In general, having IBD does not affect delivery method. The decision about delivery method for an IBD patient should be made on an individual basis by the patient and her obstetric provide. The decision should be based on obstetrical reasons, while also considering the patient’s IBD condition. While some studies report higher rates of caesarean section among women with IBD compared to healthy women, other studies report no significant difference in the rate of c-section.
There are 2 IBD-related indications for recommending c-section over vaginal delivery:
- active perianal disease (disease located around the anus) in Crohn’s patients.
- it is recommended to avoid vaginal delivery because of concerns of worsening perianal disease activity due to poor wound healing.
- women who have significant scarring from prior perianal disease may also wish to discuss delivery method with their obstetrician
- ileal pouch-anal anastomosis surgery
- although vaginal delivery may be safe for females with a pouch, a c-section may be recommended to prevent potential disruption of pouch function.
- there is concern that vaginal delivery could disrupt the function of the anal sphincter (a ring of muscle that controls the anus opening) and lead to an increased risk of incontinence