Pregnancy with an Ostomy – Possible?

The simple, bottom line of it all is, YES, you can get pregnant and survive a pregnancy that results in a healthy little being despite having an ostomy. Big sigh of relief, right?!

Having surgery to get an ostomy does not affect your fertility (most of the time), so remember to continue using birth control if you aren’t ready to add to your family. It’s good to note here that you should speak with your doctor about which birth control to use as some are less effective than others. Some birth control pills pass through your ostomy before being digested, rectumless-woman may have a hard time placing a diaphragm or keeping it in place, and IUD’s can be tricky too. Another risk is with removal of the rectum, it is possible for scar tissue to form, blocking the fallopian tubes which could make conceiving a challenge. This doesn’t actually mean you’re infertile, it just means that there’s a wall in the way. With scientific advances where they are, there are lots of options for helping you get pregnant.

Before you run off and get pregnant talk to your doctor to ease your fears. Although ostomies are relatively common, not all OBGYNs have had patients with ostomies. Luckily, this doesn’t really matter because your ostomy doesn’t affect your reproductive organs.

If you have your ostomy because of Familial Adenomatous Polyposis (FAP), remember that it’s possible that your child will inherit it and need surgery as well. Inflammatory Bowel Disease has been suggested to be partially genetic so it would be worthwhile to do some research on the latest studies and ask your doctor to see if there are more concrete links.

While it is entirely possible to have a normal pregnancy, feeling great the whole time and delivering a healthy baby, some potential ostomy-related complications include:

  • Blockages – since babies move in the uterus, and the uterus grows throughout a pregnancy, there is risk for the uterus to pinch your intestines and cause blockages. Extra precaution through diet and chewing may help avoid it, though it’s good to talk to your doctor about what to do if a blockage does occur.
  • Kidney infections – This is more relevant for people with a urostomy, but it’s important for all ostomates to keep drinking fluids and maintain good hydration.
  • Stomas can change shape/size – As your abdomen grows, your stoma may grow or change shape. Often the stoma becomes more oval shaped. If the ostomy pouches you’re using start to cause leaks with the growth of your abdomen, it’s worth experimenting with more flexible baseplates to find a good fit. It’s also important to measure your stoma and cut your baseplate to fit it if it does change size. You might need to use a mirror to see better when changing your pouch as your belly gets big if your ostomy is lower on your abdomen.
  • Discomfort – If you have adhesions and scar tissue, as your abdomen grows to make room for baby, there may be discomfort/pain. Luckily, it doesn’t harm the baby. Unluckily, it doesn’t make for a fun pregnancy.

Labor and Delivery

In many cases, you can give birth vaginally. Of course, each of us is different and our medical histories are different, but there’s a chance for the need of a c-section in many non-ostomy pregnancies anyway.

Parastomal hernia – A hernia can develop during birth, talk to your doctor to see if there are ways to prevent this (and then email me and let me know what they say!).

Bring your emergency kit, you’ll want to change your ostomy pouch soon after you give birth since there will be such a big shift in the shape and size of your abdomen.
Bring something that can be prominently displayed to hospital staff alerting them to the fact that you have an ostomy. If you don’t have your rectum, include that you can’t have a rectal temperature taken.

If you know where you plan to deliver your baby, see if you can talk to someone at the hospital to alert them of your ostomy so their nurses can familiarize themselves before you arrive, if they so choose.

Now, don’t let the complications scare you. Talk to your doctor and your partner about your concerns, get educated, and go make a family!

Sometimes it’s more comforting to read information from someone who’s been through the thick of it.  If you want to read about someone’s real experience, check out Stephanie’s posts about her pregnancy and birth experiences at stolencolon.com.  It’s a happy ending!