Ostomates and Childbirth

Many lady ostomates have questioned their ability to have children, and in the process have either postponed or done away with the idea of becoming pregnant. However, experience and studies have shown that ostomies are seldom a deterrent. Close professional monitoring throughout the gestation and delivery can just about assure a normal and memorable experience.

Pre-Conception:

Most doctors would likely recommend at least a year to recoup from the surgery followed by a complete medical evaluation to assess reproductive health before attempting conception. Good physical condition including healthy vitamin and mineral levels are critical. Poor intestinal absorption may have led to lack of iron, folic acid, and vitamin B. Additionally a fully recovered abdominal wall from the ostomy surgery is a must. Usually, with no fertility issues present, a normal pregnancy should be awaiting you after that period.

Complications:

• The major complication possible is an intestinal obstruction. The uterus dilates and tends to rest on the intestines creating pressure and preventing effective stool discharge. If this occurs, you may have to switch to a liquid diet and lay on bed as much as possible. A more extreme alternative may require hospitalization and intravenous therapy. If this fails, surgery might have to be performed including a caesarean section to allow access to the obstructed intestine.


• Morning sickness and nausea may happen just like in most pregnancies. However for women with ostomies this may be a sign of intestinal obstruction. If nausea and vomiting become severe, a health professional must get involved.


• A stomal prolapse may develop but it will usually resolve after the pregnancy and will not require your doctor's intervention. If you can manage your ostomy supplies, there is probably nothing to be alarmed.


• Higher progesterone levels may lead to enlargement of the uterus which in turn might create constipation.


• Peristomal hernias may originate as well. Wearing an ostomy belt during the pregnancy would help (a few sizes might be needed as the abdomen enlarges). After delivery, the hernia is likely to wane or disappear.


• The stoma may widen due to uterine pressure. You will need to change to ostomy bags with a larger opening. The stoma may or may not return back to its original size after delivery. You may also have to deal with more frequent pouch changes.


• As the abdomen increases in size, it becomes increasingly difficult to see the stomal opening. Placing the skin barrier and the bag may require that you use a hand mirror or that you ask for help.


• Colostomates who irrigate will have to go for drainable pouches during the last stages.


• Those with ostomies because of Crohn's disease or ulcerative colitis might need extra precautions because of a slight chance of recurrence.


• Urostomates might experience stretching from the ureters or the ileal conduit causing mild incontinence, but when adequately watched, it can be managed effectively.

Birthing:

The birth itself should present no more complications than for a woman without a stoma. Normal vaginal deliveries are completely possible. Nevertheless your doctor might recommend a caesarean section specially if the rectum was removed, if there is an internal pouch, or another special circumstance. In case of a C-section, it might be a good idea to have a surgeon present at delivery. An incision is bound to find adhesions around organs and could complicate matters.