Although sexual relationships and pregnancy may be the last thing on your mind immediately following an ostomy surgery, your mind may eventually change. Living with an ostomy doesn't have to restrict you from intimacy or forming a family, but there are some precautions you'll want to take if you decide to try for a baby. To help, here's a comprehensive guide for navigating pregnancy with an ostomy.
Does Having an Ostomy and a Stoma Affect Fertility?
Simply put, no. Being an ostomate should not affect your fertility. As long as you don't have any other underlying health issues, getting pregnant should be the same as if you didn't have an ostomy. However, the condition that requires a stoma may be a different story. Crohn's disease and ulcerative colitis may affect fertility to some degree, which is why it's important to talk to your healthcare provider before trying to conceive. Although these effects are minimal, it's a good idea to go into the process with as much information as possible.
What to Do When You're Ready to Start a Family
Before starting a family and having children, it's important to talk to your doctor. For one, you want to make sure that any underlying condition is managed and under control. You should also make lifestyle changes that could affect pregnancy at least three months before you start trying to conceive. Prenatal care is important for any mother-to-be, ostomy or not. Plus, seeing your doctor ahead of time allows you to ask any questions and make sure that you're prepared to navigate stoma care as your pregnancy progresses.
Important Information About Being Pregnant With an Ostomy
The vast majority of women with an ostomy go on to have no issues with their pregnancy. However, living with an ostomy may require a different approach to guiding your way through pregnancy. To help, consider some of the following tips for pregnancy with a stoma.
Morning Sickness and Ostomies
Morning sickness is a normal part of any pregnancy, but it can be dangerous for ostomates in certain situations. Vomiting can result in fluid and electrolyte imbalances, which can lead to dehydration. Since dehydration is especially troublesome for individuals with an ostomy, you may need to use supplements to help keep your body functioning at its best. Electrolyte imbalances can occur rapidly with nausea and vomiting with an ileostomy. Therefore, it's important to talk to your doctor or GP if you can't keep anything down. Extreme morning sickness may require intravenous medications to maintain hydration levels.
Be Prepared for Ultrasound Appointments
Getting an ultrasound can also be a little tricky with an ostomy. While having a stoma won't necessarily affect the view into your uterus, the gel or oil that's used can cause problems with the adhesion of your ostomy bag. To reduce the risk of leakage, bring plenty of supplies to change your bag after your ultrasound. Before securing a new adhesion and pouch, ensure no traces of oil or gel are left that could affect the fit.
As your baby grows, the imaging may be a little more difficult. If your baby's head is directly beneath the stoma, your ultrasound technician may not be able to get accurate measurements. Therefore, a vaginal scan may be recommended as an alternative to abdominal scanning.
Stoma Changes to Be Aware Of
Your stoma may change as your tummy grows, but that's completely normal. In most situations, an enlarging uterus will also cause your stoma to enlarge. As long as the changes aren't sudden and drastic, they should be fine. In some cases, enlargement may cause a slight bowel prolapse into your pouch, which is also fairly normal. However, if you're worried, it's best to talk to your stoma care nurse or GP. After delivery, almost all women find that their stoma size returns back to normal.
Tips for Navigating Pregnancy with an Ostomy
To help you along this process, consider some of the most important tips for navigating pregnancy as an ostomate.
Change Your Ostomy Pouch in the Mirror
Changing your ostomy appliance may get more difficult throughout the pregnancy. As your tummy gets bigger, it can be harder to see where you're putting your pouching system. Changing your pouch in front of a mirror can help ensure that you place it in the right position to cover your stoma completely.
Be Proactive About Hydration
Fluid intake is essential during pregnancy and life with an ostomy, so try to be proactive and stay hydrated. Dehydration can occur rapidly under these conditions, so talk to your doctor about any concerns you have or if you don't feel like you're able to get enough water.
Try to Eat for a Healthy Pregnancy and Delivery
Pregnant people should follow a healthy diet that is packed with nutrients. Make sure that you fit plenty of vegetables into your meal plan, along with fruits and healthy carbohydrates. Additionally, try to eat plenty of protein-packed foods. While you shouldn't have to change your diet too much, it's still important to avoid foods that can cause irritation, especially if you have inflammatory bowel disease (IBD).
You also want to avoid any foods that aren't healthy for a growing baby, such as:
- Raw meat or seafood
- Undercooked meat
- High-mercury fish (tuna and swordfish)
- Pâté
- Soft cheese
- Alcohol and tobacco
Engage in Prenatal Exercises
Prenatal exercises are just as important for expecting moms with an ostomy as they are for traditional pregnancies. Talk to your doctor about how your body will respond to certain exercises with an ostomy, and find an activity you enjoy to keep your body in motion.
Discuss Your Delivery Options with Your Doctor
While doctors will try to avoid an unnecessary cesarean delivery because of the scar, it's important to discuss your options and create a birthing plan that fits your preferences. In extreme instances, scar tissue that may have formed after a c-section may cause further issues with bowel obstructions, so natural birth is always recommended. However, having a c-section does not guarantee that this will happen, so it's always better to listen to your doctor's advice—especially in unplanned emergencies.
Be Prepared for a Little Constipation
Some pregnant women may need to supplement iron to help support a healthy pregnancy, but it can be hard on the intestines. This can result in episodes of intestinal constipation. If you experience this, talk to your doctor about liquid supplements and ensure you're drinking plenty of water to help reduce the risk of severe constipation.
Get Educated on Braxton Hicks Contractions
Braxton Hicks contractions are basically false signs of labor that may cause you to rush to the hospital. While they can happen in any expecting mother, people with ostomies may experience them more often. It can be unsettling, and it goes without saying that if you think you're in labor, head to the hospital, but if you know that they're Braxton Hicks contractions, then just try to lay down and rest until they pass.
Set Boundaries with Friends and Families
No matter how many weeks pregnant you are, once you tell your friends and family the news, they may be inclined to reach out and touch your stomach. While you may not mind, some ostomates are sensitive about their pouching system and feel uncomfortable sharing certain pieces of information. Don't be afraid to set boundaries, starting from the first trimester, to ensure that you remain as comfortable as possible.
Practice Good Stoma Care
Peristomal skin care is important for life with an ostomy, regardless of if you're pregnant. Although you might be a little more tired at the end of your pregnancy, don't neglect skin care. You should also talk to your doctor to ensure you understand how to identify damaged peristomal skin or any stoma issues and complications.
Pack Your Pouching System in Your Hospital Bag
Finally, make sure you pack your ostomy bag and plenty of ostomy supplies in your hospital bag well ahead of your due date. Although the hospital might be required to provide you with some supplies if you need them, it's always better to have access to items you know work well with your body.
For additional support and high-quality ostomy supplies, you can rely on Byram Healthcare. Byram Healthcare is committed to doing our part to improve the lives of those living with ostomies through convenient product delivery and a diverse ostomy product catalog.
