Ulcerative Colitis & C-sections

Updated on December 18, 2009
S.S. asks from Saint Louis, MO
13 answers

Hello to all you moms. I am thrilled to be 9 weeks pregnant with our second child. My first child I delivered natually without any medications whatsoever. That was to be my plan this time around until my doctor told me otherwise. After my first child 2 years ago, I was diagnosed with Ulcerative Colitis. My OB has told me that in fear of any risks, she would like me to have a C-Section this time around. I know that is not the worst thing that could happen, but I am devastated. I was wondering if there are any moms out there with this diagnosis who have gone through this either way.

I want to do what is best for me and my baby, however, I just want to do my homework and know all of my options.

Thanks so much.

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D.M.

answers from St. Louis on

I guess times are different now but my mother has ulcertive colis and has had three perfectly normal pregancies and deliveries. That was 30 years ago but her condition was never even a issue.

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S.L.

answers from Kansas City on

I fail to see how the colitis affects a delivery at all. Are you sure you don't want to find a new OB doctor?

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S.T.

answers from St. Louis on

Get a second opinion. Most often than not, doctors recommend c-sections out of convenience.

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J.V.

answers from Kansas City on

I don't have Ulcerative Colitis, however, I did have a c-section. I, like you, had planned to go completely natural. My hubby had learned all kinds of relaxation techniques, and practiced them every night, and we were all set to go naturally. However, in my last month of my pregnancy, my daughter turned breech. I had a c-section scheduled. It was very upsetting for me as well. I just reminded myself that I was doing what was best and most healthy for my baby and myself. It really didn't matter HOW she came into the world, just that she did and came safely. I recovered VERY quickly and have a beautiful healthy little girl.
Good luck to you. A positive attitude can change everything!

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M.L.

answers from St. Louis on

Hello S.,

I'm tending to agree with the other ladies on this one. I have Crohn's Disease in the large intestine only, at this point. When my son was born 8 years ago, my diagnosis then was that I had ulcerative colitis. I was cautioned that I would flare after delivery. My son was born vaginally, and I did flare, which was difficult to manage with a newborn. I don't know if a c-section would prevent the flare, but heck, even if it did, you'll have other pains to deal with because of that.

Do question this. It's my opinion only, but I don't think having ulcerative colitis, and a potential flare that comes with vaginal delivery, is enough reason to justify putting you through a c-section. I just don't think it's necessary.

Hope this helps!

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M.G.

answers from New York on

Why Exactly did she say because of your ulcerative colitis that it would better to have a c section? I have aggressive crohns disease, only have 10ft of intestine, and have a permanent ostomy bag and have gone threw vaginal birth with my first child and plan on it with my next. Ask your GI dr. about it but unless there are some special sercumstance special to your case that would make them think a c -section is better for you it dosn't sound typical to me at all.

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V.P.

answers from St. Louis on

My friend has ulcerative colitis. Just delivered her second baby vaginally, no meds. Did the same with the first. And she has had her entire large intestine removed.
Good luck.

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J.H.

answers from St. Louis on

I think the decision whether to have a cesarean section or a vaginal birth is a very personal one. In most cases it is best to avoid one unless medically necesary. I do not know enough about this medical condition. However, it seems almost counterintuitive to add the trauma of major abdominal surgery to your current medical problems. It sounds like a great reason for a second opinion.

Has your doctor discussed the risk and benefits of a cesarean section vs. a vaginal delivery for your condition? Can she show you some studies on this particular condition and dellivery method? Are reccommendations based upon fact or conjecture? What are the sources? A good resource for you to check out is Pubmed or the Cochrane reviews to find medical studies. The Cochrane review is good because it also looks at the quality of the study. Have you and her taken into consideration how many children your family would like to have? If you want a lot of children avoiding cesarean sections are good. Each abdominal surgery creates added risk to you. Regardless of the fact that it is often viewed as low risk, it is major abdominal surgery and there are still risks.

A good resource is the International Cesarean Awareness Network stlouis.ican-online.org There is a local chapter. There are also many knowledgeable women on the international level who may have experience with this condition and pregnancy.

Personally, I would get a second opinion. Some of the OBs at St. Mary's are respectful of "natural" unmedicated birth and practice evidence based medicine. If this is what you really want, look for a OB who will tell you the facts about your condition straight-up (based on sound studies and real risks) and will support your hope for a low intervention birth if that is what you choose in the end.

Good luck

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L.H.

answers from Columbia on

S.-
I have ulcerative colitis(since 1996) and my son is 1.5 years old. I had a normal, fairly speedy vaginal delivery with my son. Although I have not entirely read the other responses, I would have to agree that there should be no reason for a c-section just because you have UC. You need to be working CLOSELY with your GI doc and OB both to keep you from flaring while you are pregnant/after giving birth and for a healthy pregnancy. My GI doc told me that most commonly a women with UC will feel REALLY GOOD while they are pregnant. He said that something about being pregnant reduces your UC. I know I felt really good while I was pregnant. I am not really sure, but I don't see how having a c-section is going to keep you from also having a flare if you are going to have a flare. The hormones in your body will be changing after you give birth. Although I did flare after my son was born, it wasn't until he was 6-8 months old. I don't really think my flare was from having a baby but just my body.

