A person who’s expecting and who has sickle cell disease (SCD) requires early prenatal care and careful monitoring, but a healthy pregnancy is certainly possible

Published: February 3, 2022 | Updated: January 31, 2023

A person who’s expecting and who has sickle cell disease (SCD) requires early prenatal care and careful monitoring, but a healthy pregnancy is certainly possible. Sickle cell disease increases the risks for mother and the unborn baby, so plan on scheduling regular visits with your obstetrician, hematologist or primary care provider.

Risks associated with pregnancy and sickle cell disease include more painful and more frequent crises, as well as risks to the baby.

“Pregnant patients with SCD can develop more severe symptoms and are higher risk for preterm labor, low birth weight, preeclampsia, infections and other complications,” said Mureena A. Turnquest Wells, M.D., maternal-fetal medicine specialist with Norton Children’s Maternal-Fetal Medicine. Low-dose aspirin at the start of the second trimester may be appropriate for some patients to reduce the risk of preeclampsia

Sickle cell disease patients are more likely to experience anemia and painful crises while pregnant than at other times, and nearly half of these patients have at least one hospital admission during pregnancy, according to the National Heart, Lung, and Blood Institute.

You may need an exam every two to three weeks during the second trimester and weekly during the third trimester.

Hydroxyurea, an effective drug for preventing recurrent pain crises, isn’t advised for routine use in pregnant sickle cell disease patients as it is suspected to increase the risk of birth defects. Hydroxyurea should not be taken while breastfeeding. Partial exchange transfusion therapy can be an option in some cases.

Key therapies for managing the pain of vaso-occlusive crises include hydration, oxygen therapy and pain management. All pregnant sickle cell disease patients should take 5 milligrams of folic acid supplementation daily, according to Dr. Turnquest Wells.

A person with sickle cell disease can deliver a baby vaginally. During delivery the mother should be kept warm, hydrated and well oxygenated to prevent a crisis. Postpartum monitoring is especially important with sickle cell disease patients, as there is a risk for a blood clot.

What about birth control with sickle cell disease?
Combined estrogen-progestin contraception has not been shown to increase the risk for complications and can be used in those with sickle cell disease if there aren’t other reasons not to prescribe it, according to Dr. Turnquest Wells.