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Crohn's VBAC with history of perianal fistula?

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Posted 12/28/2016 1:39 AM (GMT 0)
Hello,

I found a similar thread from a couple years ago, but I wasn't sure if anyone had experience with a VBAC with a history of crohn's and perianal fistula? My first baby, my OB suggested a c-section and mentioned rectal incontinence and difficulty healing, so I went that route, even though I would have preferred a natural birth.

It has been 4 years since my fistula and my GI says that as long as my Crohn's remains in remission that there is no reason that I shouldn't have a vaginal birth, my OB seems to be leaning more towards a c-section again, but will not tell me outright that I should go that route. My current colorectal surgeon recommends a c-section, but he also was not the one who performed my fistulotomy, and he seems to be too fond of recommending surgery for everything, in my opinion.

I will be seeing a fetal maternal medicine physician in just over a month, and plan to see what they suggest as well, but thought I would see what others have encountered!
Posted 12/28/2016 2:29 AM (GMT 0)
I have not had a child however did have a RVF from Crohn's. From my research and experience I would be most inclined to trust the OB. RVF can happen with vaginal birth in women without Crohn's or prior history. The stats I was given were in general they are more common among women who have given birth than as a result of Crohn's.

Seems to me the OB would have the most experience with them. And of my OB, CR surgeon, and GI, my GI seemed to know the least. OBGYNs and CR surgeons see them the most and are the two that would repair.
Posted 12/28/2016 4:04 AM (GMT 0)
I have to agree with cupcakespinkgal. I have an RV fistula, but it developed well after my daughter's vaginal birth. Even without a fistula at the time, I had significant tearing which didn't heal properly, and had to have torn tissue cut out a year later. I would give greater weight to the OB's and surgeon's opinions since they would have more knowledge of the risks.

Post Edited (JaSanne) : 1/1/2017 12:44:07 PM (GMT-7)

Posted 12/28/2016 6:06 AM (GMT 0)
I have a RV fistula that I got before both of my children. I had a c-section each time. I already have enough issues with my fistula not healing, etc. that the last thing I want is to tear it further. I would go with what the CR surgeon says and also the OB. I think what your GI is suggesting is a bit dangerous, tbh.
Posted 1/1/2017 12:33 AM (GMT 0)
I'm pregnant again with fistula and plan on having another csection.
If my OB insisted on a vaginal delivery, I would fire her ass in a hot minute!
And it's better to call it a vaginal delivery, not natural, because it implies that there's something wrong with a csection when there really isn't.
Posted 1/1/2017 3:01 AM (GMT 0)
Hi,

I had surgery on a periannal fistula when I was 20. At 28 I delivered my son vaginally and tore open my bottom end. I was lucky it healed as lots of scar tissue. I had a c-section for my daughter 2 years later. There is no way I should have delivered my son vaginally.

Listen to your OB, I learnt this by personal experience.

All the best,
Julia
Posted 1/7/2017 3:17 AM (GMT 0)
I fired an OB who insisted on trying vaginal delivery with my first. We had just moved to another state and it was 3 weeks before I was due. The GIs and surgeons in both states were adamant on c-section, as had been my first OB. So this second OB threw me for a curve when she started insisting on trying vaginal delivery. I switched and I don't regret the decision one bit. I would much rather do the c-section than the risk of tearing and not being able to heal and then dealing with an ostomy while having a new baby.
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