Medical management during pregnancy, delivery, and postpartum

None of the current disease-modifying medications — Aubagio®, Avonex®, Betaseron®, Copaxone®, Extavia®, Gilenya®, Glatopa®, Lemtrada®, Novantrone®, Ocrevus™, Plegridy®, Rebif®, Tecfidera® Tysabri®, or Zinbryta® — are approved for use during pregnancy. Women who are taking any of these medications should discuss their plan to become pregnant with their prescribing physician. 

For more information about treatment considerations in women and men in their reproductive years, refer to the MS Coalition’s Consensus Paper — the Use of Disease-Modifying Therapies in Multiple Sclerosis: Principles and Current Evidence.

Women with MS usually need no special gynecologic care during pregnancy. Labor and delivery are usually the same as in other women and no special management is needed. All forms of anesthesia are considered safe for women during labor and delivery and.seem to be well tolerated.The disease-modifying drugs are not recommended during breastfeeding because it is not known if they are excreted in breast milk. A woman should also review any other medications she is taking with her neurologist and obstetrician in order to identify those that are safe during pregnancy and breastfeeding.

Studies have indicated no increased risk of relapse of MS associated with breastfeeding.

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