SCD is a genetic disorder that can run in families. A child is born with SCD when they inherit two sickle cell genes, one from each parent. A child is born with sickle cell trait if they inherit one sickle cell gene. There are different types of SCD, based on the genes a person inherits.  

About 100,000 people in the United States have SCD. It is more common in certain regions, such as parts of Africa, Central and South America, India, the Middle East, and Mediterranean.   

In the United States, about 1 in 365 babies born to African American or Black parents are diagnosed with SCD. All newborn babies in the United States are tested for SCD after birth.  

All people planning a pregnancy or receiving prenatal care should have a blood test called a complete blood cell count. A test called hemoglobin electrophoresis may also be recommended. This test checks for abnormal types of hemoglobin in the blood. People with sickle cell trait or SCD should also have their partners tested as well.  

A baby’s chance of having SCD depends on the genes passed down from both parents. Genetic counseling and screening tests can assess whether the parents have the gene. This can be done before pregnancy. Prenatal diagnostic tests can be done to see if the fetus is affected. If one or both parents carry the gene, in- vitro fertilization (IVF) may lower the chance of passing SCD to a baby.

SCD can range from mild to severe. It can cause health problems such as chronic pain, painful crises, anemia, and infections. These problems may happen more often or worsen during pregnancy. People with SCD have a higher chance of pregnancy complications such as preeclampsia, placental abruption, stillbirth, and preterm birth. Fetal growth restriction is also more common. Fatigue, depression, and anxiety can worsen during pregnancy or after the baby is born.  

The impact of these problems on pregnancy depends on the pregnant person’s overall health and medical history. For some people with pre-existing heart or lung problems, pregnancy may not be recommended. However, people with SCD can have healthy pregnancies by getting the right care.   

Pregnant people with SCD should see a maternal-fetal medicine subspecialist and a hematologist. A genetic counselor, pain management specialist, behavioral health provider, and social worker may also be helpful. Experts also advise the following for those with SCD: 

• Schedule a pre-pregnancy visit to review current health, medications, vitamins, and genetic risks. Medications that are not recommended during pregnancy may need to be changed. Prenatal vitamins may be suggested to start before pregnancy.   

• Update vaccines, including COVID-19, flu, Tdap, respiratory syncytial virus (RSV), pneumococcal, and meningococcal vaccines.  

• Follow the recommended prenatal visit schedule and take any prescribed medications, such as aspirin, to help reduce risks of pregnancy problems.  

• If needed, have additional ultrasounds or other tests during pregnancy to check the baby’s growth and overall health. 

If there are no complications, delivery is usually recommended at 39 weeks of pregnancy. If problems develop, the healthcare team may advise delivering earlier than the due date. Vaginal delivery is preferred unless there are complications that make a cesarean delivery safer.  

Breastfeeding is recommended for people with SCD. It has many health benefits and may help lower a baby’s risk of infections. This is especially helpful if the baby has SCD. 

Most medications used to treat SCD, including many pain medicines, some blood thinners, and hydroxyurea, are safe during breastfeeding.  

Breastfeeding can be harder during periods of acute pain or chronic pain. If breastfeeding is not an option, formula is a safe and healthy choice. Bonding happens during feedings no matter which method is used.