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Hi everyone.  I am 38yrs old and have had Crohn's for 18yrs.  I am currently in remission, after having a re-section 4 yrs ago.  I am pregnant with my first child and am getting conflicting information as to whether or not it is better to have a C-section vs going thru labor.  I want to stay in remission (of course!) and have concerns that a long intensive labor could make my Crohn's active again, or could cause complications, such as ripping the scar tissue from my previous surgery.  My old gastroenterologist thought a c-section would be best--he retired and I am now seeing a new doctor who doesn't know me and my history that well.  My OB/GYN wants me to try labor but even though she knows about my Crohn's, she has only been my OB for about 2 years and is also unfamiliar with what I have been thru.  I am desperate to stay healthy for my baby, so if anyone has any suggestions, opinions, information they could share, it would be appreciated.

 Reply posted for mhattoon.

Im 38 yo and was diagnosed w/Crohns 3 years ago.  Long story short, we had 2 miscarriages over the last 2+ years and Id stopped my treatment (Remicade & Pentasa) because I was symptom-free and thought it would be best for pregnancy.  Unfortunately, I developed a bladder fistula a year ago.  But my docs knew what wed been through and by this time we were committed to the fertility process.  They agreed to put off surgery if I went back on Remicade.  It took a couple of months,but eventually I was completely symptom-free again - and feeling better than ever.  Meanwhile, we had our first round of IVF in April and it worked!  Were due on the 18th.  I am having a scheduled c-section on the advice of my OB.  Hes a high-risk OB and I went to him because of my age, miscarriages, high-blood pressure, and, of course, Crohns.  Although Ive never had any surgery, hes cautious (w/a urologist & colorectal surgeon present at the c-section) because he doesnt know what sort of adhesions/scarring hes going to find.  I dont know, either, I just know that Ive had the easiest, most fantastic pregnancy imaginable.  It was harder getting/staying pregnant than actually being it!  Maybe its the Remicade, maybe its the suppression  of pregnancy - I dont know.  I was very disappointed about the c-section, but Ive had time to come to terms with it - and after everything Ive been through, I just dont want to take any chances.  So Im focusing more on the outcome than the process.  I am concerned about the fistula and even other symptoms returning with a vengence afterward - and not looking forward to surgery - but Im hoping that like the pregnancy, I'll be pleasantly surprised.  If not, Ill just take it as it comes, one thing at a time, like we all do with IBD.  Best of luck to you....

 Reply posted for mhattoon.

Hello, well I'm 32 and have had two beautiful daughters, my first one everything was fine, except labor being roughly 48 hours.   when she was about 1 and 1/2 I had suurgery with a bowel resection, and went  into remission for about 3-4 years, It wasnt untill I had my 2nd daughter and 8 months later that my crohns went out of control, I was down to 84lbs.  now 'm not telling you this to scare you but to let you know that every pregnancy and labor is definately different. just look at my two pregnancies. the first i had no probs and the 2nd the probs didm' come untill months after she was born. so good luck with everything

 Reply posted for mhattoon.

Hi,

I'm 41, have 5 children, planning a 6th, and have had Crohn's for 28 years. Children are SO fun!

Now, I have never heard Crohns and labor being an issue. ( and I am a nurse).  Except maybe in the case of having Rectal Crohns.

During labor, it is extremely common to have an episiotomy - small slice to bring baby out easier. There are two ways - transverse and lateral. One is a small cut directed toward the rear of you (as in your rear). And the other cut is directed diagonally. Discuss this possiblilty with your OB ahead of time. When I needed an episiotomy, he chose to make the cut to toward the rear. BUT when baby came out, the cut directed the tear (big baby head I guess) and tore clear through to the rectum, requiring 30 stitches, and ruined my rectal spincter nerve, and make me incontinent. Thus I left the hospital in diapers, just like my baby! My OB said maybe I would need to where a "pad" for the rest of my life!! YEAH RIGHT. An incontinent Crohns patient. NOT a good combination. SO if I had the episiotomy simply transverse, it would have directed the rip to the side, and not affected my rectum. You don't want things affecting your rectum when you have Crohns disease. Fortunately, GOD above healed me, and I don't spill out my innards uncontrollably.

SO I have elected to have the last three as C-Sections. Either way are fine, and have not had an affect on my Crohns. After delivery or breastfeeding sometimes CD can hit, but if you and your CD doctor and prepared you can ward it off.  After I have my 6th, my CD doctor is planning on having my resume 6-mp, whether I have syptoms or not. I will happily take it because after the last two kids I have been hit hard, and wanted to be "drug free" and natural.....

God Bless and take care - hope this helps. Natural birth is fine, just get the episiotomy that is diagonal, and wont rip into your rectum. (Don't be scared when I mention "rip". Tearing is normal. -- a huge head is coming out!)

 Reply posted for fushiastarz.

I'm 30 weeks pregnant and have scheduled a C-Section. No one mentioned that labor might cause a flair. i hope that's not true. My doctor was concerned that any tearing during natural labor could result in fistulas or an abcess with my rectal Crohn's. I also had a small bowel resection in the 90s and I'm worried about scar tissue being an issue during the C-Section. My OB will have a general surgeon available if any interference presents itself.

 Reply posted for mhattoon.

I had a baby 3 years after my re-section. My OB/GYN was less than thrilled when I showed up at his office pregnant. He felt that Crohns patients should adopt. I had a very short labor. Less than 1 hour but he threw my into a 6 month flare up. I remember a nurse stopping my Dr. in the hallway saying that she couldn't get a straight answer out of me. She said that when she asked my if I had a BM I said about 6 of them. He said to her " she probably did" When I went in for my 6 week check up, he said to me, If you ever get this brainstorm again and I'm not your Dr. insist on a C-section. Go for the C-section, they knock you out and you wake up a mother. Good Luck.

 Reply posted for mhattoon.

A first baby, how wonderful!   I can only address going through labor.  I too have Crohn's, since I was 20 yr old.  I have delivered 4 babies going through labor.  I never had my Crohn's flare up because of the delivery.  I think I was my healthiest and in remission each time during my pregnancy and during nursing them. I was 29 yrs old for my first and had my 2nd at 38, 3rd at 40, and 4th at 43.  So if the resection isn't a problem normal labor should be okay.  Wishing you the best of luck.