By Elaine O’Rourke, Ostomy/IBD Health Mentor
Many women with ostomies wonder if they can get pregnant and if pregnancy is safe with an ostomy.
I talked with Dr. Sonia Friedman, Director of Women’s Health at the Crohn’s and Colitis center at the Brigham and Women’s Hospital in Boston about these issues which you can watch in the video.
Every case is different and these are just guidelines. Make sure to discuss thoroughly with your doctor.
I believe the most important factor to a safe pregnancy is being in good health before getting pregnant along with being fully educated about the process.
How does ostomy surgery affect fertility?
If you have had your rectum and anus removed, or pelvic surgery, then this could lead to scarring on your fallopian tubes. This may cause a slight decrease in fertility rate if you have an ostomy. But with laparoscopic surgery this is becoming less of an issue.
However, In Vitro Fertilization (IVF) is very effective for ostomy and Inflammatory Bowel Disease (IBD: Crohn’s/Colitis) patients.
Getting an ostomy should not deter you from trying to get pregnant. If you want to have a child, don’t let that keep you from having an ostomy if you need one. Talk it all through with your medical team.
Is it safe to get pregnant with an ostomy?
Yes it is safe to get pregnant with an ostomy and in fact ostomy patients can do very well provided they are not dealing with other health issues.
There are many reasons why you get an ostomy. Therefore the most important consideration is your overall health before getting pregnant.
For example, if you have an ostomy due to IBD then you want to be in remission of IBD for at least 3 months. Most IBD medications are fine to stay on during pregnancy (see full episode video below).
But if you are under-going chemo treatments and serious other medical issues then you would need to know all the side effects from those medications and most likely that is not the time to get pregnant.
Always consult with your doctor, be well educated and informed.
What happens to your stoma during pregnancy?
Sometimes the stoma size increases but then it should go back to normal. This may require using different products or adjusting the size of the flange each time you change your appliance. If you usually get your flange/wafer precut then you will need to get the ones that you cut yourself.
How do you change your ostomy when pregnant?
As your tummy expands it might become more difficult to see your stoma. This is where changing in front of a mirror will help.
As with any other time, having everything laid out and easy to reach will really benefit you. Also, change your appliance (when possible) when you are not having any output as it will likely take you longer to change it. If you start having output then you can always get in the shower and clean off until output stops.
J-Pouch and pregnancy
Women with J-Pouches should do quite well with pregnancy. These days with laparoscopic surgery and small incisions, it makes it easier. There is a slightly decreased amount of fertility with J-Pouch but they can respond well to IVF.
Although with a J-Pouch a C-section is recommended as the pushing pressure could compromise the J-Pouch.
A birthing plan should be put into place in case of any complications and your OB/GYN should have a surgeon on call if needed. But most woman can have vaginal deliveries, unless there are other issues going on.
If you have an ostomy then you are likely trying to avoid a C-section. This is due to you already having stoma surgery in this area and having adhesions.
A C-section would be advised if you have recto/vaginal fistulizing disease.
Valuable resources for you and your doctor
Crohn’s and Colitis Foundation
United Ostomy Association of America
If you are living in a more rural area then you can direct your doctor to these sites so they can be well informed too.
Make sure to grab your FREE GUIDE: ‘3 simple ways to eliminate fears about your ostomy” by visiting Elaine’s website www.ElaineOrourke.com
Elaine O’Rourke is an Ostomy/IBD Health Mentor and the creator of the program “Surviving To Thriving: Overcoming Ostomy Challenges So You Can Live a FulFilling Life”. She is a certified Yoga Therapist & Teacher since 2003, Sound Healer, EFT & Reiki Practitioner, Recording Artist and International Retreat Leader. Her lighthearted and fun personality shines through her teachings/programs as she loves to inspire others. She is a contributing writer to the national Phoenix Magazine and UOAA, presenter at the UOAA National Conference and speaker at Girls with Guts retreat.
YouTube: Elaine O’Rourke Yoga, Ostomy, IBD
Full video on Ostomy & IBD Women’s Health: Fertility Pregnancy and Sexual Function