One after-effect which I and indeed most of the survivors of infant surgery have had no difficulty escaping is what the adhesions (so common after abdominal surgery) can add to the discomfort and pain of pregnancy. Many congenital and other infant abnormalities of our bowels affect baby boys more often than the girls.
All of us who have had infant surgery for a bowel complaint like pyloric stenosis (by far the most common culprit) hold their breath for a few months after the birth of our offspring. My wife and I were certainly on high alert four times for a recurrence of the trauma I visited on my parents two generations ago! Our fourth (and last) was an enthusiastic puker for a while, but we remain thankful that this never developed into the projectile vomiting and bowel blockage I had.
I have posted three times in recent months about the distress which adhesions bring to some who have had surgery during their infancy. This time I want to review some of what I have learnt from women who have posted about their experience of pregnancy in the light of their having had pyloric stenosis.
Understandably I’m writing this post with some trepidation… I do so as a male who has been through four pregnancies and births with my married partner of 46+ years, and just as importantly, as one who has seen serious questions raised rather often on internet forums and blogs. Having learnt so much about the possible long term effects of infant surgery, I am passionate about sharing the issues and some of the material I have read.
So here we go…
Will my surgery and scar stop me from having children?
Certainly not. Some few people worry about this but there is no connection between the defects of and repairs to our food passage and our ability to carry a baby.
What’s more, the old scar will not tear open or become unsafe. A surgery scar may affect the surrounding tissue as it is stretched: it is not as supple, but after a year or two, a surgical wound has developed scar tissue which is very tough. Massaging the scar area with a topical cream may help it become more supple than otherwise.
Will my surgery and scar affect my pregnancy?
It probably won’t – but it may.
I find it telling that I have never come across any research on this and must doubt that this important although passing possibility is given much attention. I do imagine it must be hard to find the subjects for such a study.
Worse, I have not yet heard of a doctor who actually dealt with a patient’s clear symptoms of adhesions from upper abdominal surgery adding to the discomfort of her pregnancy. Everybody whose story I’ve read says her doctor ignored, sidelined or brushed off her concern. Again, I realise doctors have a schedule to maintain and must stay focused on the core reason for the consultation (in this case managing the pregnancy), but from everything I have read and experienced myself, doctors could do much better in dealing with their patients’ expressed concerns – or directing these to others more expert in the area concerned.
Something to watch out for is that several people report their doctor having blamed their pain on an inflammation of the gall bladder or caused by the liver, and I even have several reports of people having gall bladder surgery which proved to be unnecessary! Wow! Make sure there is a thorough diagnosis before you go too far down this path.
The good news is that adhesions in the abdomen seem to affect only a small percentage of those pregnant women who have had surgery here. Almost all mothers with a pyloric stenosis (and other) surgery history report that their pregnancy was not affected by it very much or at all. Several comment that there was some discomfort around the scar, but elsewhere too. Adhesions from endometriosis, gynaecological conditions and surgery of the lower abdomen do cause many problems – but that is not within the scope of this blog.
The bad news is that for an unknown but probably small percentage of women, a pregnancy after abdominal surgery brings with it some additional problems. As well as itching, these may include tearing, jabbing or stabbing feelings, mild or severe pain in the middle to right upper abdomen, and in some cases even some bleeding. Certainly uncomfortable and distressing, but nothing more serious from a medical point of view.
One sufferer wrote: The pain is at best mild, but can get worse, usually 30-45 minutes after eating. It is constant, but I have learnt to recognise, offset and control it with painkillers.
Another mother-to-be has written: It feels as though the scar is somehow attached to my ribs and my growing belly is pulling on it. It feels like something is slowly being ripped inside of me, some days it is a slight ache while others it is a throbbing /shooting pain on my side. It seems to come later in the day, as if the pull of the weight of the baby is straining it somehow. Also, some days it feels numb and tingly, but not in a good way.
A third young woman wrote: My scar just feels like it’s going to bust open…. The pulling, burning and stabbing pains are becoming unbearable…
Will my baby have what I had?
It all depends. On the web there are statistics on the various possibilities: only one in three or four pyloric stenosis cases is female, but a mother with a PS history is more likely (about 20%) than a father (about 5%) to have a child with the problem. PS can also skip a generation or two and occur on different branches of the family tree; in some families there are many sufferers, but in my family I’m the only one so far (and as far as I know). I plan to post more about this at a later date.
Can my baby be tested for an abnormality pre-birth?
Scans very sometimes show up “minor” defects like pyloric stenosis, but not with great certainty. Scans may or may not show up a particular abnormality, and the baby’s later development often “overtakes” early scans. Some abdominal defects are truly congenital (present at birth); others like pyloric stenosis almost always develop after birth (but 20% show up very early, well before the usual range of between 3 weeks and 3 months).
What can I do about the grief my scar is giving me during my pregnancy?
The value of massaging and skin creams is emphasised by some and doubted by others: try it and make up your own mind! Using mild and doctor-approved pain medication in later pregnancy is probably the best course. It is sensible to keep weight gain to a safe minimum to reduce pressure on the abdominal wall and scar region. Some women report that pregnancy stretched and smoothed out their scar; other mothers report their scar looked (even more) unsightly and affected the surrounding area; if this remains so after the birth it can be reduced later by plastic surgery.
My scar affected my last pregnancy: should I expect this again?
Every pregnancy is different: there are countless variables. Despite this, women with adhesion-like pain generally report having increasing discomfort during later pregnancies.
Finally, if you are uncertain about something related to the subject of this post, or are convinced something needs to be checked out, please urge and be prepared to pressure your doctor to work with you. Read my recent post on getting supportive help in this!
Please remember that this blog is an overview of what information websites and web correspondents have put on the record and that it is not personal or professional advice.