Childbirth & Crohn's - how to decide how to deliver?

[killerzoey]

Hi

It's been a while since I've been on here.

I have Crohn's and it's active in my rectum and perhaps stomach/duodenum and a few spots in my colon. Hasn't been too bad during pregnancy.

I am 36 weeks pregnant and early on I tentatively scheduled myself for a c-section on Dec. 1st, at 39 weeks.

But now I'm reviewing all the info and trying to decide if I really need to go this route.

My incentive for opting for a c-section was wanting to avoid any avoidable horribleness that can be caused by vag. delivery.

The first time I gave birth I had what I thought were terrible hemorrhoids. Walnut-sized, one thrombosed. Maybe they really were hemorrhoids. I don't know because I didn't know I had Crohn's then and I didn't really have them analyzed, lol. So at the very least I can probably expect that to happen again. They were so painful I required Vicodin for a week or so (after having delivered drug-free at home, lol).

So anyway, I have read the studies that say that in a certain segment of Crohnies, c-sections are recommended. And that whether or not you are in that segment has to do with if you have "active perianal disease". I saw a colorectal surgeon last week and he took a look and said that he could definitely tell I was pregnant due to the tissue being softened, and some hemorrhoid tissue as well. But he didn't see anything that screamed "Crohn's" or "don't let this woman deliver vaginally!" He did, however, stop short of advising me on how to deliver.

I understand that regardless of my current condition (and even regardless of if a woman hase Crohn's) that a bad tear can lead to a recto-vaginal fistula. I have discussed attemtping to get an accurate read on baby's size and he said not really possible in 3rd trimester. Can be off by a pound or more and even head circumference isn't reliably measured. He just wants me to do a c-section and says why bother tearing things up down there...but then he says that if he were a woman he'd opt for one regardless.

I just don't want to be cut open if it's not necessary.

Any thoughts or experience anyone can share with me to help me make up my darned mind? The time is drawing near...

Thanks in advance!

 

[ladyB]

I had three children, all while dx'd with CD.

Each one was delivered by c-sect.

I have rectal inflammation.
It went very smoothly. I was terrified at first, but after my first c-sect I opted for my other two births to be c-sects.

Good luck on your decision, let us know what you choose.

 

[killerzoey]

Thanks for that! I'm curious - did you opt for the c-section because you had rectal inflammation? OR did you end up with one on your first and decide against VBACs for the subsequent ones?

 

[My Butt Hurts]

First of all, congratulations! How exciting to almost have another child of your own coming into the world!
I had a recto-vaginal fistula while pregnant with my second child, and I was afraid that it would rip open and become huge during delivery. My gyno didn't know, and had me ask my colo-rectal surgeon who said I could deliver vaginally. I had no problems, and it didn't get worse. I think it has actually healed on its own in fact. I don't notice it anymore.
I can't remember if I had any rectal inflammation at the time, but I have had a peri-anal fistula since then, but doubt it was related to the delivery.
I don't want to even think about giving advice on your decision, it's that important, but I'd rather have the vicodin for a week for my sore butt than pain killers for 2 weeks for a super sore tummy sliced open.
Good luck with your decision, super good luck with delivery, and let us know when your precious baby gets here!!

 

[Rosemarie]

First- Congrats on the baby =)
I am about 34 weeks pregnant myself and have perianal Crohns... 1 fistula currently in the area, which means I am having a planned Csection. My docs insisted from the beginning that it was better for me to have the surgery rather then push her out because of the fistula (its position and how deep it is, yadda yadda...). If I didnt have this issue I would be happy to give birth naturally but I havent been given that choice.
In my opinion- If you have been through this once without serious complication and feel you are up for it again, go with your gut and push! But if you do decide to have a Csection dont feel bad- you arent alone =)

 

[ladyB]

I was in labor for three days and wanted to go 'natural' but my daughter's heart beat started slowing down and they found out she was breech-so i was rushed for an emergency c-sect. My GI wasn't overly supportive of a vaginal birth because of my inflammation, but who can tell a stubborn , prego woman anything...lol
My stomach was worse for both of my other prego's so I then opted for my other two births to be the same.

 

[katiesue1506]

I am quite biased... but Crohn's or not, I wouldn't wanna push a bowling ball out my giney. The ripping and tearing in a normal person is rough, I'd think trying to heal that area with Crohn's would be next to impossible. I'd go with a C-section, but then again I'm not pregnant and don't want to be. So basically my post to your thread is useless.

I just wanted to use the word "giney" in a thread

 

[mommy1st]

I had both of my kids after being diagnosed with Crohns and have had two c-sections. They were actually afraid to do the c-sections because of all my surgeries, but my first son was in distress so they did the c-section without problems. They did have a GI surgeon there just in case there were problems, but everything was fine, so when I had my second son I just scheduled another c-section. Good luck in whatever you decide.