Beginning the Baby Journey- Dr Suggested No C-Section?

Hi Everyone! 

It's been a while. Got my j-pouch in 2008, and it is still going strong, just pouchitis a couple times a year (or maybe it is sometimes bad IBS... we often aren't sure). 

My husband and I went to consult with a high-risk specialist before we begin trying for a baby (I'm in my late 30s, and the pouch allowed me to qualify for a specialist.) 

To our surprise, right off the bat, my doctor said I should think about having a vaginal birth. She said I would have to have an epidural to limit any strong pushing, and they would have to watch me every step of the way during birth, but that it is easier on the body than another surgery, entirely possible, and should be ok, if no immediate complications arise. She seemed really sure of opting for the v-birth if no immediate complications arise. 

Okay.... this is the first time in ten years I have EVER heard that. I ALWAYS heard that it is c-section or nothing. This v-birth thing makes me feel nervous. I spent SO long wrapping my head around the benefits of a c-section and got really used to the idea.

Now, here's the other part. A few years ago I had a hemorrhoidectomy. I'm not gonna lie, I had the biggest dang hemorrhoid anyone ever saw, and it made doctors nervous. It was positively awful and the surgery to remove it was a bit of a risk. Thank goodness, it turned out ok and the darn thing is gone now. HOWEVER... that makes me more nervous about a v-birth. 

I know an ostomy bag works well for some people, but it just wasn't good for me. I never want to go back to an external bag again. In fact, that fear made me delay pregnancy for a long time, although having a child had been a very dear dream of mine, and if anything would be worth a risk, it would be a child. BUT I still don't want to go back to the bag if I can help it. I LOVE my j-pouch, and I don't want to ever face that bag again.

What do you all think? Should I just skip the worry and go for a c-section? 

What did you choose, and how did it turn out?

Thank you for sharing!

Original Post

Hi, how exciting thinking about having a baby!!  I had my J pouch done in 2003. I like you am in my mid to late 30’s. I got pregnant when I was 33 and delivered via c-section right before I turned 34 (2 weeks). I never saw a high risk doctor. My obgyn was very great and capable, she totally understand that with my history I was more comfortable with a c-section and she never tried to push a v birth on me. I think you may need to get a second opinion and find a dr who is going to listen to your concerts and be open to what you also feel is best and more comfortable with. Good luck!!! I hope this helped

Congrats with this next adventure. After I had my J pouch 20+ years ago,  I too was informed by the surgeon, that yes the pouch wouldn't prevent me from future pregnancy's, but he felt that with the J-pouch, I would have to consider a C section. But again.. my J pouch was done more then 20 years ago, so I'm sure they have made many positive advances with this procedure.

Putting your question out there at this site, is going to be a great resource for you with connecting to other's who went through pregnancy's and deliveries after  J-Pouch surgery.  

Back when I had my surgery there was no site like this to connect with others. While in the hospital waiting for my surgery, my doctor gave me a list of over 300 J- pouch patients and informed me that he wanted me to make calls and connect with some of his former patients. He felt the importance of direct contact with patients who had gone through the procedure and with answering any of my questions and concerns. I do remember it was very uncomfortable for me to make those personal calls, but those who answered were wonderful. Many years after my surgery, I too was the receiver of many calls from new patients with many questions.

This has been a wonderful site that circles the wagons for it's members for J-Pouch questions & answers.    

Good Luck!  Claudia  

I had my Jpouch surgeries in 2013 and then csections 2014 and 2016. I remember my GI surgeon warning  of incontinence should my sphincter tear during a vaginal delivery so he strongly advised csections. I figured after all that work to finally have control over my bowels I wouldn’t risk it.

My csections went very well but I was relatively young (27-29) and healthy and my doctors also noted I don’t seem to scar badly which can cause a lot of issues (internally specifically). 

That being said, I had little babies and I always kind of wondered if I had been able to do vaginal birth... I really appreciate your doctor’s attitude and confidence. In your case it could be less risky to do a vaginal birth since csections certainly have risks as well. 

Congratulations and keep us updated!

How exciting!

My babies are already 6 and 9 years old, so I agree that doctors may feel differently  now, but I had 2 c-sections for my babies.  All went great!  My colo-rectal surgeon didn't even want me to go into labor so I had scheduled c-sections in week 38.  I never went into labor and all went according the plan.   My babies were healthy and strong then, and likewise now! 

I will note that my colo-rectal surgeon said he sees women ("normal" women without pouches) who have incontinence issues post delivery.  He is only able to help 1 in 3.  That made my mind up for the c-section.  I had r/v fistulas and many issues that meant there was nothing left to sew back together if I had any issues from delivery.

Yes, c-sections come with their own risks- it is surgery!- but I have no regrets.

Best wishes!!

Laura

Just chiming in here to say that I had a baby a year ago, my first, and it was a vaginal delivery. There are good reasons to choose either option, but I was with a doctor and hospital that aim to avoid unnecessary c-sections, and we agreed that my best chance at reducing complications was to try for a vaginal delivery. It was luckily not affected by and did not affect my pouch, and I hope to have more vaginal deliveries in the future. 

Good luck as you consider your options!

My doctor told me that it would be a vaginal delivery unless I needed an emergency surgery. After consulting the literature I was quite comfortable moving forward with a vaginal delivery. They took precautions to make sure I wouldn’t tear into my anal muscles by having her be delivered in a slow and controlled way. It was an amazing experience and an easy recovery 

Thank you everyone! 

@little greeny and @susbo I was wondering what precautions they take to avoid impacting the anal muscles. Were you able to feel calm and confident throughout the process? Did you go into a normal labor process? My doctor mentioned that an epidural is a must, and the goal is just to let the baby "slide out" as slowly as possible. Was that how it was for you? 

It still makes me a little nervous! But, time has a way of working these things out.

Thanks for your stories and your help, ladies!

That's interesting about the epidural! I never heard anything about that during my care-- it was just up to me whether or not I wanted one (which I did). To reduce the risk of tearing my doula prepared warm compresses for my perineum during the pushing stage (to help the tissue stretch). I do think having a doula was integral to helping me feel comfortable attempting a vaginal delivery. She was not only well-versed in what happens in a "normal" labor and delivery, but she also knew my whole story and could help make sure that everyone was keeping that in mind in making decisions about my care. 

Also, I'm sure this would be a controversial choice, but the doctors had decided ahead of time that if the need for an episiotomy arose (and I was at a hospital with very low episiotomy rates overall), they would make the incision horizontally instead of vertically, like it normally is. They explained that although this isn't usually the preferred method because it has a longer/more difficult recovery, they wanted to try to direct any major tearing away from my rectum. Luckily, I didn't need one. I did have a second degree tear, so it was confined to my vagina and has healed well. 

As for my labor, I ended up being induced at 40w4d because the amniotic fluid was low. Since my body was clearly not ready to be in labor, it took about 48 hours until I was ready to push. I pushed for 3.5 hours. It was absolutely exhausting, but absolutely worth it! 

The comment above me said it perfectly, it was necessary for me to have an epidural so that the baby would “slide out”. They said that in unmedicated births, moms push too hard and delivery too quickly to avoid tearing. They had me get an epidural at 8cm (which was a welcome relief at that point) and then she came an hour later. They had also discussed doing an emergency transverse episiotomy if there was any evidence of tearing . That being said, that wasn’t necessary as with the counter pressure and the slow delivery I didn’t tear at all. I didn’t even need pain medication in my recovery. I’m interested to know (if you are open to sharing) where you delivered. I delivered in Toronto and plan on delivering all future children there 

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