Your OBGYN may decide to do an episiotomy at the time of delivery, which is a surgical cut made at the opening of the vagina during childbirth, to aid a difficult delivery and prevent rupture of tissues. The episiotomy may be done to avoid an uncontrolled tear in your perineum.
The decision to do an episiotomy is particularly important if you have active inflammation in the area because active inflammation can slow healing of an uncontrolled tear around the anal sphincter or rectum after delivery.
Make sure to discuss any concerns you may have about episiotomy or the risk of tearing with your healthcare team.
Generally, the decision whether or not to do a C-section should be left to your OBGYN. There are a few complications associated with IBD that may require a C-section to help protect your anal sphincter muscle.
One such complication is if you are having active complex perianal disease (complications of the rectum or anus). This might include fistulas or abscesses.
Another complication that could require C-section protect the sphincter is having an ileal pouch, such a J-pouch, S-pouch, or W-pouch.
There is a risk of fecal incontinence if your sphincter becomes damaged in vaginal delivery.
If you are planning to have a C-section, you may want to ask your OBGYN about deep vein thrombosis (DVT) prophylaxis. DVT is the formation of a blood clot in one of your deep veins. C-section is a risk factor for DVT, and various medications can be given to protect against this.
Find out about recovering from an episiotomy or C-section in our next section, After Giving Birth.
If you were taking a biologic during pregnancy and it was stopped towards the last trimester, we recommend the biologic infusion be restarted before you leave the hospital. This saves you the trouble of having to return to the hospital later, possibly with baby in tow, to get your infusion done.