Some of the concerns that people with MS raise about giving birth are covered here, such as the possible need for assisted delivery, the likelihood of a normal vaginal delivery and the use of pain-relieving measures.

Am I more likely to need an assisted delivery because I have MS?

In people with MS who are not disabled, the answer is no. However, the more disabled you are, the more likely you are to have an assisted delivery or caesarean section. The latter may be due to fatigue and a lower threshold for the obstetric team to intervene in labour if a woman is significantly disabled. Please discuss the type of delivery you would like with your midwife and/or obstetrician.

Will I be able to have a normal vaginal delivery?

Yes, you should be able to have a normal vaginal delivery. The exception is women with MS with significant disabilities (see above), but even then, a normal vaginal delivery is possible. Providing there are no contraindications, you might consider having a trial of labour and if it fails you can have an intervention such as a caesarean section. Please discuss this with your midwife and/or obstetrician who are best placed to advise and to help you plan.

Will I be able to have an epidural during labour?

Yes, you can have an epidural and other standard pain-relieving measures during labour. There have in the past been cases of people with advanced MS not tolerating spinal anaesthesia well, with some reported to have a slow and incomplete recovery of function. The anaesthetist should be aware of this because an epidural occasionally needs to be converted to a spinal anaesthetic if the epidural needle pierces the dura surrounding the nerve roots at the base of the spine.

References

Krysko KM et al. Treatment of women with multiple sclerosis planning pregnancy. Curr Treat Options Neurol 2021;23:11.

Other articles in this series on Pregnancy and childbirth
Planning for pregnancy
Managing MS during pregnancy
Breastfeeding if you are on a DMT
Concerns about parenting