SCD is a genetic disorder that runs in families. It is inherited when a child receives two sickle cell genes, one from each biological parent. These genes affect how hemoglobin works. There are different types of SCD, depending on the inherited genes.

Approximately 100,000 people in the United States have SCD. SCD is more common among people whose ancestors came from sub-Saharan Africa, Spanish-speaking regions in the Western Hemisphere (South America, the Caribbean, and Central America), Saudi Arabia, India, and Mediterranean countries (Turkey, Greece, Italy).

In the United States, one in 365 newborns born to people identifying as African American or Black are diagnosed with SCD. All newborns are screened for SCD.

All people seeking pre-pregnancy or prenatal care should be offered a complete blood cell count (CBC). Some physicians may also recommend hemoglobin electrophoresis, a test that can look for abnormal types of hemoglobin in the blood. If you have sickle cell trait (you have one sickle cell gene) or SCD (you have two sickle cell genes), your partner should also be screened.

Your baby’s chances of getting SCD depend on the specific genes that you and your biological partner have. Your healthcare professional or a genetic counselor can help explain the different genetic screening and testing options.

SCD can range from mild to severe, and it can cause varying complications, such as chronic pain, painful crises, anemia, and infections. These complications can develop or worsen during pregnancy. Pregnancy complications like preeclampsia, placental abruption, stillbirth, and preterm birth also happen more frequently in people with SCD. Pregnant people with SCD also have a higher risk of fetal growth restriction or having a baby with a lower-than-average weight at birth. Fatigue, depression, and anxiety can worsen during pregnancy or the postpartum period.

The risk and severity of complications depend on your current health and medical history. For people with pre-existing heart and lung problems, pregnancy may not be recommended. However, many people with SCD have successful pregnancies.

Ideally, a maternal-fetal medicine subspecialist and a hematologist experienced in SCD should be involved in managing your pregnancy. A genetic counselor, pain management specialist, behavioral health provider, and social worker may also be helpful.

Experts recommend the following pregnancy care plan for people with SCD:

• Schedule a pre-pregnancy visit with your healthcare team. This is an opportunity for you and your healthcare team to evaluate how pregnancy may affect your future health and your baby’s health. During this visit, your doctors will assess your general health, review your medications, and provide genetic counseling. Some medications may not be recommended during pregnancy and may need to be adjusted.

• Get vaccinated with all vaccinations recommended for your age group before pregnancy. You should also get the 4 vaccinations recommended during pregnancy: COVID-19, flu, Tdap, and respiratory syncytial virus (RSV). Also, make sure that your pneumococcal and meningococcal vaccines are up to date.

• Follow your doctors’ schedule for prenatal care visits. Regular prenatal care throughout pregnancy is important to stay as healthy as possible. You may also need additional ultrasounds to check fetal growth and monitor your fetus’s health during pregnancy.

If you don’t have any complications, delivery is usually recommended at 39 weeks of pregnancy. If problems arise, it may be recommended that you deliver your baby earlier than your due date. Vaginal delivery is recommended unless other complications happen that make a cesarean delivery the safer option.