While having an ostomy should not affect pregnancy, there are some issues that may arise and are good to know about in advance:
Changes to the Stoma
As the abdomen and pelvis enlarge during pregnancy, it may be necessary to modify the ostomy pouching system. It’s best practice to measure the stoma during pouch changes and change the stoma size of the ostomy pouching system accordingly throughout pregnancy as needed. If there is leaking, itching around the wafer and/or a need to change the pouch more frequently, please consult an ostomy nurse.
Soon after delivery, the stoma usually reverts to its pre-pregnancy size.1
Childbirth Considerations
Prolapse or Intestinal Obstruction
As the stoma becomes enlarged during pregnancy, this may cause a small degree of prolapse of the stoma, but this is usually not a major concern. It’s best to keep an eye on it and speak to a colorectal surgeon and ostomy nurse for monitoring and to ensure that it’s possible to maintain proper pouching without leaks.
As the uterus becomes larger, it may block the passage of stool in the intestines, preventing it from flowing into the ostomy pouch. In such an event, the abdomen becomes distended and nausea may occur. Bowel rest and hydration may help to resolve this problem, though if something like this does occur, please contact a colorectal surgeon and/or gastroenterologist immediately. Please note that there is no need to oversew the stoma for delivery. This is an antiquated practice that has no merit in the vast majority of patients.2
Breastfeeding
Breastfeeding with IBD, an ostomy or IPAA/J-Pouch while on certain IBD medication(s) is safe. While there may be trace amounts of IBD medications that are passed into breast milk, it is generally not of significant concern. It is always best to discuss medications and their effect(s) on breastfeeding with a GI care team to ensure there are no contraindications. The other thing to keep in mind is that it is very important to work with a GI dietitian while breastfeeding to ensure nutritional recommendations are followed to keep the mother and baby as healthy as possible.3
Genetics
If one parent has Crohn’s disease or ulcerative colitis, there may be an increased risk of their child developing IBD as well, although the rates are generally very low. If both parents have IBD, the rate of their child developing IBD does increase. It is best to discuss any concerns with a gastroenterologist and MFM specialist prior to conception. Do keep in mind that medications and surgeries have quickly evolved over recent years and IBD is now very well-managed proactively, even if a child does happen to develop it.4
IVF Treatment
Content coming soon.
There are many ways to have a family. If carrying a pregnancy is not possible or advised based on your health, gestational surrogacy and adoption are all various ways to have children. To learn more, please refer to the American Society of Reproductive Medicine website: Adoption: Where to Start and What to Think About & Fact Sheet: Gestational Carrier (Surrogate).
Written by Tina Aswani Omprakash. Medically reviewed and validated by Jordan Axelrad, MD, MPH. These webpages are funded by a grant from The Leona M. and Harry B. Helmsley Charitable Trust.
- Pregnancy with an Ostomy. (2020). Hollister Incorporated. https://www.hollister.com/en/ostomycare/ostomylearningcenter/livingwithanostomy/pregnancywithanostomy
- Source: Uma Mahadevan, Advances of IBD Conference, December 2020.
- Source: Uma Mahadevan, Advances of IBD Conference, December 2020.
- IBD Clinical Nurse Specialists. (2016). Pregnancy & Inflammatory Bowel Disease (IBD).Oxford University Hospitals NHS Foundation Trust. https://www.ouh.nhs.uk/patient-guide/leaflets/files/14054Pibd.pdf
Contact Us
United Ostomy Associations of America
P.O. Box 2293
Biddeford, ME 04005-2293
Call us toll-free at: 1-800-826-0826.
Our Information Line hours are Monday-Friday, 9am to 3pm EST. If you have an emergency, please dial 911 or contact your local medical professional.
Please understand that UOAA is a private, nonprofit, advocacy and informational organization. We are not a medical facility and we do not have medical or legal professionals on staff. Therefore, UOAA does not provide Medical, Mental Health, Insurance or Legal Advice. Visit UOAA Virtual Ostomy Clinic provided by The Wound Company for non-emergency, virtual ostomy support.
