Uncomplicated, routine antenatal care is carried out by community midwifes, but if you have Crohn's disease, you may benefit from obstetric care throughout your pregnancy. This is not because you're guaranteed to have a difficult pregnancy and experience problems, but because having Crohn's disease can impact on some aspects of pregnancy. Obstetricians have the training and experience required to manage pregnancy complications and oversee the care of high-risk pregnancies. Here are three benefits of seeing an obstetrician when you have Crohn's disease:
Multidisciplinary Health Management
Obstetric care is hospital-based, and this makes multidisciplinary health management much easier than when you have a community midwife overseeing your pregnancy. Your obstetrician can easily liaise with your gastroenterologist, bowel surgeon, dietician and any other member of your Crohn's disease care team. This allows them to make decisions that don't cause the management of your Crohn's disease to suffer. For example, if you develop gestational diabetes or a blood clotting disorder while pregnant, your obstetrician will ensure the medication you're prescribed is safe to take alongside the current medication you use. Additionally, an obstetrician can monitor your health more closely than a community midwife. They can carry out regular blood tests and imaging for early detection of some of the problems you're more likely to experience when you have Crohn's disease, such as iron-deficiency anaemia, dehydration, vitamin deficiency and predicted low birth weight.
Safe Birth Plan
Your obstetrician will take your current disease activity and disease history into consideration when advising you on a safe birth plan. You will still, of course, be able to make your own choices when planning the birth of your baby, but you'll have the benefit of your obstetrician's experience. They will explain the types of problems that can occur during labour when you have Crohn's, such as bowel perforation or abdominal scarring getting in the way if you need an emergency C-section. It's entirely possible you'll have a straightforward pregnancy and birth, but it's wise to be fully informed when making decisions about your health and the health of your baby.
Informed Choice Of Delivery
Most women with Crohn's disease will have no problem having a vaginal delivery, but an obstetrician may recommend a planned caesarean birth after reviewing your medical history and drawing on the latest research and clinical recommendations. For example, a planned C-section may be recommended if you have an internal rectal prolapse caused by Crohn's disease, as a vaginal delivery could make it more pronounced and increase your risk of developing incontinence. Whatever their recommendation, they'll be able to discuss the potential risks and benefits of each type of delivery with you.
In all likelihood you'll have a healthy pregnancy and straightforward delivery, but if you do develop any complications along the way, already being registered with an obstetrician means you won't have to change your antenatal care provider. You'll be monitored closely throughout your pregnancy, and this can offer reassurance at a time when anxiety is often running high.