To ensure appropriate education of women of childbearing age with MS. To evaluate for any unmet needs in this population regarding patient or physician knowledge gaps and areas for improvement in family planning and MS outcomes.

Patients with multiple sclerosis (MS) have a female predominance and average age at diagnosis in their 20s and 40s, leading to a disproportionate impact on women of childbearing age. 1/3 of female patients will become pregnant after their diagnosis. A women’s health initiative was created at Vanderbilt University Medical Center (VUMC) to provide consultation to patients with MS surrounding future or active pregnancies and the postpartum period. The consultations also identified gaps in patient education that should be addressed moving forward.

Prospective, observational cohort with 55 consultations for pregnancy planning, active pregnancy and postpartum management from the VUMC Women’s Health Initiative. Areas of educational need, driven by both patient and physician, were documented.

55 MS patients have been referred to this program. The patient-requested topics of education included pregnancy planning, unplanned pregnancies while on disease-modifying therapies (DMTs), current pregnancies, symptom and relapse management, postpartum planning, and oocyte preservation/fertility treatments.

Unexpected educational needs included beliefs that patients could not safely get pregnant due to MS and that patients must be off DMT to try to conceive/patients who self-discontinued DMT. Additional needs included patients unaware of how to adequately prevent, and the importance of preventing, pregnancy when not trying to conceive and how to increase likelihood of pregnancy. 

Women with MS of childbearing age require unique consideration regarding pregnancy planning and how this can affect, and is impacted by, their disease process. Patients should be asked about their goals for pregnancy early and often to provide them with optimum care and to avoid adverse outcomes from inaccurate assumptions by either patient or physician.