After going through an ostomy procedure, many women go through a period of emotional crisis where matters of sex and intimacy keep them continuously anxious. Thoughts of conceiving, pregnancy and childbearing complicate things further while some of these concerns can be settled by simple assurance, a pregnant woman usually requires special care since the physiological and structural changes brought about by pregnancy have effects on the functioning of the ostomy.
Ostomies do not affect your chances of pregnancy
One of the main concerns many ostomate women have is whether the ostomy will affect their likelihood of becoming pregnant. The truth is that chances of a pregnancy are not related in any way with having an ostomy. When any difficulty is experienced in trying to become pregnant, it is easy to associate it to an ostomy because of the profound effect it has in a person’s life. It is important not to be discouraged as visiting a doctor can easily bring about discovering where the actual problem lies.
Early pregnancy and ostomy
Informing your doctor about your pregnancy as early as possible is recommended. Morning sickness is a common disorder that varies in severity in different women and is characterized by nausea and/or vomiting. If the vomiting is severe enough, other issues such as dehydration and loss of body salts (electrolytes) can occur which can lead to hospitalization. In most cases however, many pregnant women with ostomies go through pregnancy without any incidence.
Issues obviously arise however, for example an enlarged uterus compresses on the intestines. This reduces gut motility and in effect slows down discharge from the stoma and intestinal obstruction can occur, creating more complications. Changing to a diet high in liquids can help to resolve this problem. In some cases, obstruction is complete with accompanying symptoms of pain, abdominal distension and vomiting. Such a situation requires immediate consultation by a physician.
Pregnancy with a urostomy
Women with this type of ostomy have an increased risk of kidney infection and urinary tract infections. They will develop symptoms such as fever and maybe foul-smelling and discolored urine. If you notice any of these symptoms in during pregnancy, please see your doctor without any delay.
Other changes in pregnancy and ostomy
Having an ostomy while pregnant pose special challenges with antenatal exercise programs. These exercises are healthy and women with ostomies are encouraged to participate in full but it is important to know that some moves or positions increase the chances of the ostomy pouch leaking. To avoid this, always empty the pouch before the exercises start.
Another problem is the change in the pouch alignment on the abdomen. Abdominal enlargement shifts the position and configuration of the stoma such that using a different pouch size becomes necessary. This is important to avoid pouch leakage.
Diet and medications
Pregnancy and ostomy affects digestion in several ways. As already mentioned, there are slower bowel movements. The problem can be compounded by foods that make stools too hard or in turn too watery. It’s a good idea to identify any foods that give you problems and simply avoid them. If you are intolerant to any prescription medication, inform your healthcare professional immediately. Eating small frequent meals and drinking enough fluids is important.
The postpartum period for mothers who have an ostomy is managed in the same way as it normally would. The only change that might be necessary is switching back to a different sized pouch now that the abdomen is no longer enlarged.