Understanding Parkinson's Disease and Pregnancy Risks

Parkinson Pregnancy and the Medication Dilemma

Many women have sat in a doctor’s office waiting room, pondering whether they can have a baby because of possible infertility, recurring miscarriages, or other medical conditions. For a woman with Parkinson’s disease, there is a unique set of questions a mother may ask for which very few answers are available, and for the physician, there aren’t many easy answers to give because of the uncertainty and the lack of published data. For a normal pregnancy, the body does an amazing job of protecting the fetus during its development. The placenta protects and nourishes, providing oxygen and filtering out most harmful substances that can impact a fetus’s growth and development. What can the placenta do to protect the infant from the changes made to the mother from Parkinson’s disease? Based on the limited data available so far, fertility, conception, and the ability to carry to term are not impacted, at least by Parkinson’s, but the impact of the disease on pregnancy is still being explored. As a woman continues to term, the impact of motor and non-motor symptoms, including tremor, rigidity, fatigue, sleep disruption, mood changes, and hormonal shifts, may become more challenging to manage. However, not all women report worsening symptoms. One small group described a temporary improvement in their symptoms, which could have been the result of hormonal changes and elevated estrogen, that may have allowed the brain to use dopamine more effectively.

Birth Defects/Miscarriages/Intellectual Disabilities

There is no strong or conclusive evidence showing that Parkinson’s directly increases the risk of birth defects. or miscarriages. Though miscarriages do occur, as in normal pregnancies. However, across the available case literature, there’s no consistent signal that Parkinson’s disease itself causes higher-than-expected rates. However, these findings are based on very small studies, often involving fewer than 100 reported pregnancies worldwide, so there isn’t a lot of data available to theorize or prove a correlation between the two.

For those worried about an increased risk of their baby growing up with a disability, published case reports have not identified a consistent increase in intellectual disability, such as Down syndrome, Fragile X syndrome, or developmental delays, such as Fine motor delay or Cognitive delay, among children born to mothers with Parkinson’s disease. However, long-term developmental follow-up data is limited, and larger studies are needed to draw definitive conclusions about this subject. There is no supportive or non-supportive evidence to date that having Parkinson’s disease as a parent increases a child’s risk of Autism, ADHD, or other neurodevelopmental disorders.

Deliveries and Complications

Because there are no large-scale medical databases on Parkinson’s and pregnancy currently available to guide researchers, the data currently available has been collected from a combined review of published case reports to piece together what a delivery might look like for a woman with Parkinson’s. In the published studies reviewed, several mixed deliveries were performed: 41 vaginal deliveries, 23 C-sections were performed for various reasons, including prior C-sections, two cases of Preeclampsia, breech, and Placenta previa, and 8 abortions (no data on these were provided). Several other C-sections were performed, but the reasons were unknown. Complications during pregnancy included: Gestational diabetes, hypertension, fetal bradycardia, postpartum hemorrhage, postpartum depression, and uterine prolapse. Several women in the Parkinson’s Europe interviews describe the postpartum period as more physically challenging than pregnancy itself, an observation consistent with smaller case studies noting symptom fluctuations after delivery. Sleep deprivation, hormonal withdrawal, and the physical demands of newborn care may temporarily worsen both motor and non-motor symptoms.

Several studies to understand the effects that the disease has on patients have been done, and while there haven’t been any definitive answers, these studies, combined with interviews from women who went full term in a Parkinson’s Europe article, give an overview of what one could expect as they consider childbirth while combating the disease.

Medication

Even with a doctor’s advice, the choices of whether to take their medication during pregnancy or not put that choice almost directly into the hands of the patient, forcing them to make uncomfortable choices in order to protect their health and the health of their unborn child.

In the studies currently published, women who stayed on their medications, particularly Levodopa, seemed to do better and experience fewer motor skill complications. Those who remained on treatment were less likely to experience a significant worsening of tremor, rigidity, or bradykinesia. Patients who chose to forego their medications during the term experienced worsening tremor, rigidity, or bradykinesia as the stages of pregnancy advanced. This, in itself, is a data point showing that, at least in the case of Levodopa, the medication remains a safe choice. Because it directly replaces dopamine, it is often viewed as the most recommended treatment option when medication is necessary.

However, many women interviewed described ambiguity about their situations in part due to a lack of formal guidance, and no established and standardized pregnancy protocols specific to Parkinson’s. Having to make choices about medication without evidence of possible effects that it could, or could not have, for their child, or themselves. Many of the neurologists had never had a pregnant patient before.

Will My Baby Have Parkinson’s?

As a mother-to-be, if you are worried about any possible threats of passing on Parkinson’s to your baby, there is no evidence that Parkinson’s disease is transmissible during pregnancy, nor has there been any baby yet born with Parkinson’s documented anywhere in the world. There is a genetic component to Parkinson’s in 10 to 15% of cases of the disease that are inherited, according to the 2021 Global Burden of Disease Study. While more than 20 genes have been linked to inherited Parkinson’s, most cases are not directly caused by a single genetic mutation. Those men and women who have the genetic form of Parkinson’s, symptoms usually start to manifest (if it were an early-onset form), which often begins in the 20s, 30s, or 40s. While later-onset genes often don’t cause symptoms until the 50s or 60s. Carrying a mutation does not mean the disease is guaranteed to develop; it only means there may be an increased risk.

Breastfeeding

Many of the women from the Parkinson’s Europe article, and those from the study, don’t point to any adverse effects of breastfeeding after pregnancy, but voiced emotional uncertainty and the long-term impacts due to a lack of medical data, and don’t report any complications of breastfeeding for the mother of the infant. However, anyone taking dopamine agonists like Pramipexole could see a reduction in milk production.

According to one of the authors of the 2025 MDS Publication, Pregnancy and P a rkinson’s Disease: What Clinicians Need to Know, Dr. Adam Morton states: “Evidence regarding anti-Parkinsonian medications during pregnancy and lactation is limited. Monotherapy is preferable. For motor manifestations, the greatest safety data are for levodopa/carbidopa or levodopa/benserazide during pregnancy and lactation.” He further notes that dopamine agonists may suppress lactation; Amantadine is not recommended during pregnancy because it may increase the risk of birth defects, and its safety during breastfeeding is not well understood. Data on COMT inhibitors and MAO-B inhibitors during lactation are lacking, and there isn’t enough research available to determine whether they are safe for breastfeeding mothers or their infants.

Inspiring Words

While the research continues to evolve, some of the most grounding reassurance comes not from a journal, but from women who have walked this path before.“Don’t be afraid,” Annelien says. Probably, the most positive and powerful advice given by the mothers in the Parkinson’s Europe interviews. For first-time mothers with Parkinson’s, these can be uncertain times, but Annelien says that life returns to normal and has inspired her to help other women with Parkinson’s and to give them resources to help guide them.

Despite the limited amount of data currently available, that data will grow over time as more women come forward with the expansion of international registries, collaborative research efforts, and shared patient experiences. Each documented pregnancy adds another piece to the puzzle that is still being put together by doctors and patients alike. Caitlin’s reassuring words to other women with Parkinson’s: “Trust your gut. Some days are going to be tough, and that’s okay,” She lets everyone know to remember how strong anyone can be and to focus on “how amazing you are for being able to grow a beautiful baby in your womb.”

So when a woman sits in a neurologist’s office and asks the question, “Can I have a baby?” The answers come with a growing body of evidence from women that went before them that pregnancy with Parkinson’s is not a solitary journey, but a collaborative effort with care, planning, and hope, and for many women, that hope is powerful enough to move them forward.