Graves’ Disease in Pregnancy and Newborn Babies
What parents need to know:
Graves’ disease is an autoimmune thyroid condition.
Some women experience it earlier in life,
are treated, recover well,
and go on to have healthy pregnancies years later with no ongoing symptoms.
Occasionally, a history of Graves’ disease is raised during pregnancy or after birth,
particularly in relation to newborn blood tests.
This can sound worrying if it isn’t explained properly.
This article sets out what actually matters, what doesn’t,
and why monitoring is sometimes suggested.
What is Graves’ disease?
Graves’ disease is an autoimmune condition where the immune system produces antibodies that stimulate the thyroid gland to produce excess thyroid hormone.
Key points:
It affects thyroid regulation, not fertility or the uterus
It is not inherited in a simple genetic way
Many people recover fully and remain well for years
Symptoms may resolve long before pregnancy
Even after symptoms settle and thyroid levels return to normal,
thyroid-stimulating antibodies (often called TRAb or TSI antibodies)
can sometimes persist quietly in the bloodstream.
Why Graves’ disease may be mentioned in pregnancy
In pregnancy, the main relevance of a past history of Graves’
disease is not the mother’s health,
but the possibility that antibodies could cross the placenta.
Important distinction:
Thyroid hormone levels affect the mother
Antibodies are what may affect the baby
This is why some babies are offered blood tests after birth
— not because a problem is expected,
but because a small minority of babies may show temporary thyroid changes.
Does Graves’ disease affect labour or birth?
For women who:
have been well for years
have normal thyroid function
are not taking antithyroid medication
There is no evidence that Graves’ disease affects labour physiology or how birth unfolds.
It does not automatically justify:
induction
continuous fetal monitoring
obstetric-led care
intervention “just in case”
Any change to birth care should be based on current clinical findings, not a historical diagnosis.
Why babies may be offered blood tests after birth
Thyroid-stimulating antibodies can cross the placenta late in pregnancy. In a small number of cases, this can temporarily stimulate the baby’s thyroid.
For this reason, some babies are offered:
a blood test at birth (or shortly after)
a repeat test around 48 hours
This is postnatal monitoring, not a judgement about the birth or the baby’s health.
What happens if antibodies are present in the baby?
Many babies with antibodies:
have no symptoms at all
simply clear the antibodies naturally over time
If symptoms do occur, they usually appear between day 2 and day 10, not immediately at birth.
Possible signs include:
fast heart rate
irritability or jitteriness
feeding difficulties
poor weight gain
loose stools
warm skin or sweating
These symptoms are uncommon and usually temporary.
Treatment if needed
If a baby shows symptoms and blood tests confirm raised thyroid hormones:
treatment may include a beta-blocker to manage symptoms
occasionally short-term antithyroid medication is used
Key reassurance:
treatment is usually short-term
babies are monitored carefully
long-term thyroid problems are rare
outcomes are generally excellent
As maternal antibodies leave the baby’s system, thyroid function returns to normal.
Would antibody testing in pregnancy be helpful?
In some cases, testing the mother’s blood for thyroid antibodies during pregnancy can be useful.
If antibodies are:
negative or very low → the likelihood of neonatal thyroid issues is extremely small
present → postnatal monitoring makes sense, but still doesn’t predict illness
Crucially, antibody testing:
does not affect labour
does not justify intervention
is about information, not escalation
A note on language and fear
Parents are sometimes told that a baby “could become very poorly”.
While technically true in rare cases, this language often overstates risk and increases anxiety unnecessarily.
A more accurate framing is:
the condition is uncommon
usually temporary
treatable if needed
closely monitored
In summary
A past history of Graves’ disease does not usually affect pregnancy or birth
Postnatal monitoring is precautionary
Most babies are completely well
When issues occur, they are temporary and manageable
Clear information protects families better than fear-based messaging
References and further reading
You may wish to link or cite the following reputable sources:
NICE Guideline NG145 – Thyroid disease: assessment and management
(Sections on pregnancy and neonatal thyroid disease)Endocrine Society Clinical Practice Guideline (2017)
Alexander EK et al. Guidelines for the diagnosis and management of thyroid disease during pregnancy and the postpartumBritish Thyroid Foundation
Patient-friendly explanations of Graves’ disease and pregnancyLazarus JH (2011)
Thyroid function in pregnancy – The British Medical Bulletinvan der Kaay DCM et al. (2016)
Neonatal thyrotoxicosis: clinical features and treatment – Journal of Pediatric Endocrinology
Home Birth and a History of Graves’ Disease
A past history of Graves’ disease does not automatically rule out home birth.
When Graves’ disease is settled, thyroid levels are normal, and the woman is not taking antithyroid medication, there is no evidence that birth is safer in hospital than at home purely because of this diagnosis.
Graves’ disease affects thyroid regulation, not the uterus, pelvis, or the hormonal physiology of labour. For women who are well, labour progresses according to the same physiological processes as it does for any other woman.
Why home birth is still appropriate in many cases
For women with a history of Graves’ disease who:
have been symptom-free for years
have stable thyroid function
are not experiencing pregnancy-related complications
Home birth remains a reasonable and valid choice.
There is no evidence that:
labour is more unpredictable
emergencies are more likely
intervention improves outcomes
simply due to a historical diagnosis.
Where confusion often arises
Graves’ disease is sometimes listed as a “risk factor” in maternity notes, even when it is no longer active. This can lead to:
assumptions that hospital birth is “safer”
increased pressure toward induction or monitoring
reluctance to support home birth without clear clinical justification
These responses are usually procedural, not evidence-based.
The baby’s monitoring happens after the birth
The main relevance of Graves’ disease in pregnancy relates to the newborn period, not labour.
If postnatal blood tests are recommended for the baby, these can:
be planned in advance
be discussed calmly
take place after a home birth, with community or hospital follow-up if needed
Neonatal monitoring does not require birth to happen in hospital.
Home birth and neonatal checks
In many areas:
cord blood can be taken after a home birth
or a neonatal blood test can be arranged within the first days
follow-up at 48 hours can be planned with community midwives or paediatric services
The need for these checks does not invalidate a home birth plan.
Informed choice matters
Choosing home birth with a history of Graves’ disease is not about ignoring risk. It is about:
understanding what is relevant
distinguishing between current health and past diagnosis
avoiding unnecessary medicalisation
For many women, the sense of safety, privacy, and continuity that home birth offers actively supports hormonal labour physiology — which benefits both mother and baby.
A note on autonomy
Women have the right to choose where and how they give birth.
A historical medical diagnosis, in the absence of current illness, is not a reason to override that choice.
Supportive care means:
providing accurate information
planning postnatal follow-up where appropriate
respecting informed decisions