Does IBD affect fertility?  Do people with IBD have more adverse outcomes in pregnancy?   Are biologics (eg. Infliximab and Adalimumab) safe to use in pregnancy? How do you treat a flare in pregnancy?  If you work in primary care and you want to know the answer to these questions and lots more, this is the podcast for you.

In this episode, I discuss contraception, pregnancy and breastfeeding in people with IBD with Dr Aarthi Mohan.  Dr Mohan is an extremely experienced Obstetrician at St Michaels hospital in Bristol who runs a quaternary level service for pregnant women with concurrent medical conditions.  She shares a wealth of experience with me about all aspects of fertility and pregnancy in patients with IBD.

According to a study by Tavernier et al., infertility rates in people with IBD is mainly due to voluntary childlessness rather than infertility contributed to by the disease itself (Tavernier et al.Systematic review:fertility in non-surgically treated inflammatory bowel disease, Alimentary pharmacology and therapeutics, Oct. 2013).  This voluntary childlessness is significantly higher than those not affected by IBD (14-18% vs. 6%) and this is mainly due to incorrect beliefs about how their disease may affect their fertility and outcomes in pregnancy. Therefore having a good knowledge of these issues is important for both primary care and secondary care clinicians looking after patients with IBD so that these patients can have accurate advice when planning their family.

We cover:
Contraception
The effects of IBD on fertility
What to do with various medications in pregnancy
How should we approach flare management in these patients. 
IBD and venous thromboembolism risk in pregnancy
Folic acid use
Mode of delivery in those with IBD
The pregnancy pathway for those with IBD
IBD and breastfeeding
Post-natal depression in patients with IBD.

You can visit the RCGP IBD toolkit at: https://www.rcgp.org.uk/clinical-and-research/resources/toolkits/inflammatory-bowel-disease-toolkit.aspx

For a link to an excellent patients' guide to IBD and pregnancy, follow this link to the Crohns and Colitis UK website:  https://www.crohnsandcolitis.org.uk/about-inflammatory-bowel-disease/publications/pregnancy-ibd

NB. This episode was recorded in a busy maternity hospital, so there are some background noises as a result of this!