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Delivery and Post Partum

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All forms of anesthesia are considered safe for women with MS; anesthesia management does not need to be altered. Epidural anesthesia does not affect the likelihood of post-partum relapse (Vukusic & Confavreux, 2006).  [This information should be discussed with the anesthesia team during the early weeks of pregnancy].

Women with MS may deliver infants of lower birth weight than women without MS (Dahl et al., 2008).

Compared to the general population, women with MS are at significantly-increased risk for depression, which means that may also be at greater risk of depression in the post-partum period.  Women and their doctors need to be alert to mood changes during pregnancy and the post-partum period, since these can affect self-care and care of the baby. Antidepressant medications should be used with caution during pregnancy (Patil et al., 2011).

Women who wish to breastfeed should be encouraged to do so unless it is judged critical that they resume their disease-modifying treatment as soon as possible after delivery. Breastfeeding does not affect the likelihood of relapse post partum (Vukusic & Confavreux, 2006).

Glucosorticoids are excreted in breast milk, which means that a woman may need to stop breastfeeding before receiving glucocorticoid treatment for a relapse.

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