Multiple sclerosis is chronic, autoimmune-mediated, demyelinating, and degenerative disease of the central nervous system that affects a broad population of patients of childbearing potential. The disease does not negatively influence pregnancy outcome or foetal health. Due to the availability of disease-modifying therapies, it is possible to individualise treatment decisions to include family planning. Certain disease-modifying therapies may impact foetal health. Decision-making in women has to take into consideration guidelines from the Food and Drug Administration and the European Medicines Agency, as well as data from clinical trials and pregnancy registries. Health care providers should discuss family planning early and frequently with patients and their partners, considering disease activity, comorbidities, wash-out periods after treatment, and the risk of discontinuation rebound. Postpartum care should focus on the health of both the patient and the newborn. Patients should be encouraged to plan a family and breastfeed. Disease-modifying treatment should be resumed in women at risk of postpartum relapse. An increasing body of data on drug transfer to breast milk helps choose safe treatment for both the patient and the newborn. Counselling around disease-modifying drugs and symptomatic medication in pregnancy should ideally take place before the woman discontinues contraception. There is a need for new updates and data to guide how to balance multiple sclerosis stability during pregnancy and postpartum with foetal and neonatal safety.