Can I get pregnant with a stoma, and can I give birth normally or only by caesarean?
Yes, pregnancy with a stoma is possible, and many people go on to have healthy babies. A colostomy does not affect your fertility, though it is wise to check with your doctor that you are fully recovered before trying to conceive. As your abdomen grows the stoma may change shape and the bag may need adjusting, and a few stoma problems such as a blockage or a hernia are more common in pregnancy, so the team will keep an eye on things. On birth, having a stoma is not by itself a reason for a caesarean: the vast majority of people with an ileostomy can give birth vaginally, and caesareans are chosen for the usual obstetric reasons. In practice caesarean rates are higher in this group, but the right mode of birth is an individual decision made with your obstetric and surgical team. Speak to your doctor or stoma care nurse to plan ahead.
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Yes. People with a stoma get pregnant and have healthy babies. The NHS is clear that a colostomy will not affect your fertility, while sensibly adding that you should check with your doctor you are fully recovered before trying to conceive (NHS). If your stoma followed bowel disease, you may also want to read our answer on fertility and IBD.
During pregnancy
As your abdomen grows the stoma can change shape, and the bag may need adjusting or a different system for a while. A few stoma problems are a little more common in pregnancy: a multicentre audit of pregnancies after stoma surgery found stoma-related complications such as prolapse, parastomal hernia or a blockage in about a quarter of pregnancies (multicentre audit). This is why the team keeps a close eye on you, and most pregnancies still end in a healthy birth.
Vaginal birth or caesarean?
Having a stoma is not by itself a reason for a caesarean. The Ileostomy and Internal Pouch Association states that the vast majority of people with an ileostomy can give birth vaginally, and that a caesarean is chosen for the usual obstetric reasons, not because of the stoma (IA Support). In the audit above, caesarean rates were higher than average in this group, but normal and assisted vaginal births happened too (multicentre audit). The right choice is an individual one, made with your obstetric and surgical team.
Planning ahead
The earlier you involve your team, the smoother things tend to be. Your stoma care nurse can advise and support you before and during pregnancy (NHS).