Birth with Crohn's

I saw a few discussions in the archives, but I was wondering if anyone else could give me input. I have perianal Crohn's disease with tags and right after I got pregnant I developed two anal fistulas (lucky me). My GI is recommending I get a c-section. I talked with my OB, and he said he would go with what my GI says.

I have read on other forums of women with fistulas who gave birth vaginally and were ok, and their doctor didn't even mention a c-section. I obviously respect my doctor's opinions, but my GI said he had no patients with perianal disease who gave birth vaginally, so I think he is just erring on the side of caution, which I don't blame him.

I'm nervous about a c-section, but I'm more afraid of somehow becoming permanently incontinent. Does anyone have any experiences they could share?

This is one topic I know well! I had a skin tag/tags before and during my pregnancy. (I did NOT go the 'infertility route) and became pregnant with TRIPLETS! Needless to say, everyone in my 'circle' of friends, family and docs was a bit nervous. I did develop a rectal/vaginal fistula at the time. (during the pregnancy) although, no one was listening to me, and didn't for YEARS. Although I had NO choice (with the triplets ALL three in breech position) but to have a C-Section, it was probably for the best. I was always told (since rx'd in Jan of 99) to try not to have any abdominal surgeries unless absolutely necessary, so I was a bit nervous, but what do you do? Gotta get them babies out! Fortunately though I believe that not having that added extra 'pressure and 'irritation'' to the birth canal kept me going for years to come. The surgery did NOT harm me any further as far as the Crohns goes, and the fistula settled down for quite some time. I would SO not do anything to upset the fistula if at all possible.
Years later (my babies are now 10 1/2) I FINALLY got a dr (happened to be an ER dr) to look at and listen to me when I said "I have a FISTULA") and I now have had a Seton placed. Not pretty. Since that, I've gotten GREAT relief from the painful fistula, HOWEVER, I have WAY LESS control....(as my grandma used to say "the ole pucker strings don't work as well as they used to") and it causes GREAT embarrassment and hassle. I would RATHER pee my pants! SO, I would HIGHLY recommend to do ANYTHING you can do to NOT aggravate the fistula.....Let it ride for as long as possible, but DO make sure your dr.s listen to you. Mine didn't until it was too late!

~Mom to Trevor Abbey and Dylan
~Author of "Get Up and Walk" on Amazon, Barnes and Noble
~Crohns rx'd for 13yrs, feeling IT for 14+yrs
~Spondylitis
~Jerked around for years by Dr.s that didn't have a clue, but now have some of the BEST there is!

pb4- Thanks for sharing your experiences. I'm happy to hear you had successful natural births. If I "just" had the skin tags, it may be a different story, but if your GI also suggested a c-section if you developed a fistula, I'm thinking most GIs would probably be on the same page with that.

CDTripletMom- What a terrible thing for you to have to deal with and no doctors listening to you! I'm sorry you had to deal with all that, I can't imagine. I'm glad someone finally listened to you, but I cannot believe how long it took. I'm so sorry! Thanks for the advice. I should probably do a c-section, I'm just really nervous about it. Anyways, congrats (though a bit late) on the triplets. That's awesome. I'm nervous about taking care of just one, I can't imagine 3 newborns at once, plus dealing with Crohn's.

Oh man! Your situation is so similar to mine!! I had skin tags, however no perianal disease with my crohns. All my disease was in my terminal ileum. I was planning on a vaginal birth, and developed two perianal abscesses which stemmed from a horseshoe fistula, which was basically like having two fistulas, since there were openings on both sides. My dr's recommended a c-section, because if there were any tearing from the birth my crohns could develop anywhere I tore. I ended up going into labor early, and having several other complications, so a c-section was inevitable. But it was good it was planned on anyway due to the fistulas. I was completely ready mentally for it. Plus, I had to have surgeries on the abscesses while pregnant and had a spinal block for each of my two surgeries, so I knew what to expect with that as well. I would not have chosen to have my baby any other way in my situation. I knew that there was no way my crohn's could spread through tearing. The surgery was not that bad, and it was quick. The only thing I hated was you don't get to hold your baby right away with a c-section. My husband brought the baby over, and I could touch her, but my blood pressure dropped and I was feeling sick. The recovery is pretty quick as well. I was out of bed the same night. The recovery did not hinder my taking care of my baby. A c-section is not as big of a deal as it is sometimes made out to seem. The entire process takes like an hour. Honestly, if I have another child I wouldn't even consider not having a c-section. As I said, I had some other complications, so I think I would have to have a c-section-but I'm not sad about it. Good luck whichever route you end up going. The birth of your baby is a huge deal, but it's amazing whether it's a c-section or a vaginal birth. I will NEVER forget the moment they held her up over the sheet. I will NEVER forget how connected I felt to my child when my husband held her next to me right after she was born. (This all happened 6 months ago) Good luck!

lady1012- Thanks for the tips. I'm glad the c-section worked out for you. I know, I should listen to my doctors, I'm just scared, but then I'm more scared of the baby not being the only one who has to wear diapers, so I will most likely just go with the c-section.

trickynikki- Oh, I'm so sorry you had a horseshoe fistula, that sounds horrific. You're right, at least I get to mentally prepare myself. I'm scared since I've never had major surgery before, but I know there are so many women who do it. I'm also sad about not being able to hold my baby right away either, but I guess that's better than not being able to take care of her if I had severe tearing that would further complicate my Crohn's. Thanks for the support.

riley- That has to be confusing with your high-risk and GI both recommending a c-section but your OB saying he would have the final word. I'm glad at least my OB is open to what my GI says, he's pretty laid back. You're pretty far along (I'm a little over 5 months as well), so it would probably be hard to change doctors at this point. I have fissures too, which I know can really be an issue, but I've read about a few women who had natural births even with fistulas and were fine. I guess it depends on the person. Let me know what you decide. Good luck to you too!

My CD is in my ileum, but I have had a fistula surgery on my anus and a lot of scar tissue down there. My doc recommended C-section for fear of tearing really bad. I didn't listen, I was deteremined to have both (2 births) naturally. I used Primerose Oil to help with stretching the skin and it worked! No tearing. Everyone's situation is different, but if you decided to go vaginally I would definately talk to u'r doc about the Primrose Oil. You can get it at any pharmacy over the counter. It comes in a liquid filled capsule. I would poke a hole in the capsule with a pin and place it inside my vagina every night before bed starting at about week 32. I had a mid-wife and that is what she suggested I use, it made the area down there soft and stretchy. I had large babies too (9lbs 11 oz.) and no tearing what-so-ever.
Good Luck to you and whatever decision you make, it will be the right one for you.
-Jeny

October girl, one more here with perianal crohns that was advised c-section was the way to go, i had a colorectal surgeon weigh in on the decision and she felt natural child birth could leave me in bad shape do to my existing tags and excessive scar tissue. I like you feared the c-section but had no major complaints. Good luck to you!