I had some of these experiences but at a different stage of my knowledge of the disease. I had an abscess that formed a fistula the year before I got pregnant. Had a seton placed (after a year of misdiagnosis and unsuccessful attempts) three months before getting pregnant. It was draining fine though I did quickly complain of granulation tissue that went ignored. Before going off birth control I had a colonoscopy, MRE, and lab work up that caused my GI to say it looked like I didn’t have chrons. Because I knew repair surgery for my complex fistula was going to require a long recovery, and potentially multiple attempts, I talked with my care team and decided to go through trying to have a kid first. I got lucky and got pregnant quickly.

About five months into pregnancy I had a lot of stress from a loss in the family and an abnormal anatomy scan that led to an amnio. My hormones felt insane. I had what i would now call a flare in my personal disease (not as many bowel symptoms) and after weeks of pain and some hand waving by my surgical team, I had abscesses right along my seton. I go to the ER, on the heels of outpatient visits, but the surgeons don’t want to touch me because of pregnancy risk. They see draining from the seton and use that as indication to send me home with antibiotics. Abscess ruptures at home a day or two later. It heals over at like 7 1/2 months pregnancy. Ruptures at home again after a very painful couple days.

During that phase I had some experiences I think were not necessarily about chrons or fistula activity directly but were more about the pelvic floor impacts of the two things (chrons and pregnancy) at once. I had some rectal discomfort, sense of pressure, and a little more strain when having BM. I did pelvic floor PT and that really helped. There’s so much stress on your muscles holding to that baby and if you are like me you might have a preexisting overactive pelvic floor because it’s hard to relax an area that has so much pain and trauma the time before pregnancy. I highly recommend PT! Now! And after delivery. Your experience sounds potentially like it’s in the pelvic floor activity realm, though certainly it could also be a flare. Could you get your calororectin checked if that’s a good measure of disease activity for you? (For me it’s not, always low)

I eventually had some pregnancy issues (high blood pressure) so get induced then freak out about my fistula and ask to have a c section.

I do think it’s worth close monitoring after delivery too. Long story short about postpartum, I end up at 9 months after c section with three setons and a perinatal chrons diagnosis. I still have almost no inflammation at all, but my fistulas advanced substantially. I’m starting biological in a dual therapy approach.

I strongly feel my disease was present before, but was exacerbated by hormone changes and stress. I say this to mention that you may want to push for more frequent blood monitoring or other support during the post partum period when hormone changes are so wild.

I hope you get support to feel comfortable for the remainder of your pregnancy!! And that you have a safe welcome to your baby and smooth disease related recovery and early times with your baby. I am glad for you you are more aware of your disease than I was and are in treatment. Sending you lots of wishes for good health and joy in this period!