Pregnancy and M.E. – Are There Risks Involved?
No doubt quite a number of women who have M.E. have successful pregnancies. Advice is commonly given from patient support groups that M.E. will not harm the baby. No one denies that there will be extra fatigue during the early years of caring for babies and young children.
However, the most serious questions in the minds of women who have diagnosed M.E. and wish to have a baby, are these:
What chance is there that my illness could harm the baby? Can M.E. be passed on to a young child? Will my husband and I be able to cope with the extra demands of pregnancy, labour, and sleep loss after the birth?
There are no simple answers to these questions. Early research has found a small but definite number of M.E. pregnancies that have not progressed normally. Any virus, if active during early pregnancy, may occasionally cause miscarriage, or abnormalities in the newborn. Rubella (German measles virus) and cytomegalovirus are well-known culprits. In a 35-year follow-up of family contacts of proven cases of enterovirus infection (in one area of England), Dr John Richardson, general practitioner, estimated a foetal loss of 30 per cent (of which at least 5 per cent is natural loss). This includes miscarriage, stillbirth and congenital abnormalities. (Personal communication from Dr E. Dowsett.)
There is also the probability that there is some inherited factor which may make the child more susceptible to M.E. -in the same way that a tendency to allergies is inherited (and seems to be more common among relatives of M.E. sufferers). In this way a mother may pass on a gene that makes the child vulnerable to getting M.E. Further research may clarify this potential hazard of childbearing. Any inherited susceptibility to M.E. applies, of course, to fathers as well as mothers. Some M.E. women feel better throughout pregnancy (which is a natural immune suppressant), but relapse after an exhausting birth, or with the post-natal drop in hormones. Some are ill throughout pregnancy. The consensus of advice from doctors, and from mothers who have experience of M.E., is to put off pregnancy until the M.E. has stabilized and signs suggesting infection (e.g. fevers, diarrhoea , lymph glands, throat infections) are settled.
Then, only consider it if the mum-to-be can rest well during pregnancy, and if plenty of domestic help is planned (and budgeted for - more important than fancy frills for the baby) after the birth. I have not heard of any evidence to show that breast-feeding passes on M.E. to an infant. Breast-milk, if available, will provide the best protection against other infection, and also the best source of natural GLA (an essential fatty acid) to protect the infant against developing allergies. Obviously good nutrition is supremely important during pregnancy and while breast-feeding. A useful source of information on nutrition for pregnancy, especially for women with allergies, chronic infections or a history of pregnancy disasters of any kind, is the organization Foresight.
Even the strongest of new mothers can suffer from post-natal depression, lack of sleep, and exhaustion. M.E. will not exempt you from these tribulations! However, the joy of a new child may well outweigh the problems, and a decision about embarking on a pregnancy must be yours and your partner's.
The question of drugs during labour, such as painkillers, gas and air, or an epidural, is one to discuss beforehand with your obstetrician and midwife. Many women with M.E. do cope quite well with labour, however exhaustion in the second stage may set in earlier than normal, so that there may be a greater likelihood of needing help (e.g. forceps) with delivery. It is wise to let the health workers concerned with your pregnancy and delivery know in advance about M.E. and how it affects you, emphasizing the nature of the muscle fatigability.
Dr Anne Macintyre