I am 37, and have had 2 children naturally before having my surgeries...the surgeries have been very successful and I have had a great result for nearly 2 years now...Would someone like me automatically be high risk? What are the risks with prgnancy and the j-pouch and what are the risks with vaginal birth (beside possible tearing)?

Any info would be appreciated

Alex

I'm not sure if "technically" we're considered high risk but a lot of women here do see a high risk doctor just to be safe. There are a lot of issues we could have even during the pregnancy dealing with scar tissue adhesions or obstructions.
And I think it is best to have a C-section because you could damage the J-pouch.
I'm sure someone else will be along shortly with more information.
Lori

When I had my pouch I was told I did not have to see a high risk OB. However, I always knew I would because it made me feel better. In the end, I had a perm ileo at the time of my first baby (I'm pregnant with #2 now) and I am very glad I had the high risk dr as I had a near total obstruction during month 5. One of my j-pouch friends suffered obstructions from week 16-22 during her pregnancy. I was fortunate enough to find a high risk OB who has other j-pouch and ostomy patients.

However, if you have had two successful pregnancies already and aren't having any problems, you can probably see a regular OB if you are comfortable with it.

The reason c-section are recommended is not because of immediate risk to the pouch but due to the natural degeneration of the sphincter muscles over time that occurs in all women who deliver vaginally. The more babies you have vaginally the more possible poor muscle tone down the road. For women with healthy colons, loss of this muscle tone usually isn't an issue. For pouchers it is for obvious reasons. Cleveland CLinic has the best articles about c-section with a j-pouch if you want to read up on before making a decision. They are published on the Clinic website.

Just wanted to add my own experience so far. I was also told when I first got pregnant that I did not need to see a high risk OB right away. My usual OB docs and I discussed complications, etc. and said we'd cross that bridge if anything should happen. Now I'm 33 weeks pregnant with twins and I haven't had to see a high risk doc at all. I've had many conversations about having a C-section, especially now with twins on top of having the J-pouch. I just don't know when the C-section will be yet!

Here's the link to the Cleveland Clinic article about pregnancy with the j-pouch:
http://cms.clevelandclinic.org/digestivedisease/documents/POG_2004_Summer.pdf

Jan

Jan,
One thing this article said was that fecal incontinence was increased in the 2nd or 3rd trimesters but it didn't say if this resumes to a pattern similiar to what these women experienced prior to pregnancy.
Does anyone know if that is the case? If you do experience incontinence is this something that resolves after delivery or something you still suffer?

Yes, it does resolve for most women. It is all about the increased pressure on the pouch.

Jan

Jan, Thank you for the link to that article. I appreciate it. Just scheduled my C-section for March 11! (If I can make it that long) ;-)

Thanks for all your posts! After reading all the stuff about a c-section being recommended, I'm a little freaked. As stated in my beginning post, I have two children, both were vaginal deliveries. I really don't want to have a c-section.

What exactly is it about a vaginal delivery that makes it risky for j-pouchers? Is it the pushing? Is it the risk of ripping? As always, any info is appreciated.

Thanks,
Alex

Just wondering if anyone saved a PDF of the link to the article listed above... the link no longer works and I looked around the clincs web site and couldn't find it anywhere.

I would love to have this handy to show my OB.

Thanks,

Nicole

Cleveland Clinic completely revamped its website, so it was really difficult to find. I wound up just doing a Google search to find it. Here it is:
http://my.clevelandclinic.org/Documents/Digestive_Disease/POG_2004_Summer.pdf

Jan

Thank you so much Jan!!