Pregnancy With Sickle Cell Disease: Planning Ahead and Getting Support

Medically reviewed by Warren Brenner, M.D.

Written by Rashida Ruwa

Posted on October 26, 2026

Feel better informed on sickle cell disease and get real support from your community.

Join

Key Takeaways

Pregnancy with sickle cell disease (SCD) is considered higher risk, but planning ahead and working closely with a healthcare team can help people prepare for the extra monitoring and care that may be needed.
SCD can increase the chance of certain complications during pregnancy, such as pain crises, preeclampsia, and premature birth, though not everyone will experience these. Before and during pregnancy, a care team may review medications, check overall health, recommend additional ultrasounds, and monitor blood pressure more closely.
Talking with your SCD care team before and throughout pregnancy, building a support network for everyday needs and emergencies, and knowing when and where to seek care can help you feel more prepared for every stage of the journey.

View all takeaways

Pregnancy can bring up a lot of questions when you have sickle cell disease (SCD). You may also have concerns about getting the care you need, especially if you’ve had difficult experiences with the healthcare system.

But planning ahead can help you prepare for the extra monitoring pregnancy may require. Working closely with your healthcare team can help you understand what to expect as well as how to manage your SCD and plan for possible complications.

Why Can Pregnancy Be Higher Risk With SCD?

During pregnancy, your blood volume increases to support the extra blood flow needed by your uterus and growing baby. SCD can make it harder for your body to meet these increased demands.

🗳️ What concerns you most when thinking about pregnancy with SCD?

How pregnancy might affect my SCD symptoms

How to prepare for pregnancy complications

How SCD might affect my baby’s health

How to manage medications and treatments

SCD may increase your risk of complications such as:

Pain crises
Worsening anemia
Infections, including urinary tract infections
Acute chest syndrome (serious lung complication)

Pregnancy also changes how your blood clots, which can increase your risk of developing a blood clot. SCD can add to this risk by making your blood more likely to clot.

SCD is also linked to a higher chance of pregnancy complications, including preeclampsia (high blood pressure during pregnancy) and premature birth. These complications may require closer monitoring or treatment during pregnancy.

An animal study found that SCD can affect blood flow through the placenta. These changes may limit the oxygen and nutrients your baby receives, increasing the chance of fetal growth restriction, when a baby grows more slowly than expected.

However, having SCD doesn’t mean you’ll have these complications. Pregnancy with SCD is considered high risk, so you may need closer monitoring by a multidisciplinary team.

What Should You Do Before Pregnancy?

If you’re thinking about becoming pregnant, talk to your SCD care team ahead of time. Preconception care gives you a chance to monitor your health and plan for pregnancy.

Review Your Medications

Some SCD medications may need to change before pregnancy. Your healthcare provider may review hydroxyurea, pain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids, and other medications you take.

Don’t stop a medication on your own. Your healthcare team can help you weigh the benefits and risks and decide whether any changes are needed. They can also help you make a pain management plan for pregnancy, including what to do if a pain crisis happens.

Check Your Folic Acid, Vaccines, and Overall Health

Your healthcare team may recommend folic acid before and during pregnancy. Ask which prenatal vitamin is right for you, including whether you need one without iron.

Some people with sickle cell disease may have high iron levels from past blood transfusions, so ask your healthcare team before taking extra iron.

They may also review your vaccinations and overall health. Depending on your history, your care team may check your heart, lungs, kidneys, or liver for SCD-related complications.

Consider Genetic Counseling

SCD is inherited, so your partner’s hemoglobin status can affect the chance of your baby having SCD or sickle cell trait. Sickle cell trait (SCT) means a person carries one sickle hemoglobin gene, and most people with it don’t have SCD symptoms.

If you don’t know whether your partner carries the sickle cell gene, ask about genetic testing. Genetic counseling can help you understand your results and what they could mean for your baby. If testing or counseling is hard to access, tell your sickle cell care team.

How Will Your Pregnancy Be Monitored?

