Hi there,

Just wondering whether anybody has been in the same situation as me and can offer some advice. Backstory - Basically, I've had a chronic AF for about 5 years now, been to docs many times and have had tried loads of treatments but nothings worked long term. I went to see a surgeon a few years ago after getting fed up and he just told me that there was absolutely no way he was going to operate on me because it wasnt that bad in his opinion, and that I'm far too young (i was 19 at the time), so I basically went away thinking that surgery was never going to be an option for me. Anyway, I've learned to 'live' with it now, it has its good days and bad days and I can pretty much put up with it most of the time.

But my question is whether any of you have experienced a chronic AF during pregnancy, i.e. it existed before conception? Me and my boyfriend are wanting to start a family but I'm worried about the impact that pregnancy might have on the AF, not least the birth. I would imagine that giving birth naturally would not be good for an unhealed fissure - would this constitute as a 'medical reason' to have a C-section? If anybody has any advice I would appreciate it, it would be nice to know what to expect before hand!

Thank you in advance!

Hi there,
I have not been in the same situation as you but just wanted to offer some of my experience and suggestions. First, sorry that you are suffering with this. It is not fun!
I guess I can see why your doc doesn't want to do surgery...although some people have great results. I did not have LIS, I had botox and it healed my deep and significant fissure. Maybe that is an option for you? I would think that it is really best to begin a pregnancy in the best of health. You don't want to put pressure on that area until it is healed. Just my opinion. However, blood flow is great during pregnancy and I have heard of people having no problems at all during heir pregnancy. I had issues with a fissure years ago but didn't realize it until it got very bad this past May and then I had botox.
I have a 2 year old and I know that the pushing contributed to the fissure. Although, in my case I wound up having a section after labor and pushing for a few hours! It was a real bummer!
But I can tell you that there is no way I will try to push my next baby out. I will definitely have a c section. I absolutely think this qualifies as a reason to have a section. Some might disagree but after the hell I have been through I know I will not risk getting this in childbirth. No way. And any doctor or midwife who disagrees with me would not be the right person for me.
This is obviously just my experience. I'm sure you will figure out what will be best for you :) Do try to heal before gettig pregnant though. Good luck and keep us posted!

I would call your obgyn and ask. They would be the ones to make the call and I am sure each doctor is different.

I did find this discussion about pregnancy after LIS. Slightly different situation but wanted to pass it along.
http://www.healthboards.com/boards/preg ... otomy.html

Best to discuss it with your doctor. In my situation, I suffered with fissures since college and suffered on and off for 10 years with retears. I never had any botox or LIS, but I did have one of my fissures cauterized. I was also worried about what would happen with my fissures during pregnancy due to increased constipation and hemorrhoid complaints.
As I stated previously on another post, my fissures were non-existent during my pregnancy. I was never constipated, never had a painful bowel movement, and never had pain the whole time. It was amazing! After birth is a whole other story but during the pregnancy I was great, never better. I was told it was due to the increased blood flow to the area and the hormonal changes to relax the pelvis in preparation for birth.

My delivery was pretty rough with tearing and suction assistance needed, but my fissures did not seem to be affected. It wasn't until a month or so later that post-partum factors led to retearing. Everyone's story and body is different, but that is how it was for me. Hope that helps!

wl1014 wrote:Best to discuss it with your doctor. In my situation, I suffered with fissures since college and suffered on and off for 10 years with retears. I never had any botox or LIS, but I did have one of my fissures cauterized. I was also worried about what would happen with my fissures during pregnancy due to increased constipation and hemorrhoid complaints.
As I stated previously on another post, my fissures were non-existent during my pregnancy. I was never constipated, never had a painful bowel movement, and never had pain the whole time. It was amazing! After birth is a whole other story but during the pregnancy I was great, never better. I was told it was due to the increased blood flow to the area and the hormonal changes to relax the pelvis in preparation for birth.

My delivery was pretty rough with tearing and suction assistance needed, but my fissures did not seem to be affected. It wasn't until a month or so later that post-partum factors led to retearing. Everyone's story and body is different, but that is how it was for me. Hope that helps!

Hi, thanks for the reply! That makes me feel so much better, i never thought that the increased blood flow might help, and glad to hear that your fissures weren't affected by the birth.

jlm1 wrote:Hi there,
I have not been in the same situation as you but just wanted to offer some of my experience and suggestions. First, sorry that you are suffering with this. It is not fun!
I guess I can see why your doc doesn't want to do surgery...although some people have great results. I did not have LIS, I had botox and it healed my deep and significant fissure. Maybe that is an option for you? I would think that it is really best to begin a pregnancy in the best of health. You don't want to put pressure on that area until it is healed. Just my opinion. However, blood flow is great during pregnancy and I have heard of people having no problems at all during heir pregnancy. I had issues with a fissure years ago but didn't realize it until it got very bad this past May and then I had botox.
I have a 2 year old and I know that the pushing contributed to the fissure. Although, in my case I wound up having a section after labor and pushing for a few hours! It was a real bummer!
But I can tell you that there is no way I will try to push my next baby out. I will definitely have a c section. I absolutely think this qualifies as a reason to have a section. Some might disagree but after the hell I have been through I know I will not risk getting this in childbirth. No way. And any doctor or midwife who disagrees with me would not be the right person for me.
This is obviously just my experience. I'm sure you will figure out what will be best for you :) Do try to heal before gettig pregnant though. Good luck and keep us posted!

Thanks for the reply, I had never considered botox as a treatment, Ill look into it definitely. I agree that it would be better to begin the pregnancy in full health, but its hard not to lose hope that it will ever get better. I am going to make an extra effort to try and get it to heal though, or at least get it 'better' than it usually is. Sorry to hear you ended up having to have a c section in the end after all the pushing! I will definitely see my doctor beforehand to see what they say about it all, I'll tell them my concerns and hopefully they will either tell me that a natural birth wont affect it or that it would qualify as a medical reason to have a c section. I'm also just under 5ft and really petite so you never know i might be able to qualify for being teeny lol! Not sure how small you have to be before they suggest it :P

Thanks again :)

My first baby was an emergency c-section, and I was so happy to get my natural birth this time. I'm almost 2 months postpartum and now I think if I could go back in time I would choose the c-section. My c-section recovery was so, so much easier than this. Although with my first daughter I never got to the pushing phase. I've developed an anal fissure that they believe was caused by childbirth, and this pain is even worse than childbirth, in my opinion. Not the initial BM but the spasms that follow for hours afterwards. The only thing that gives me comfort in my decision to have a vbac is that I did find I bonded much more quickly with this baby and mentally I was better, no postpartum depression this time, which I had with my first. I believe the c-section contributed to it the first time, because you don't get that wonderful rush of endorphines and joy that you get with a vaginal birth. I dont' know if that helps at all. In my opinion, I would rather die than give birth with an ongoing fissure. I do think that could make it a whole lot worse and really become debilitating. I would either make sure it's completely resolved before giving birth, or opt for a c-section if that's an option.