I've had two successful vaginal deliveries post pouch. I plan for the same this time as well. From what I understand, due to tearing and the pelvic floor trauma from delivery, some women choose to go for a caesarean. I have found at nights, if I have pouchitis, I may have an accident here and there since giving birth. I didn't tear much with my first and not at all with my second, but I'm assuming that if I did tear I would have even more accidents....so it really depends on your preference that way and it's s but if a chance thing. I did see a high risk ob with my first just to ensure that if something did go badly, I'd be in the same building as a GI and surgeon...as I wasn't sure how my pouch would do with all that added pressure. My second pregnancy I saw a regular ob and with this one I have a midwife (but still choose to deliver at a hospital just to be safe)!