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Sickle cell disease and pregnancy: planning a safer pregnancy | CION Cancer Clinics
Yes, you can have a healthy pregnancy with sickle cell disease, but it is a high-risk pregnancy and needs a haematologist and an obstetrician working together. Pain crises, infections, high blood pressure and clots become more likely, and the baby may grow slowly. This page explains the warning signs, your partner's blood test, how birth is planned, and what happens in the weeks after. At CION Cancer Clinics, our haematologist cares for anaemia, bleeding, clotting and inherited blood disorders, with ArogyaSri, CGHS and cashless insurance accepted.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- Can you have a safe pregnancy with sickle cell disease?
- What can go wrong, for you and for the baby?
- What does care look like, from planning to after the birth?
- Will the baby have sickle cell disease?
- What do families believe that is not true?
- What can this page not tell you?
- Common questions about sickle cell and pregnancy
The short answer
Can you have a safe pregnancy with sickle cell disease?
Yes, many women with sickle cell disease have healthy pregnancies and healthy babies. But it is a high-risk pregnancy, and it goes most safely when it is planned and watched by a haematologist and an obstetrician working together from the start.
Why pregnancy is harder on the body
Pregnancy asks more of your blood. Your body needs more oxygen, your blood thickens a little to prepare for birth, and you lose fluid more easily through sickness and heat. Each of these makes red cells more likely to change shape and block small blood vessels. That is why pain episodes can come more often, especially in the later months.
Who this page is for
It is written for women with sickle cell disease, which usually means two changed genes, such as HbSS or HbSC on the report. If you have sickle cell trait, meaning one changed gene, your own pregnancy is usually managed like any other. Your partner's test still matters for the baby, which is covered further down.
If you are already pregnant and have not told a haematologist, do that this week. Do not stop or change any medicine on your own while you wait.
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When to go to hospital the same day
Call 108 or go to the nearest emergency department if you are pregnant and have pain that does not settle with your usual home plan, a fever, chest pain or breathlessness, a severe headache with blurred vision or sudden swelling of the face and hands, bleeding, or you feel the baby moving less than usual. Say you have sickle cell disease and are pregnant as soon as you arrive. Do not wait for your next clinic date, and do not rely on painkillers at home to see if it passes.
Not sure whether this applies to you?
Ask an oncologistThe risks, plainly
What can go wrong, for you and for the baby?
Most of these can be watched for and acted on early. Knowing them is what lets you and your team catch them in time.
More pain episodes
Crises tend to come more often as the pregnancy goes on. They need the same quick care as always, with medicines chosen to be safe for the baby.
Infections
Urine and chest infections are more common and can set off a crisis. Your urine is usually checked at routine visits, even when you feel well.
Blood pressure and clots
High blood pressure in pregnancy, called pre-eclampsia, is more likely. So are blood clots, especially in the weeks after birth.
Your team will watch
- Blood pressure at every visit
- Protein in the urine
- Leg pain or swelling
The baby's growth
Blood flow to the afterbirth can be reduced, so the baby may grow more slowly or arrive early. Extra scans check growth through the second half of pregnancy.
Step by step
What does care look like, from planning to after the birth?
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Before you try
See your haematologist a few months ahead. Some sickle cell medicines, hydroxyurea among them, are not advised in pregnancy, and the team will plan any change safely. Folic acid is usually advised. Your partner is offered a blood test.
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Early pregnancy
Book early with a hospital that has both a haematologist and a high-risk pregnancy team. Expect more visits than a usual pregnancy, with blood counts, urine checks and blood pressure each time.
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The middle and later months
Growth scans look at the baby. Some women are advised a daily medicine to lower the chance of pre-eclampsia, and a few need blood transfusions. Your team decides this, not a pharmacist or a relative.
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The birth
Plan to deliver in a hospital with a blood bank and a haematology team on call. Staying warm, drinking enough and good pain relief all matter in labour. A normal birth is often possible.
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After the birth
The risk of clots and crises stays higher for several weeks. You may be given injections to prevent clots. Your baby is offered a newborn blood test for sickle cell.
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Your partner's test
Will the baby have sickle cell disease?
That depends on your partner. You will always pass one sickle gene to the baby. If your partner has no sickle gene, the baby will have sickle cell trait but not the disease. If your partner carries the trait, each pregnancy has an even chance of a baby with the disease or a baby with the trait.
Which test your partner needs
A quick screening test, often called the solubility test, can miss other changed genes such as beta thalassaemia. Ask for a confirmatory test, usually HPLC, which shows the type of haemoglobin in the blood. Ideally this is done before pregnancy, so you both have time to think.
Testing the baby during pregnancy
If both of you carry a changed gene, a test on the baby can be offered in early pregnancy. It carries a small risk of miscarriage and is not done everywhere. Ask your obstetrician where it is available and how long the result takes. Whether to have it is your family's choice.
