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Hi guys,

I really need some advice, I've had an ileostomy for about a year and half, it was done as an emergency after my 1st pregnancy, (he's 2 now Smiler ) basically in pregnant again 34 weeks today and I've just seen the midwife who's referred me to breach clinic because they are worried baby's still breach and said I may have to have a planned c section I was hoping to avoid it because I'm worried they could nip my bowel or something and leave me with more problems, because I do want to have the reversal done after 1 more pregnancy maybe in about 2 years or so... So basically I was just wondering if my one has had a c section with an ileostomy and then had another baby after that also, and if after the c section anyone has had a j pouch done and been ok??

Sorry for such a long babble I just seem to keep getting more and more complications everyday :/

Sally xxxx

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C-section with ileostomy is common, and I actually would recommend it, even without the breach presentation, because of your desire for a j-pouch in the future. Each vaginal delivery can weaken the sphincters, so as time goes on, your risk for incontinence later in life is an issue. Usually, it is not much of an issue, because most women do not need super strong sphincters. That is because they don't have chronic loose stools (common with j-pouch).

You are not at any greater risk of nicking the bowel now than when you hd a colon. The incision is low, horizontal, and along the pubic bone. The expanded uterus is up front, with all the bowel behind. Your ileostomy is off to the side.

I had both of my pregnancies before j-pouch surgery. The first was a c-section for frank breach presentation. No problemo, and I was awake with an epidural. Delivery number two was vaginal. BIG baby...I had 4th degree lacerations (tearing completely through the rectum). I healed up nicely, but now have cystocele and rectocele 25 years later from the obstetric trauma. So far, I am OK, but I do have concerns for later on.

Regrdless, there is NO WAY that a breech vaginal delivery would be safer than a c-section, even with an ileostomy. I am sure you already know that. I don't even know if there are OB's that would even do it now.

You can have your colorectal surgeon on standby for a planned c-section, in case something comes up. But, much better to to the c-section.

Jan Smiler
Jan Dollar
Thanks jan, I asked the midwivea about the muscles being damaged because I had read that before also but I'm just getting so frustrated that they keep on pushing me for a vgainal delivery, I'm honestly so scared of the j pouch messing up because of a mistake I make giving birth, and I want one more baby also so 2 normal deliveries twice the pressure :/
S
It is one of those things that are not written in stone, especially if you had an easy vaginal delivery the first time. But, I would not worry about the c-section putting you at more risk. Basically, you just have to assume some risk by having babies, and personally, I think they are worth every bit of it! Big Grin I certainly have zero regrets, even when they test my patience!

Jan Smiler
Jan Dollar
One thing I failed to mention. If this babe stays breech and you have a c-section, you'll likely have a c-section for the next one. VBAC (vaginal birth after c-section) has fallen out of favor. When I had mine back in 1987, it was popular and considered safe. But, c-sections have become so safe, they are safer than VBAC. So, OBs advise against it now.

Maybe in the UK it is different though.

Jan Smiler
Jan Dollar
Hey guys!

Just thought I would update you, I went to breach clinic and well he's still breach! I'm 35 weeks now and she said more likely than not he'll stay breach but may still move around so no clear answered there, I went to my surgeon however and asked him what he thought and he said if you want the ileostomy reversed in the future (which I said I really did want) then he wants me to have a c section and it was no questions asked he said if during a normal vaginal birth I was to get a tear they would not be able to do the reversal :/ I was so glad he just have me a straight answer Smiler xxxxx
S

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