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Hello,

I have a question for all those who had a c-section.

I'm currently 35 weeks pregnant, and my pregnancy has been going really well without any complications. 

My OB initially had said that there's no reason not to do a vaginal delivery, but now she's really concerned about the possibility to tear and compromise my j-pouch, and recommending a c-section.  Most of all, my little baby girl is still in a breech position. 

If I'm gonna be cut open again, I'd like to have an incision that minimizes scar tissue on my body.  What was your experience?  I asked my doctor if they can cut my existing incision and only do the cross cut on my uterus.  I'm also curious if they can cut out some of the surface scar and re-saw it nicely. 

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I’m not a doctor but I imagine the old school c-section would be a big no for your provider unless it is medically necessary; they have research based reasons they have come to prefer the bikini line incision (healing time I believe being a big one). As far as scar tissue, I think that will depend on your body- did you have excess scar tissue with your surgeries? If not, I would not stress about excess scar tissue with this surgery.

I know there are several ladies on here who could tell you about vaginal delivery option and had great experiences going that route. I personally chose to go c-section despite two healthy vaginal births prior to my pouch but that was just my comfort level.

my c-section scar is very thin compared to my (traditional cut) colon removal scars and so low down it is never seen even in a bikini.

I actually had OB who wanted to do a vagina delivery and my pouch surgeon was like NO! You don’t want to take a risk of messing up the one shot you’ve got at the pouch. She recommended another OB who was really knowledgeable about pouches and the OB office had a weekly meeting to hover a plan of action as I got closer to delivery.

The plan was to do a c section and have a colorectal surgeon on call in case they ran into scar tissue or a problem. they said the likelihood of that was low since the uterus was in front of the colon, so most of the scar tissue, if any, would be BEHIND the uterus or above where they would be cutting. The cut was very low- right above where my hairline is, so it didn’t even come close to my ostomy scar or my belly scars.

I think the location is pretty standard now-a-days. I don’t think you can really request where you have the c section unfortunately, if you want to minimize future scaring or see if they can work it into your precious scar. I think they try and do this to avoid main arteries (not sure that’s the right term, but main blood lines or bleeders) and keep away from other essential organs so to speak. I hope this helps!

Last edited by Bubba1028
@Bubba1028 posted:

I actually had OB who wanted to do a vagina delivery and my pouch surgeon was like NO! You don’t want to take a risk of messing up the one shot you’ve got at the pouch. She recommended another OB who was really knowledgeable about pouches and the OB office had a weekly meeting to hover a plan of action as I got closer to delivery.

The plan was to do a c section and have a colorectal surgeon on call in case they ran into scar tissue or a problem. they said the likelihood of that was low since the uterus was in front of the colon, so most of the scar tissue, if any, would be BEHIND the uterus or above where they would be cutting. The cut was very low- right above where my hairline is, so it didn’t even come close to my ostomy scar or my belly scars.

I actually had my annual GYN appt today and she was just saying how good it was that I delivered via c section!

Anyway, I know some people do still deliver vagi ally but I personally didn’t want to risk having an ostomy the rest of my life, if I could prevent it. Not for all the pain and stuff I went through to ge the pouch! I hope this helps!

Everything you said was awesome!!! If I ever have kids biologically, I am so doing a C-section too lol.

I do not have kids but my colon surgeon told me that vaginal deliveries are out for J-pouchers. And C-sections are MANDATORY. Breech position??? Definitely MANDATORY for that too, a vaginal delivery in breech position is DANGEROUS!

I would not worry about scars when it comes to my health; scars are your battle wounds/scars; it shows what you overcame

Wow. "And C-sections are MANDATORY." This is so far from accurate... Check this article from 2014, just read the abstract, you will see:

https://idp.springer.com/autho...utz_L7V3zmGyf71ae_6A

Lauren, you might be well-meaning, and this excessive confidence might simply be your style. But spreading wrong information on a site like this is actually very harmful to people looking for help and support.

Now, I would also recommend against vaginal delivery to any j-poucher. But, unlike you, I am not confusing my opinions about risk-taking with the actual facts. Not only you sometimes unintentionally confuse your opinions with facts, you sometimes push your opinions as facts with strong emphasis and confidence on others. You do this on a regular basis.

This comment has nothing to do about bullying. Bullying involves threatening and intimidation.  I am not trying to intimidate you. This is not the first time that I am giving you feedback on the wrong information you are spreading. If we would not correct you when you are spreading falsehoods on this site, people would get hurt.

Not everything we claim has to be true, we are not oracles. Yet, before pushing your very strong bold and upper cased opinions on others as facts, just do a simple google search beforehand.

