Ulcerative Colitis and Pregnancy: What You Need to Know

When you have ulcerative colitis, a chronic inflammatory bowel disease that causes ulcers and inflammation in the colon and rectum. Also known as ulcerative colitis, it doesn’t go away when you get pregnant—but how you manage it can make all the difference for you and your baby. Many women worry that pregnancy will make their symptoms worse, or that the meds they need will harm the baby. The truth? Most women with well-controlled ulcerative colitis have healthy pregnancies and healthy babies. The real risk comes from uncontrolled flares—not from the right medications.

That’s why knowing which drugs are safe during pregnancy matters more than ever. mesalamine, a common 5-ASA drug used to reduce colon inflammation in ulcerative colitis is one of the most studied and safest options. It doesn’t cross the placenta in harmful amounts. Same with sulfasalazine, another 5-ASA medication that’s been used safely by pregnant women for decades. Even corticosteroids, like prednisone, used short-term to control flares are considered low-risk when needed. But drugs like methotrexate or tofacitinib? Those are off-limits. Stopping your meds cold because you’re scared is riskier than staying on the right ones.

Flares during pregnancy don’t just cause discomfort—they raise the chance of preterm birth, low birth weight, or even miscarriage. That’s why keeping your disease in check isn’t optional. Regular check-ins with your gastroenterologist and OB-GYN are critical. Blood tests, stool tests, and sometimes colonoscopies (done safely in the second trimester) help track your condition. Diet changes, stress management, and avoiding NSAIDs (which can trigger flares) also play a role. And yes, breastfeeding is usually safe too—most ulcerative colitis meds pass into breast milk in tiny, harmless amounts.

You’ll find real stories here from women who managed their colitis through pregnancy, tips on talking to your doctor about staying on your meds, and clear info on what drugs to keep taking—and which ones to avoid. No guesswork. No fearmongering. Just what works.