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Vaginal or C-Section Delivery?

Hi Everyone
I am nearing 33 weeks pregnant and am trying to determine the best labour route for me. A couple of years ago I developed fistula in the bladder and in my belly button. They've been completed closed thanks to Remicade for over 5 years now (YAY). My OB and my Crohn's doctor say I am perfectly ok to deliver vaginally but I am scared of the fistula re-opening. I am leaning towards C-Section because of this fear. I am wondering if you can tell me how you delivered...C-Section or Vaginal whether you had fistulas or not. And can you tell me why you chose that route? I am really confused on what to do and am looking for some advice. Thank You!
 

Lisa

Adminstrator
I had active fistula, both peri-anal and rectovaginal. Both my gi and ob doctors advised
a c-section would be safest, didn't want to risk testing anything as heading could also be an issue.....this was before I was on Remicade too.
 
I started out with going for a vaginal birth but wasn't progressing so had a csection.. But my drs said it was perfectly fine for me to have a vaginal birth.
 
Thanks ladies. This is giving me some food for thought. I am hoping to get more replies from women who can share what their GI's or OB's have said about their delivery decisions.
 
Hi,

Congratulations on your pregnancy, you've come so far!
I delivered vaginally last year. I didn't have any fistulas, but I had recently had a very bad flare up with crypt abscesses etc, so I remember so was very worried about how my colon would handle all the pressure etc. I tried to speak to my gastroenterologist about it, but he had no knowledge of IBD and pregnancy. I was adviced by the midwife doing my check ups to give birth vaginally. Most literature states that a vaginal birth was much better for mum and baby in most cases, and I read that you heal quicker. My gastroenterologist said c-section scarring could be an issue with Crohn's disease. Any Surgery near the intestines could be an issue, he said. But he didn't elaborate any further. I must add that where I come from you don't have a personal choice of what you want to do, you need a medical reason for a c-section, so in my case I didn't actually have a choice either. So I delivered vaginally and it went very well. They did an episiotomy, so I was pleased that bit was controlled. Sorry I can't give any advice on the fistula part, but I understand your fear. The fear of giving birth gets multiplied when we have a medical condition that can be worsened as well. Whichever decision you land on, the most important thing is that you feel safe and confident. It really helped me to write a letter to the midwife that I brought with me won the day I gave birth. I wrote down my concerns And wishes, and they took this into account when they supported me during delivery. Best of luck, we will keep our fingers crossed for you!
 
My only concern for a c-section is the scar tissue and the chance for adhesions later on.

While I have never had a fistula, if its been healed and closed how high are the chances it wold open up again?

Congrats on the baby, my youngest is 21 and its so sad to see them grown and just about gone!

Lauren
 
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