Pregnancy with a Stoma

Pregnancy is an exciting time for many women that comes with its own set of challenges. But for women with a stoma, the journey to motherhood needs a bit of extra planning. Your stoma will need to be closely monitored and managed during pregnancy for the health of both you and your baby.

If you, your partner, or a loved one is preparing for or is pregnant with a stoma, the following guide provides advice and information to answer your most important questions.

Preparing for a healthy pregnancy with a stoma

Your healthcare team should be your first port of call to make sure your stoma is working correctly and that you’re in good health. They’ll go through any risks or complications that can happen when having a baby as an ostomate. You’ll also be told if you need to change your stoma care routine and diet to accommodate the changes in your body.

Seeking support from fellow ostomates who have gone through pregnancy can also be beneficial. With the right preparation and support, you can have a successful and healthy pregnancy with a stoma.

Should I see a doctor when planning to get pregnant?

You should try and see your doctor before trying for a baby. They can confirm that there are no issues that may cause complications later on in the pregnancy. This appointment will also give you a chance to ask questions and help you understand what to expect at each stage.

Is it harder to get pregnant with a stoma?

A stoma does not make it harder to conceive. While there may be some challenges or adjustments to make, such as managing medication, you can still conceive naturally.

Will I need a C-section?

Having a stoma doesn’t mean that you will automatically require a caesarean section. The preferred delivery method will always be vaginal, if possible, due to the formation of scar tissue that likely developed during your stoma surgery. This will be discussed by your surgical and obstetric team to make the safest decision for both you and your baby.

Managing stoma care during pregnancy

Managing stoma care during pregnancy requires careful planning and communication with your healthcare team. Follow your stoma care routine and monitor any changes in your body that may affect your stoma, such as skin sensitivity and stoma output. Consulting with a stoma nurse specialist and discussing any concerns or questions can help ensure a smooth and healthy pregnancy for you and your baby.

Changes in stoma size & shape

The size and shape of your stoma may change significantly during pregnancy for various reasons, such as the growth of the uterus and the shifting of organs in the abdominal area and changes in hormones. As the baby grows, the stoma may become larger and more stretched, requiring the stoma bag to be adjusted. The shape can also affect making the stoma flush with the skin or protruding more.

Will my stoma return to normal after delivering a baby?

As long as there have been no complications during delivery, your stoma will return to its normal shape and size after giving birth and your abdomen adjusts.

Does a stoma affect the ultrasound?

A stoma does not typically affect the accuracy or safety of a pregnancy ultrasound. As the stoma will not interfere with the ultrasound waves, the procedure can still be performed as usual. The location of the stoma may sometimes affect the visibility of some parts of the baby, but the ultrasound technician can easily adjust this, so don’t worry.

Choosing the right stoma pouching system when pregnant

Changes in a stoma’s size and shape during pregnancy make choosing the right stoma pouching system important. The first step is to consult with a stoma care nurse who can help assess your individual needs and provide tailored recommendations. You should also consider the stoma type, your lifestyle and daily activities.

Some women may prefer a one-piece system for convenience, while others benefit from a two-piece system for flexibility. Most importantly, ensure that the pouching system is comfortable, provides proper support for the stoma and is secure enough to prevent leaks.

Coping with morning sickness

As with all pregnancies, there is the risk of morning sickness. This can be a particular concern for women with a stoma. Unless managed, electrolyte and fluid imbalances can quickly develop. If nausea makes it harder for you to eat, you should inform your doctor or stoma nurse.

Maintaining peristomal skin health

Pregnancy can be a challenging time for women with a stoma, as changes in the body can also affect the peristomal skin. Maintaining good peristomal skin health during this time is important to prevent complications.

One of the best ways to do this is to regularly check the stoma and surrounding skin for signs of irritation or redness. Appropriate skin barriers and pouching systems can also help protect the skin and keep it dry. Make sure you stay hydrated, as this can improve skin health.

Dealing with parastomal hernia during pregnancy

A potential complication during pregnancy is a parastomal hernia, due to the pressure placed on the abdominal wall. This occurs when part of the bowel protrudes through the abdominal wall and can be a source of discomfort and concern.

Some steps can be taken to manage and prevent parastomal hernia. Consulting with your stoma nurse and wearing a proper support belt can help alleviate the symptoms and reduce the risk of further complications.

It’s important to be proactive when dealing with a parastomal hernia during pregnancy to ensure your and your baby’s health and wellbeing.

Do ostomates need to adjust their diet during pregnancy?

There is no need to change your diet significantly, but ideally, you should aim to eat more protein, including meat and eggs, supplemented by plenty of fruit and vegetables.

As with all pregnant women, you should avoid the following foods:

• Raw or partially cooked eggs
• Raw or undercooked meat
• High mercury fish, such as tuna and swordfish
• Soft cheeses

Pregnancy also increases the amount of water needed, so expectant mothers should increase the amount of water they drink daily to reduce the risk of dehydration.

Common pregnancy and stoma-related health issues

Some of the most common pregnancy and stoma-related health issues include skin irritation around the stoma, constipation, and an increased risk of infection. It is important for women with stomas to closely monitor their health during pregnancy and communicate any concerns with their stoma nurse or healthcare team.

Skin irritation around the stoma during pregnancy

Hormonal changes can make the skin around the stoma more sensitive. Changes in the abdomen often lead to irritation, making it uncomfortable and even painful for expectant mothers.

This can affect the fit of the stoma appliance and lead to leaks and skin exposure to stoma output. Moisture build-up can also increase the risk of fungal infections, adding to the discomfort.

Ensuring the appliance fits properly, using protective barrier products and keeping the area dry can help manage irritation. Regular check-ins with a stoma care nurse can provide crucial support in adjusting care routines and alleviating discomfort.

Infection Risk

Pregnant women with a stoma, especially those with urostomies, may have an increased risk of developing infections such as urinary tract infections (UTIs).

Changes in the urinary tract make it important to maintain proper hygiene and consult a stoma nurse if any signs of infection arise.

Bowel Obstruction

The growing uterus during pregnancy can compress parts of the intestines, increasing the risk of bowel obstruction, a condition where the bowel becomes partially or fully blocked. This is a particular concern for women with a stoma, who are already at risk for obstructions.

Symptoms such as severe abdominal pain, nausea, or reduced stoma output should be monitored closely and immediate medical attention should be sought if they occur.