my daughter was born at 33 weeks naturally with no drugs. it was pretty easy, i assume because she was so small. i loved being able to deliver her and feel every minute of it! i am having my takedown on about 2 weeks. surgeon said that after 6 weeks of not having sex, we are good try for another baby! but, she also said i HAVE to have a c section...now, the way i understood it was that a natural childbirth could possible damage anal nerves and you might have some continence issues. but i thought the issues would come years later, not immediately...but several women on here have done it!! i would give almost anything to have another natural childbirth. but, i realize that my health and the baby's health comes irst, not my feelings. should i try and convince my surgeon to let me try it, or follow orders and have the c section (assuming i am even able to concieve)...

i need to add that she was "pre-pouch"...and this is my second takedown surgery coming up.

I think you should decide with your doctor when the time comes. It's kind of too soon to really contemplate it at this point IMO.

I opted for a C. I was not willing to risk incontinence.

RnR is right on the money. Talk to your doctor (OB or perinatologist) when the time comes. For me, the risk just wasn't worth it. My perinatologist left it up to me to decide though -- he was supportive of whichever option I chose, though my son had his own plan, as he was transverse when I had him at 34 weeks and that is a maditory c-section, j-pouch or not.

My only advice is to be flexible depending on the situation rather than have a rock-solid plan of what makes up a perfect birth. It's the end result of a healthy mom and baby that matters. Good luck.

In favor of a vaginal birth is the fact that you have delivered vaginally before. However, you do not say how small she was, and size DOES matter. Obviously, you will not know the size of the baby until you are near term, but know that just because you had a small baby the first time, it does not mean it will be the same second time around. My first was about 7 1/2 pounds, and my second was nearly 10 pounds. I delivered him vaginally, but that was pre-pouch and I may regret it as I age. But, so far, so good (I'm 54 now). Also, there are many more reasons to have a c-section than a j-pouch, as mentioned above. My first was breech, so was a c-section (totally unplanned). Now that my boys are grown, I look back and wonder why it is such a big deal how kids are born. The main thing is that they are here!

I agree, don't hang your happiness on any particular birth plan. That just sets you up for disappointment. But, if you feel strongly about a vaginal birth, you need to have a good discussion with your surgeon to find out if there is any specific reason he considers a c-section mandatory for you. You may find that it is not arbitrary.

Jan

i know. its the end result that matters. my daughter was only 4 lbs 11oz. she spent 11 days in the NICU. she had no trouble breathing. just had trouble keeping her temperature up and took a few days for her to eat well. i am very nervous i will have another early baby. i guess im worried that if i need to have a c section, and the baby decides to come early again. what happens?? emergency c section?? im not set on a vaginal birth, just what i would prefer. i really want another baby most. so whatever i have to do to make it happen...=)

Yes, if the baby comes early it would be an emergency C. Given your first was early, I would think you should go to a high-risk OB for your 2nd pregnancy and that they will monitor you pretty carefully throughout.

I had my takedown surgery on 2.24.10 and had my two week follow-up with my colo-rectal surgeon yesterday. One of the things we discussed was vaginal delivery vs C-section. She told me that a vaginal delivery was not an option for me if and when I get pregnant. I had to have a recto-vaginal fistula repair in December 2009. She said because she had to cut through the sphincter muscles for the repair, she didn't want to take a chance of tearing and sphincter muscle damage that could occur with a vaginal delivery. She said if any muscle damage occurred I would have a high risk of incontinence and would possibly have to go back to an ostomy. Make sure you discuss this with your surgeon AND OB/GYN. I am really lucky that mine have a great working relationship and that my surgeon wants to be there the day I have my first child.

Again discuss this with both doctors. And good luck with your pregnancy!

Kim

Talk to multiple doctors. Some will require a c-section with them because they aren't comfortable with vaginal deliveries in pouchers. Others have no problem. Talk to some midwives while you're at it. My old doctors said a c-section was absolutely mandatory. My daughter was born at home. Vaginally. No tearing.

Unfortunately there is less liability in a c-section for doctors, and their liability plays into what they will recommend.

My OB/GYN insisted that I give a vaginal birth. I had my j-pouch surgery in 2002 and gave birth to my daughter vaginally in 2008. I did not tear into the rectum (you can do some vaginal stretching to help prevent tearing) and I did not notice an increase of incontinence. My doctor was actual dead set against a C-Section because he did not want to perform surgery on top of what was already done -- he did have a surgeon on call in case I did require one. It worked out for my body (we are all different).

I am having issues now, but it only started after I had a small abscess surgically removed from my anus a year ago. Now I leak often.

Wow, Nicole! A doctor who actually was dead-set against a c-section? I'm impressed!

my OB was against a c-section as well. she wasn't comfortable with what she may find in there. I had already "proved" myself by having two vaginal births before my surgeries. She decided she wouldn't let me deliver a baby bigger than my biggest and she would use any forceps or vacuum during the delivery.

would forceps or vacuum necessarily help preserve sphincter function??

quote:

would forceps or vacuum necessarily help preserve sphincter function??

My understanding is that forceps and a vacuum assist is more likely to result in birth trauma and/or sphincter function issues, but I hope that Jan can clarify for us to be sure.

That is correct. I think that indianapouch just made a typo and intended to say would NOT use instead of would use.

Vacuum assist and forceps in particular would increase the risk of sphincter damage. I had outlet forceps used with my vaginal delivery and wound up with a 4th degree laceration (but another major factor was the size of the baby too).

Jan