This page cannot tell you your own chance. Bring both partners' reports to a haematologist, who will read them together.Commonly believed
What do families believe that is not true?
"A girl with sickle cell should never marry or have children."
Many women with sickle cell disease become mothers. The risks are real, but planning, partner testing and joint care make a large difference. This is a decision for the woman and her family, with good information.
"If she feels well, she can wait until the later months to see a doctor."
Early visits are where medicines are reviewed, the partner is tested and a delivery hospital is chosen. Waiting leaves less time to act if something changes.
"She must have a caesarean because of the sickle cell."
Sickle cell disease on its own does not mean a caesarean. The way the baby is born depends on how the pregnancy goes, the same as for any mother.
"She should not breastfeed, the baby will get sickle cell from the milk."
Sickle cell is passed on through genes, not through milk. Breastfeeding is encouraged. Tell the team about every medicine you take so they can check it is suitable.
Being straight with you
What can this page not tell you?
It cannot tell you how your pregnancy will go. Women with the same type of sickle cell can have very different pregnancies. Your past crises, your kidneys, your lungs and your blood counts all shape the plan, and only your own team can weigh them.
When the plan may be different
Some women need closer care from the start. That includes women who have had a stroke, acute chest syndrome, many transfusions, high pressure in the lungs or kidney problems. If any of these apply, tell the team at the very first visit.
What CION can do
CION's haematology team can review your reports, plan medicines before and during pregnancy, and work alongside your obstetrician and delivery hospital. We do not deliver babies ourselves, so we help you find a hospital with a blood bank and a high-risk pregnancy unit.
Questions we are asked
Common questions about sickle cell and pregnancy
Can I take hydroxyurea while I am pregnant?
Hydroxyurea is generally not advised during pregnancy or breastfeeding, and is often changed before trying for a baby. But do not stop it on your own. Talk to your haematologist first, ideally before you are pregnant, so they can plan what replaces it and how closely to watch you.
My husband has sickle cell trait. What does that mean for our baby?
If you have sickle cell disease and he carries the trait, each pregnancy has an even chance of a baby with the disease or a baby with the trait. Ask a haematologist to read both reports together, and ask about testing the baby early in pregnancy.
Will I need blood transfusions during pregnancy?
Not always. Many women never need one. Some are offered transfusions if crises become frequent, if haemoglobin drops a lot, or if there were serious problems in an earlier pregnancy. The decision is made by your haematologist and obstetrician together, based on how you and the baby are doing.
Can I have an epidural in labour?
Usually yes. Good pain relief in labour is important with sickle cell, because pain and stress can trigger a crisis. Meet the anaesthetist before your due date if the hospital offers it, so they know your history and any past reactions to medicines.
Is a pain crisis during pregnancy dangerous for the baby?
A crisis that is treated quickly is usually managed safely. The danger comes from waiting, or from a crisis that hides an infection or a chest problem. Go to hospital early, say you are pregnant, and let the team check both you and the baby.
How often will I need check-ups?
More often than in an ordinary pregnancy, especially in the later months. Expect regular blood tests, urine checks, blood pressure readings and extra growth scans. Your team will give you a schedule. Keep a copy of your reports with you in case you need hospital care somewhere else.
Can I breastfeed my baby?
Yes, breastfeeding is encouraged. Sickle cell is not passed on through milk. Some medicines are not suitable while breastfeeding, so check each one with your team. Drink plenty of water, because feeding adds to the fluid your body loses.
Is care covered by Aarogyasri or other schemes?
Sickle cell care and pregnancy care are covered under several government schemes, including Aarogyasri, PM-JAY, CGHS, ECHS and EHS, and many cashless insurers. What is covered changes, so check the current rules with the scheme office or call the CION helpline with your card details.
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Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Sources
- NHS — Sickle cell disease
- NHS — Screening for sickle cell and thalassaemia in pregnancy
- National Heart, Lung, and Blood Institute — Sickle Cell Disease
- American Society of Hematology — Sickle Cell Disease
- National Health Mission, Government of India — National Sickle Cell Anaemia Elimination Mission
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Sickle Cell Trait vs DiseaseWhat your partner's result actually meansSolubility Test and Confirmatory TestingWhich test to ask for before pregnancyWhen a Sickle Cell Crisis Needs HospitalThe signs that mean go nowHydroxyurea in Sickle Cell DiseaseWhy the medicine is reviewed before pregnancySickle Cell DiseaseThe full sickle cell guide
Talk to us
Planning a pregnancy, or already pregnant?
Share your reports and your partner's test with us. CION's haematology team will review them and help you plan care with your obstetrician. One helpline serves every CION centre.