Posted 10/23/2020 9:35 PM (GMT -7)
So, I am pregnant with my 3rd child. My first 2 pregnancies were before I was diagnosed with UC (although I had experienced symptoms on and off for several years before that). Both babies were born on time, healthy weight (approx 7.5 lbs) , with a very simple, straightforward, quick, and (relatively) easy home births with midwives. Little to no medical intervention, and everything went smoothly.
Now, fast forward to this pregnancy. I'm 24 weeks along. Everything is proceeding well. My UC is more or less in remission (I occasionally have some softer stools than normal, but am only going once or twice a day and no blood or mucous). The baby is measuring right where he should be, ultrasounds look great, etc. But.. Because I have UC, my midwives had to send me for a consult with an OB. The OB now wants to be involved in my care throughout the entire pregnancy and she has also referred me to an obstetric internal medicine specialist.
I know I should feel grateful to have free access to good healthcare, but I am just frustrated with so many interventions. Every time I see another specialist, they keep adding in things that I should be concerned about that just don't seem relevant to UC, or at least not to my particular situation.
Some of the things that I've now been told I should worry about:
1. I have a new husband this time around and he is taller than the last, so the doctor thinks the baby might be "too big" to deliver vaginally (complete opposite concern from the UC risk of having a small baby or delivering early).
2. I finished a course of prednisone in Nov 2019. This baby is due in Feb 2021. The internal medicine specialist says that you can have adrenal insufficiency for up to TWO years after stopping prednisone and that I should have IV steroids while I'm giving birth to avoid this. I have never heard of the two year time period, and have always been told that you need to be careful for 6 to 12 months after stopping pred (and even this seems to be conservative - I was in a major car accident this summer, and the paramedics were not at all worried about me having recently been on pred).
3. The internal medicine doctor said I should be worried about tearing causing fistulas and I might want to consider a c-section. Everything I read says that this is only indicated for crohns patients who have active peri-anal disease.
I just feel like all these doctors are looking for anything they can to classify me into a high risk group. I feel quite strongly about delivering the baby at home, with the care of qualified midwives and with a back-up plan to transfer to a nearby hospital in case of emergency. However, if I truly am at higher risk of complications during delivery, then I would plan to deliver in hospital. But nothing has yet convinced me that I am at higher risk.
I don't want this discussion to turn into a debate about home vs hospital birth, but rather am looking for thoughts on whether the above doctors concerns are valid, and also any info on whether well-controlled UC actually increases risks for having a healthy delivery. So far the only consistent research that I've found has said that there is a risk of having a low birth weight baby and of delivering early.
As far as the concern I mentioned above about possibly having a large baby - it seems that the doctor should be happy for this, since it should offset my risk of me having a small baby ;)