Heather from the MS community: What’s the best way to reduce the risk to mother and baby if you have highly active MS?
Dr Ruth Dobson, Consultant Neurologist: So this is a really individual discussion and I think with this I’d say it’s really important actually that you have an honest conversation with your neurologist about what your plans are and that they’re also honest with you about how your MS has been active. Clearly it’s going to depend what treatment you’re on, what your very individual circumstances are. We in general, people who are pregnant, and doctors prefer for people to be on the absolute minimum of medication whilst they’re pregnant. And this is really because we have limited information about how safe lots of medications are in pregnancy. But there is also evidence coming out that for people with very active MS, that when they stop their medication, actually pregnancy, which is sometimes thought to protect against relapses, isn’t protective against all relapses. So people may have relapses during pregnancy. So it’s really that balancing up the risk of relapses or MS activity during pregnancy against receiving medication when you’re pregnant, and that’s a really individual discussion. So you’re not going to manage to pin me down about a definite answer, I’m afraid, other than to say you really must talk to your neurologist about this and bear both sides of the coin in mind.
Heather: And are there any symptoms that as a… would you say that neurologists would bear a higher risk on, do you think?
Dr Ruth Dobson: So not specific symptoms. I think as a neurologist one thing that, one thing where I’d want to be really clear with patients about is where patients, for example, may have lots and lots of disability, and actually just being really, just talking through the physical difficulties that pregnancy might cause and, you know, what to expect when looking after a small baby with lots of physical disabilities as well. That’s not to say you shouldn’t have a baby, it’s just to say that that conversation needs to be had and part of the decision making.