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

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 go away during pregnancy—but it doesn’t have to derail it either. Many women with Crohn’s have healthy pregnancies and babies, but it takes planning, the right meds, and close monitoring. Stopping your meds out of fear can be riskier than keeping them. Flare-ups during pregnancy are linked to higher chances of preterm birth, low birth weight, and even miscarriage. The goal isn’t to be symptom-free—it’s to stay in remission.

Not all medications are safe during pregnancy, but many are. biologic medications, like Humira and Remicade, used to treat moderate to severe Crohn’s are generally considered low-risk in pregnancy, especially when used before and during the first two trimesters. Studies show babies exposed to these drugs in utero don’t have higher rates of birth defects. On the other hand, drugs like methotrexate and thalidomide must be stopped months before trying to conceive—they’re dangerous to a developing fetus. Your doctor should review every pill, injection, or supplement you’re taking. Even over-the-counter remedies like NSAIDs (ibuprofen, naproxen) can cause problems in the third trimester. And while probiotics and fiber supplements are often safe, always check with your care team first.

ulcerative colitis, a related inflammatory bowel disease that affects the colon and rectum shares many of the same pregnancy risks and treatment options as Crohn’s. If you have either condition, your care team should include a gastroenterologist and an OB-GYN who specialize in high-risk pregnancies. Regular blood tests, ultrasounds, and sometimes endoscopies (done safely with proper shielding) help track your health and your baby’s growth. Nutrition matters too—many women with IBD struggle with nutrient absorption. Folic acid, iron, vitamin D, and B12 are often needed in higher doses. Don’t rely on diet alone; supplements guided by your doctor are key.

You might worry about passing Crohn’s to your child. The risk is low—around 2% to 5% if one parent has it, and higher if both do. But genetics isn’t destiny. Lifestyle, environment, and early gut health play big roles too. What you can control: staying on your treatment plan, avoiding smoking, managing stress, and eating well. Many women find that pregnancy brings a temporary calm to their symptoms, but others flare up, especially after delivery. Planning for postpartum care is just as important as prenatal care.

Below, you’ll find real advice from people who’ve been there—how to talk to your pharmacist about safe meds, what to do if a generic doesn’t work, how to spot drug interactions, and how to avoid common mistakes that can put both you and your baby at risk. These aren’t theory pieces. They’re practical, tested tips from patients and providers who know what works when your body is changing and your health is on the line.