FEAR: Pregnancy and Crohn's

I haven't been on the board in a long time as I've gotten "Crohn's buddy" who lives close to me and is willing to hear all my horror stories and comfort me and vice versa.  But she hasn't gotten pregnant yet, so I'm treading into unknown territory and would like some advice.

I am 16 weeks pregnant coming this Thursday.  Before I got pregnant, I was in remission for about 12 months.  We started trying to get pregnant about 9 months ago but had issues due to a missed/undiagnosed thyroid problem (the tests showed within the normal range but my gyno said that he knew people usually had problems getting pregnant if the number was over 2.0).  I'm still on medication for my thyroid and my number is hovering around 1.0 still, so we are all good on that front!

Anyways, when I first got pregnant I noticed the excess hormones were causing issues with stomach cramping, bloating, mucus in stool, revved up the pain and increased nausea.  Now that I'm out of the first trimester and my hormones have sort of decreased, I am feeling mostly better but I can tell that my gut just isn't the same as it was before hand.  Several years ago, even having my period would increase my Crohn's symptoms - it's the main reason I got an IUD for multiple years... the doctor said it could stop my period all together.  I'm really worried that the actual labor is going to put me in a major flare up.

Please be brutally honest; I'd rather be prepared than feel consoled 

1) When you had your child, did you see a flare-up either during or after pregnancy?

2) In terms of pain, how bad was labor pain compared to pain associated with Crohn's disease?  I'm like 90% certain I'm going to get an epidural because I think maybe the pain would make a flare up more likely; I feel like being aware of uterine cramping and pain was what increased my Crohn's pain and cramping during periods.  I feel like I would want to experience a drug free birth at least once, as a badge of "honor." (Yes, I know that sounds silly; maybe you should talk me out of it. )

3) Anyone have a recommendation of a good book or blog for a first time mom that is upfront and blunt and not all rainbows and sunshine?  I really like feeling like I'm receiving straight talk, and not as if I'm this porcelain doll who can't handle herself and has to be fed white lies.

I appreciate the help!  I've talked to a couple of my friends who have had babies, but I feel like besides the extra level of complications that could arise (which I've spoken about with my drs) that maybe this pregnancy will vary a lot compared to theirs.  I know all pregnancies are different, but I guess I feel that the differences between two people without CD would be less significant that between a person with CD and a person without.

as far as labor pain goes, I found it completely manageable. One thing I learned in the Bradley classes was to relax through the contractions and that definitely helped. The hospital where I delivered had one birthing room with a hot tub and I sat in there during labor for my 2nd baby and it flew by. I got out of the tub when I felt some pressure to push and my daughter was born 30 minutes later.

The hardest part is the last 30 minutes when the contractions are very frequent. It's only 30 minutes though, and you can get through that. I would compare the pain of labor to strong period cramps. They do not feel like indigestion or bowel cramps. Many women have diarrhea during early labor, like you would on the first day of your period - this is good - it clears your bowel and helps make your labor easier I think. Many women also vomit during the last 30 minutes of labor - it can be pretty intense - but I did not.

There are huge metabolic changes in your body when you're pregnant in addition to the hormonal changes and others, too. All of that goes through tremendous change once your labor starts. After birth when your prolactin gets high and your estrogen crashes and you lose a lot of fluid volume and your nutritional absorption changes....blah blah blah...it's a lot. Your body is a wonderful thing and growing a baby is hard work. A Crohn's flare seems somehow inevitable with all that going on.

Since you are sensitive to period cramps it seems likely that you will also feel labor pain pretty intensely. I would work at learning how to relax through them to the best of your ability. Take a birthing class somewhere other than the hospital where you will deliver. Please. And talk to your OB about your birthing plan once you figure it out (that will be at around 34 weeks). Get your husband fully on board because he will be the one interacting with the doctor and nurses more than you, most likely.

Congrats on your pregnancy! Here's what I can share:

I flared after each of my pregnancies around the 4month mark when all of the pregnancy hormones were fully out of my system. I didn't know that could happen when I had the first kid, so the flare hit me like a truck and I was completely unprepared. It took almost a year to recover from it and it was hell. With babies #2 and 3 I knew it could happen and so I had a plan in place in case the flare came on quickly. I chose to breast feed my kids AND use an occasional bottle of formula because with baby #1 I had to wean her quickly due to the severity of the flare and it was horrible for both of us. She hated formula and we both cried a lot. With the next kids I figured it was better for them to at least know the taste of formula in case I had to wean so they wouldn't freak out and refuse to eat for a day or two. I never ended up having to wean them and I never severely flared like I did the first time, but it was way less stressful knowing I had a plan.

I'm not one for a lot of pain, so I went with the epidural. My advice to you is not to get it too early. Your doc can tell you when is the right time. I ended up having a c-section because my cervix wouldn't dilate. I had c-sections for the other two also, so of course I had epidurals. I was in labor with kid #2- contractions hard and only 1 minute apart (I was going for a VBAC, but cervix wouldn't dilate) and it was no picnic, but I don't think the pain of labor is going to cause a flare. Think about it- the contractions still happen, you just aren't feeling it because of the epidural. The muscle stuff is still going on. I don't think pain alone is enough to trigger a flare.

My pregnancies were pretty smooth, but after was a bit tricky. With kid #1 every time I nursed her, my guts would churn and I would have to run to the bathroom. Fun times, nursing while pooping. :) I would keep a baby chair or seat in the bathroom so I could put her in it, or keep a blanket/clean towel on the floor to lay baby down so you can handle your business. Everyone is different, but those are some of the adjustments I had to make in dealing with the Crohns post partum.

You are wise to get advice/info now. The more prepared you feel, the less stressed you will be. Keep us posted!!!

Scifigal - you're welcome! ;)