Understanding the complexities involved in managing inflammatory bowel diseases (IBD) during pregnancy and lactation is crucial to ensuring the well-being of both the mother and the fetus. During this period, delicate decisions must be made, ranging from the selection of safe therapies to the careful monitoring of symptoms and potential complications. In this context, a multidisciplinary approach is fundamental to providing the best possible care to women with IBD who wish to conceive or who are pregnant (Fig. 1). In addition to close collaboration with obstetricians and fetal medicine specialists, gastroenterologists play a crucial role in adapting treatment strategies to minimize potential risks to both mother and baby while keeping the disease under control.

Effective management of IBD during pregnancy is critical, as active disease increases the risk of adverse outcomes for both mother and child. This chapter provides a comprehensive overview of strategies to support women with IBD through preconception, pregnancy, and postpartum care, highlighting the importance of remission prior to conception, safe therapeutic choices, and a multidisciplinary approach for optimal maternal-fetal health outcomes.