Once you’re pregnant, your obstetrician and sickle cell care team may work together to monitor your health. You may have more frequent prenatal visits and regular blood tests to check your hemoglobin.

Regular Blood Pressure Monitoring

Your care team may also check your blood pressure regularly because SCD can increase your risk of preeclampsia. If appropriate for you, they may recommend starting low-dose aspirin around week 12 of your pregnancy to help lower your risk of preeclampsia.

Treatment Plan Adjustments

Your treatment plan may also change during pregnancy. Your healthcare team may discuss pain management, blood transfusions, or treatment for infections and other complications based on your health and medical history.

However, preventive blood transfusion isn’t recommended for every pregnant person with SCD. Your care team may consider your past transfusions and history of severe SCD-related complications, including severe pain crises, when deciding whether regular transfusions may help.

Additional Ultrasounds

SCD can also affect your baby’s growth during pregnancy, so your healthcare team may recommend additional ultrasounds to check how your baby is growing. This is often done every four weeks, beginning at week 28.

What Happens Before, During, and After Delivery?

Planning for labor and recovery can help you feel more prepared. Your birth plan can change based on your health, your baby’s health, and how your pregnancy and delivery progress.

Before Labor

As you get closer to delivery, your healthcare team will consider your overall health and how your pregnancy is progressing to help decide when delivery should happen.

If your SCD is uncomplicated and your blood pressure and your baby’s growth are normal, your healthcare team may recommend delivery around week 39.

But if you develop a pregnancy complication such as preeclampsia, you may need to deliver earlier, depending on its severity and how far along you are.

During this time, you can also work with your healthcare team to create a birth plan to prepare for your delivery. Your plan may include:

Choosing who you’d like to have with you during birth
Preparing for a vaginal birth versus a cesarean section (C-section)
Deciding on pain relief preferences during and after delivery
Identifying birthing positions that may be comfortable for you
Planning your contraception after delivery

During Labor

During labor, your healthcare team will monitor you and your baby closely. They may check your vital signs, oxygen levels, and other signs of SCD complications while also monitoring your baby’s heart rate.

If you have chronic pain from SCD, talk to your healthcare team before delivery about how it will be managed during labor. An obstetric anesthesia specialist can help you discuss pain relief and anesthesia options.

Your healthcare team will help you stay hydrated and may give you oxygen or pain medication when needed. They will watch for signs of a pain crisis, acute chest syndrome, or other complications that need treatment.

If you develop a pain crisis or another SCD complication during labor, your healthcare team can treat it while continuing to monitor you and your baby. If labor isn’t progressing, your obstetric team may need to change your delivery plan.

After Delivery

After delivery, you may need to stay in the hospital longer so your team can watch for complications. After a vaginal delivery, monitoring may continue for 24 to 48 hours. If you have a cesarean delivery, you may need closer monitoring after surgery.

Your healthcare team can help you understand whether your SCD medications are safe while breastfeeding. Research suggests hydroxyurea may be safe, but your care team can help you decide what’s right for you before restarting or continuing any medication.

After birth, all babies undergo newborn screening for SCD and sickle cell trait. If the results suggest SCD or sickle cell trait, your healthcare team can arrange follow-up testing and care.

Before you go home, ask your care team what symptoms should prompt you to seek care and when you should have your follow-up appointments. If possible, confirm a follow-up appointment with your SCD care team after delivery.

Build Your Support System Before the Baby Arrives

Pregnancy with SCD can mean more appointments, closer monitoring, and planning around your SCD symptoms. Having people you can rely on can make these changes easier to manage, especially if you become unwell or need extra help.

Think about who can help you with everyday needs, such as getting to appointments, arranging transportation, preparing meals, completing household tasks, or caring for your other children. You may not need all of this help now, but having a plan before you need it can take some pressure off later.

Before your due date, decide where you’ll go if you have a pain crisis or another emergency. Know which hospital to contact, how you’ll get there, and who can go with you or care for your family if you need immediate medical attention.

You may not be able to fully prepare for everything that could happen during pregnancy. But understanding what to expect, having support in place, and knowing who to turn to can help you feel ready.

References