Chemotherapy during pregnancy

Sometimes, yes. Cancer during pregnancy is uncommon, but when it happens, many women can receive chemotherapy and continue the pregnancy safely. Timing is the key. During the first trimester, when the baby's organs are forming, chemotherapy carries a higher risk of miscarriage and birth defects, so doctors usually try to avoid it in this period if the cancer allows. After the first trimester, many chemotherapy medicines can be given with a much lower risk to the baby, because the placenta and the baby's development offer more protection. Studies following children exposed to chemotherapy in the second and third trimesters have generally found normal growth and development, although babies may be smaller or born a little early.

Decisions are made by a team that usually includes an oncologist, an obstetrician experienced in high-risk pregnancy, a neonatologist and sometimes a haematologist or surgeon. They consider the type of cancer, how fast it is growing, how far along the pregnancy is, which medicines are needed and the mother's wishes. Some cancers, such as many breast cancers, can be treated during pregnancy with surgery and certain chemotherapy medicines. Others may need treatment that is not safe for the baby, which leads to very difficult choices. Some medicines, including certain targeted and hormone treatments, and most radiotherapy near the abdomen, are usually delayed until after the baby is born.

The aim is to treat the mother's cancer effectively while protecting the baby as much as possible. Chemotherapy is usually paused for a few weeks before the expected delivery, so that the mother's and baby's blood counts can recover, which reduces the risk of infection and bleeding around birth. Delivery is planned carefully, and breastfeeding is usually avoided while chemotherapy continues after birth.

Care is shared between teams

The oncology and obstetric teams meet regularly and plan each step together.

The baby is monitored closely

Regular scans check growth, fluid around the baby and wellbeing.

Your wishes matter

You will be given clear information and time to decide, with counselling support.

It cannot tell you whether chemotherapy is safe for you and your baby, or which treatment you need. That depends on your cancer, your stage of pregnancy and the medicines required, and must be decided by a specialist team with you.

It also cannot make the hardest decisions easier. Some women face choices about delaying treatment, early delivery or continuing the pregnancy. These are deeply personal, and you will be supported whatever you decide.

Does continuing pregnancy affect the cancer?

For many cancers, being pregnant does not appear to change how well treatment works, provided treatment is not delayed unsafely. Ask your oncologist about your cancer.

Supportive medicines

Anti-sickness medicines and others are chosen carefully for safety in pregnancy.

Emotional support

Facing cancer and pregnancy together is overwhelming. Counselling and support for your partner and family matter.

Children's long-term health

Children exposed after the first trimester are generally followed as they grow, and most develop normally.

Future pregnancies

Ask about fertility and contraception after treatment ends.

Where care is given

Care is best in a hospital with oncology, high-risk obstetric and neonatal teams working together.

Why the first trimester needs extra care

In the early weeks of pregnancy, the baby's heart, brain, limbs and other organs are forming. Chemotherapy medicines work by attacking dividing cells, and during this period the baby's cells are dividing rapidly and are especially sensitive. That is why doctors try, when it is safe for the mother, to delay chemotherapy until the second trimester. If the cancer is very aggressive or life-threatening, waiting may not be possible, and the team will discuss the options honestly, including the risks to both mother and baby.

Which treatments are usually avoided

Some cancer treatments are generally not used during pregnancy because of known risks to the baby. These include certain targeted medicines, hormone treatments such as those used for breast cancer, and some chemotherapy medicines. Radiotherapy to areas near the womb is usually delayed until after birth, although radiotherapy to distant parts of the body may sometimes be given with shielding. Your team will explain which treatments are planned now and which will follow after delivery.

Care for the baby after birth

The neonatal team examines the baby soon after birth and checks blood counts if chemotherapy was given recently. If the baby is born early, care in a neonatal unit may be needed for a while. The placenta may be examined in the laboratory. Long-term follow-up of the child's growth and development is usually offered.

The mother's recovery after delivery

After delivery, cancer treatment usually restarts once the mother has recovered enough. Families can plan practical help with the newborn during this time, so that the mother can rest and attend treatment.

Planning childcare and support

Caring for a newborn while continuing cancer treatment is demanding. It helps to arrange support from family in advance, plan who will care for the baby during appointments, and ask the hospital for feeding advice if breastfeeding is not possible, including safe formula feeding.

Contraception after delivery

Ask about contraception after birth, as another pregnancy during ongoing treatment should be avoided.

What to do next

Ask for a joint oncology and obstetric meeting, tell every doctor you are pregnant, ask which tests and medicines are safe, plan delivery with the team, arrange emotional support, and go to hospital for warning signs.