UC C-section

Congratulations on your pregnancy!
I didn't have UC when I was pregnant with either of my boys but they were both delivered via c-section (unplanned). I wouldn't take the surgery lightly, it is pretty major, but worth talking to you OB about. I know that they usually suggest c-sections if you have a j pouch, but I haven't heard anything beyond that. but then again, I am done having kids. There are a few ladies here who have just had babies or are pregnant, so hopefully they can help you out more.

Hi and congrats!! I've had 2 c sections. Both unrelated to my uc. I don't dialate thus don't progress.

However after my first c section I was attempting a vbac. All of my doctors were on board. Gi, ob, hi risk ob. My gi and ob did mention what yours did. That should I tear or something happen it could make things more difficult in the future. I also knew that if I flared postpartum I would rather have a cut in my belly then "down there".

Regardless I wanted vaginal but for the second time wasn't progressing. So we quickly opted for a c section. With my first I labored for 42 hours before we called it. It was brutal. I was undiagnosed and flaring and flared terribly after because I was undiagnosed. The second c section was a cake walk. I didn't labor long. Maybe a few hours but the doctors knew my body wasn't doing what it's supposed to. Got to the hospital at 1 pm. Baby was out at 6 pm. The surgery isn't easy but going in and getting it done without the rest was sooooo much easier. Recovery was easier too. Plus I was all over my meds to avoid a flare.

It's a tough decision but it's your decision. And I know women who have done both with no issues. I wish you the best of luck.

I also notice in your signature that you are trying entyvio before remicade? May I ask why? Remicade got me into remission during my second pregnancy and there's no complications breastfeeding (if that's your plan) on it after. I just ask because entyvio is so new.

Marauder - I never heard that. Can you elaborate?

I bet they mean that going through the canal gives you some antibodies that you don't get otherwise. I am not sure that those antibodies mean anything for AI illnesses. I was a vaginal birth and I still have UC. No one in my family does as far as I know, so I don't know if whether that theory would carry over in the case of my birth - if that theory held any water at all, which it probably doesn't.

My GE gave me the opposite advice. I'm almost 26 weeks along, my GE said there is no medical reason for me (as far as my ibd is concerned) to have a c section. He said as long as there is no fissures and or severe rectal involvement then vaginal birth is best. I don't want a c section, the surgery, the recovery, the antibiotics, etc etc, no thanks. I spoke with my obgyn about my concerns about tearing and or episiotomy and poor rectal control afterwards (this is a concern for all women who would tear or be cut too deep into the rectum) and he said because of my ibd I'm at higher risk for early labour and a smaller baby even if I go to term (restricted intrauterine growth) and I will have an extra ultrasound or two in the third trimester to monitor growth. If there's any indication of a large baby (not expected) then we should discuss c section to ensure no severe tearing, but he assumes a smaller baby and thus a very low risk of severe tear. They've also made notes on my chart to be very caution with tear etc., because of the ibd.

Given the advice I've had by TWO specialists, I agree with them that a c section at this point seems unnecessary.

notsosicklygirl said...

Marauder93 said...
Research has clearly shown that c sections are a risk factor for UC. Has nothing to do with antibodies as antibodies are not passed during delivery, only during fetal development. The risk comes from the fact that the childs colon is not being exposed to the bacteria that it normally gets from the vaginal canal. This leads to issues in immune system development and the risk for IBD. Its not a matter of opinion, its a matter of fact....

Regardless, it didn't protect me I wasn't just a vaginal birth, i was an non-medicated, completely natural vaginal birth. I give my mom credit for pulling that off

Didnt help me either, but empirical data > anecdotes

toomuchpoopin said...
My GE gave me the opposite advice. I'm almost 26 weeks along, my GE said there is no medical reason for me (as far as my ibd is concerned) to have a c section. He said as long as there is no fissures and or severe rectal involvement then vaginal birth is best. I don't want a c section, the surgery, the recovery, the antibiotics, etc etc, no thanks. I spoke with my obgyn about my concerns about tearing and or episiotomy and poor rectal control afterwards (this is a concern for all women who would tear or be cut too deep into the rectum) and he said because of my ibd I'm at higher risk for early labour and a smaller baby even if I go to term (restricted intrauterine growth) and I will have an extra ultrasound or two in the third trimester to monitor growth. If there's any indication of a large baby (not expected) then we should discuss c section to ensure no severe tearing, but he assumes a smaller baby and thus a very low risk of severe tear. They've also made notes on my chart to be very caution with tear etc., because of the ibd.

Given the advice I've had by TWO specialists, I agree with them that a c section at this point seems unnecessary.

I'm also hoping that I can avoid a csection. Thanks for the great info! My doctor also said that lower birth weight/early delivery is a possibility for me. While this is not ideal for other reasons, I guess that it could help us avoid a csection! Maybe he just made the csection recommendation because I actually do have pretty severe rectal issues with my disease.

TotesMagotes said...
Hi and congrats!! I've had 2 c sections. Both unrelated to my uc. I don't dialate thus don't progress.

However after my first c section I was attempting a vbac. All of my doctors were on board. Gi, ob, hi risk ob. My gi and ob did mention what yours did. That should I tear or something happen it could make things more difficult in the future. I also knew that if I flared postpartum I would rather have a cut in my belly then "down there".

Regardless I wanted vaginal but for the second time wasn't progressing. So we quickly opted for a c section. With my first I labored for 42 hours before we called it. It was brutal. I was undiagnosed and flaring and flared terribly after because I was undiagnosed. The second c section was a cake walk. I didn't labor long. Maybe a few hours but the doctors knew my body wasn't doing what it's supposed to. Got to the hospital at 1 pm. Baby was out at 6 pm. The surgery isn't easy but going in and getting it done without the rest was sooooo much easier. Recovery was easier too. Plus I was all over my meds to avoid a flare.

It's a tough decision but it's your decision. And I know women who have done both with no issues. I wish you the best of luck.

I also notice in your signature that you are trying entyvio before remicade? May I ask why? Remicade got me into remission during my second pregnancy and there's no complications breastfeeding (if that's your plan) on it after. I just ask because entyvio is so new.

Hi Totes!

Thanks, for your reply and for sharing your story! I must admit that a csection certainly sounds better than 42 hours of labor! You deserve a medal!!

As for Entyvio, my doctor is a huge supporter of it. He was involved in the clinical trials for it etc etc and believes it be be highly effective with less side effects.

Marauder93 said...
Every good quality review on IBD that Ive ever read cites C-section as a risk factor, and there are many articles of primary literature to draw from. You found one relatively small (n= ~1000) case control study that found no association, but I have a cohort study that I found quickly (with 2.1 million people) that showed that there is an increase: http://www.ncbi.nlm.nih.gov/pubmed/21739532

As I said, that is just one example, but since it is considerably stronger evidence than the source you found, it wins out scientifically.

I wasn't really doubting you. I just wondered where you had read that. It just sounded strange to me and then when I did a quick search I found the link I shared above. Like others here I was delivered vaginally and am the only one in the family who has IBD.

Worriedgirl3 said...
Maybe he just made the csection recommendation because I actually do have pretty severe rectal issues with my disease.

Do you have active disease currently? I have read that active inflammation in rectum at time of birth can risk creating fissures if you even gave a minor tear, maybe he wants you to have a c section because of that? That would make more sense than worrying about what if you tear and then what if you need surgery. It seems like he's willing to subject you to very real risks (c-section) for hypothetical situations that might not even come up. I would ask for a better explanation and maybe even a second opinion.

I feel for you, I'd be extra stressed out if I felt like I was being pressured in to a c section. What does your obgyn say?