If you decide to look for a new OB please make sure that they have some experience with UC and/or UC patients. I was lucky and my OB did. She was very helpful and worked with my GI doc to make sure that everything in my pregnancy went according to plan.(as close as it could)

If you have any other questions or just need some extra support, please feel free to send me a message. I have been there and would like to again.

L.

Also, if you one of your docs decides that you should be taking some medication, please check with the other doc to make sure that it is really needed and will be safe for the baby. Your GI doc is going to know better how a UC medication will affect the baby (if it will) and your OB will know more about other medications.

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J.M.

answers from Memphis on

Hi S.,

I do not have ulcerative colitis, but I have had 2 c-sections. I know you are probably aware of the downside to the c-section, but there are a couple of perks as well. The first is that you can plan what day (and time for that matter) you want to have your baby. If your water does not break early, you will have your baby on YOUR schedule. I am a bit of a control freak, so I really loved that part. Also, once you have your baby, you can kind of sit back and relax and rest while in the hospital. The insurance companies will allow you to stay for 96 hours after a section, so there is no sense of urgency from the hospital to get you discharged. If you are doing well, of course you can leave early, but they cannot force you to leave prior to that 96 hours. If you are planning to deliver in a hospital that has a nursery and does not require the baby to "room in" with the mom, I would also encourage you to allow the baby to sleep in the nursery. That will allow you time to rest and your body to heal. The nurses will bring you your baby when you need to feed/nurse and they will CERTAINLY bring you your baby whenever you ask unless it is at shift. That's because they need to account for all babies, but it only lasts for about 30 minutes or so.

Truly, I did not experience much pain. Of course I was sore, and I really didn't feel like going dancing, but it was not terrible. In fact, once they took the PCA pain pump away, the only thing I required for pain control was Motrin, and believe me, I am a huge baby and do not like pain. I was driving within 5 days of going home because I didn't need the narcotics.

Because my second section was planned, the type of anethesia I got was a spinal. It's a little different than an epidural in that there is no catheter that is left in your back, and it truly numbs you from your chest down. As the spinal wears off, you can sense when you are starting to hurt and go ahead and take some pain medicine before it gets too bad and way ahead of you. The spinal does not harm your baby at all. You will be awake for the procedure and hear your baby's first cry. Your partner can also be in the OR with you and follow baby to the baby light while they clean baby up. The procedure literally takes less than 5 minutes. It truly takes longer to give you the spinal, prep your abdomen and stitch you up than it does to deliver the baby after the first incision is made. (They also won't put your urinary catheter in until you are numb.)

I know you would prefer a natural birth. I applaud you for that, but you need to make sure that you take care of you, so you can be there for that new little one you are about to bring into this world. Try not to dwell on what you feel you may be missing out on, and look forward to all of the perks. In the end, what you really strive for is a healthy baby and a healthy you. Try to keep your eye on that.

Good look to you. I'll say a prayer for a healthy baby and a quick recovery.

Merry Christmas,

J.

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K.O.

answers from Kansas City on

I would shop around for a new OB-GYN if I were you. C-Sections are conveinent for the doctor, but I wouldn't think that they are any safer (and probably less so) with UC. Ask your GI or PCP doc what they say (whomever treats you for your UC). Maybe there is something I don't know...I'm not an OB, just a neurologist!
K.

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L.P.

answers from Wichita on

I would question why the doctor thinks it is better and even get a second opinion on it from another OB doctor! I know that is not a time you want to find a new doctor, but why is the doctor wanting to do a C-Section...I would really want to know the why's of it and not be satisfied until I got the answers. All my children are grown now, but I know that having been there when my grandchildren were born I was the only one who asked why when they said they wanted to do a C-Section with my granddaughter, and it is important to know WHY! Is it really necessry or is the doctor just not wanting to take any chance at all...Just check your options because having had children natural and by C-Section, I would not want the c-section again!!

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M.P.

answers from Wichita on

I have had UC for atleast 5 years and been on a bunch of different meds. I am now on Lialda and I delivered a healthy baby boy two months ago naturaly. I was surprized that the pain of natural birth wasn't too bad, to me, it felt like I had a flare and had tummy cramps. So I guess I was use to that feeling. I think I did have a flare a couple of weeks after he was born, Doc said that it was normal. I did take 8 days of prednisone for a rash that had broken out all over me and that seemed to take care of the flare too. I was happy not to take 8 weeks of steriods! If you are feeling like you are going to have a flare, catch it quick before it gets bad and you might not have to do the extra meds ask your GI Doc about only increasing the current dosage of the ones that you are on now. I hope all goes well and deffinently ask all the questions that everyone else mentioned.

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