Daniela Wendt. Looking back both mothers say that the pregnancies have affected their progress of disease even positively. Daniela Wendt is sure: „The decision for the child was best of my life.“ She enjoys being a mother to the fullest and does as much as possible with her son. „If I pass a playground, I sometimes start thinking and worrying. Because I cannot climb completely up to the top with my son, like other mothers do – due to my vertigo.“ But in such moments she knows that being a good mother isn’t only made of climbing around.

* Name changed by editor

Nadine Lormis
REHACARE.de