Crohn's Disease and Pregnancy: What You Need to Know About Managing Flares and Medications

When you have Crohn's disease, a chronic inflammatory bowel condition that affects the digestive tract. Also known as inflammatory bowel disease (IBD), it doesn’t disappear when you get pregnant—but it doesn’t have to derail your plans either. Many women with Crohn’s go on to have healthy pregnancies and babies, especially when they work with their care team to keep flares under control before and during pregnancy.

One of the biggest concerns is medication safety. Drugs like biologics, targeted therapies that block specific parts of the immune system causing inflammation—such as adalimumab and infliximab—are often continued during pregnancy because stopping them increases the risk of a flare more than the medication does. Studies show these drugs cross the placenta mostly in the third trimester, so doctors often adjust timing to reduce exposure near delivery. On the other hand, methotrexate and tofacitinib are strictly avoided—they’re known to cause birth defects. Even something as simple as folic acid becomes critical: women with Crohn’s need higher doses (at least 1 mg daily) because the disease and some meds interfere with absorption.

Flare management during pregnancy is tricky. Diarrhea, cramping, and fatigue can look like normal pregnancy symptoms, which means delays in diagnosis are common. That’s why tracking symptoms and keeping up with blood tests (like CRP and hemoglobin) matters more than ever. Nutrition is another big piece—many women lose weight or struggle with appetite, but protein and iron needs go up. Working with a dietitian who understands IBD can make a huge difference. And while stress doesn’t cause Crohn’s, it can trigger flares. Support groups, mindfulness practices, and even talking to others who’ve been through it (like those in the posts below) help more than you’d think.

What you’ll find in the articles below aren’t just general tips—they’re real, practical insights from people who’ve managed Crohn’s through pregnancy, along with clear breakdowns of which drugs are safe, how to talk to your OB and gastroenterologist, and what to watch for after birth. No fluff. No guesswork. Just what works.