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Vaginal Birth with history of Perianal Fistulas

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Posted 3/23/2016 10:07 PM (GMT 0)
Has anyone with a history (Hx) of perianal fistulae (or fistulas) opted for a natural, vaginal birth?

I am 21 weeks pregnant with my first child. I was diagnosed with Crohn's in 2010. I had a perianal fistulae (with 2 external communications). I had two setons placed in 2014. One seton fell out naturally and one was removed by my surgeon, after it started to loosen on its own.

I have been symptom free since 2014, after setons came out. I now have some scar tissue midway between my anus and vagina. It doesn't bother me at all.

I am registered with a birthing center and my plans are to have my child delivered by my OB via a natural vaginal birth.

Has anyone with a Hx of perianal fistulae (fistulas) had a successful, natural, vaginal birth without issues healing from tearing?

Thanks for reading!

Post Edited (Love_IS_Liberation) : 3/23/2016 7:57:21 PM (GMT-6)

Posted 3/23/2016 11:37 PM (GMT 0)
I'm afraid what I have to say isn't very encouraging towards natural birth. I have a recto-vaginal fistula (that won't heal) and am 38 weeks pregnant with my second child. I had the fistula with my first child as well. With both births, being treated in 3 different states, all of my OBs, surgeons, and GIs have emphatically stated that I should do c-sections. If I were to tear during labor (which is almost certain, given I already have a fistula there), then I mostly likely would never be able to heal from it. I have asked if we were able to get the fistula to close, could I then to labor? They have all said no, because fistulae can easily re-open in the exact spot during a flare, which means that closing and healing isn't really full healing and it's not worth the risk.

For me personally (and this is not what I am trying to tell you to do, just sharing my own thoughts about my situation), it wasn't worth the risk of tearing and not healing. That could lead to an ostomy, and I didn't want to try to be healing from being torn and even an ostomy while also trying to care for an infant (and now a toddler and an infant). And compared to Crohn's pain, healing from the c-section was a piece of cake! :)

That having been said, my fistula is recto-vaginal, as opposed to just perianal. I would just make sure to extensively question your OB and talk to your GI and surgeon about your plan. Congratulations, and I really hope it all goes well for you! :)
Posted 3/24/2016 1:51 AM (GMT 0)
I have read quite a bit from people who have opted for c-section after perianal and/or recto-vaginal fistulae, so I realize the status quo is elective c-section.

I can certainly understand this choice, but I am really looking for feedback from those few whose history of fistulae have not deterred them from vaginal births.

Thanks for your input though. :)
Posted 3/24/2016 2:56 AM (GMT 0)
You're not gonna find any of that feedback from me!
I have had a perianal fistula since 2009, and then a csection in 2014.
I knew the moment that I became pregnant that I would require a csection.
You can insist on opting for an elective vaginal birth. It's your choice, as are the consequences. I just hope you don't regret that decision.
I have many regrets. For example, I regret going off meds for many years. I regret not seeking a GI's opinion during my first abscess. I regret letting my second abscess rupture instead of getting it lanced. And I regret letting my the return of my fistula, after a 6 month abeyance thanks to remicade, throw me into a depression that made me think that I wasn't capable of being truly intimate with someone.
But not ONCE do I regret having a csection.
Posted 3/24/2016 5:40 AM (GMT 0)
Right. Again, I understand that the status quo is elective c-section. There are plenty of threads on this and many other forums detailing peoples choices to avoid vaginal birth.

And, again, I am seeking testimony from mothers who chose to go natural. I will likely be one of the few who choose to go natural, I am simply trying to link up with others who can advise me of how their experience of natural birth went and any advice they can offer.

For instance, one woman explained that she, like myself, had a very complicated history of Crohn's, complete with 9 fistulae surgeries. She was not symptomatic at the time of pregnancy and used primrose oil to soften the flesh starting at week 32. This woman reported having a natural vaginal birth, with absolutely no tearing.

Every one's body is different and I realize there are no guarantees, but since I am looking for a natural birthing experience, I am hoping this forum can assist me in connecting with others who have gone that route.
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