Last edited by Former Member

Bikini line cut is called a Pfannenstiel incision. See the attached image. I had a c-section before getting a j-pouch, which was done through a Pfannenstiel incision. My second step j-pouch creation surgery was an open surgery, and was also done through a Pfannenstiel incision.

It sits below underwear, and is very easy to hide.



Abdominal incisions and sutures in obstetrics and gynaecology - Raghavan - 2014 - The Obstetrician & Gynaecologist - Wiley Online Library

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@SZ posted:

Thanks for your response.

Yeah I actually have a huge scar starting from my diaphragm all the way to my pubic bone.  My j-pouch was done 20 years ago and only took one big surgery.  Never had a bag.

If it helps ease your mind, it sounds like my one scar is only slightly smaller than yours;  I was quickly cut open same day after my robotic colon removal for internal bleeding emergency so my largest scar is from diaphragm to about 1.5/2 inches below belly button. My main complaint with the c-section was that it created a belly shelf which is totally vain but I am human 😂  

Good luck btw!! My daughter was a miracle surprise after surgery and I found it a bit stressful how little information there was on delivery after jpouch. It will go great!!

@Former Member posted:

Wow. "And C-sections are MANDATORY." This is so far from accurate... Check this article from 2014, just read the abstract, you will see:

https://idp.springer.com/autho...utz_L7V3zmGyf71ae_6A

Lauren, you might be well-meaning, and this excessive confidence might simply be your style. But spreading wrong information on a site like this is actually very harmful to people looking for help and support.

Now, I would also recommend against vaginal delivery to any j-poucher. But, unlike you, I am not confusing my opinions about risk-taking with the actual facts. Not only you sometimes unintentionally confuse your opinions with facts, you sometimes push your opinions as facts with strong emphasis and confidence on others. You do this on a regular basis.

This comment has nothing to do about bullying. Bullying involves threatening and intimidation.  I am not trying to intimidate you. This is not the first time that I am giving you feedback on the wrong information you are spreading. If we would not correct you when you are spreading falsehoods on this site, people would get hurt.

Not everything we claim has to be true, we are not oracles. Yet, before pushing your very strong bold and upper cased opinions on others as facts, just do a simple google search beforehand.

First of all: My surgeon and doctor told me it was mandatory, I got that info from medical doctors, it was not an opinion of my own.

Second of all: One out of the many situations from which you are referring to was about me saying not to weight lift with a J-pouch. I got that from a medical doctor and I looked up extensive information about how weightlifting is dangerous for a lot of reasons. We J-pouchers are more fragile than colon folks, so of course it would make sense doing extensive stuff like weight-lifting can hurt us more. These are medical facts. I do extensive research on everything I post on here; I am not going to post evidence on everything I say, if you would like to research what I say like you did now, you are more than welcome to.

I do not mind people disagreeing with me but I do not appreciate some of the stuff you have told me in the past and I do not appreciate some of the stuff you have said now. In the future, I hope your approach to things are more respectful. If you disagree with me, post your opinion and let it be, but you do not have to call me out, just post your opinion.That is all I have to say.

Last edited by Lauren Of Emerald City

I had a c section because 15 years ago I think doctors thought it was mandatory with a j-pouch. The doctor used my long midline incision from my pouch surgery for the c section. He actually tidied it up quite a bit for me and released a few adhesions while he was digging around in there so I only have the one scar (although it's long) and it didn't seem to take long to heal. All though pregnancy hormones maybe?

My doctor wanted a natural delivery, but I insisted on a c-section because of prolapse.  With both pregnancies, she used the same scar.  It wasn't an issue.

The one issue I had post pregnancy is that I didn't walk enough in the days following the delivery.  So by day 2 or 3, my system hadn't started up again and they had to insert the NG tube (worst part of the JPouch surgeries for me).  So my advice is make sure you walk.

Congrats on your pregnancy.

Just want to update everyone that I had a c section back in December with a vertical incision on my existing scar. It is taking longer to heal but I personally think it’s worth it rather than making a new crisscross one. My doc wasn’t able to do much scar revision since I didn’t have much extra skin to cut out around my belly. But the new scar looks like a thin pink line over the old incision.

My scar darkened quite a bit during my pregnancy with the hormones and it being right on the linea negra. Did this happen to anyone else? Does it lighten again at all?

Last edited by SZ
@SZ posted:

Just want to update everyone that I had a c section back in December with a vertical incision on my existing scar. It is taking longer to heal but I personally think it’s worth it rather than making a new crisscross one. My doc wasn’t able to do much scar revision since I didn’t have much extra skin to cut out around my belly. But the new scar looks like a thin pink line over the old incision.

My scar darkened quite a bit during my pregnancy with the hormones and it being right on the linea negra. Did this happen to anyone else? Does it lighten again at all?

Congratulations!!!! Boy Or Girl??? And what is the name???

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