How Endometriosis Affects Pregnancy



March is the month dedicated to raising awareness for endometriosis, and you might have seen the #1in10 campaign going on social media to highlight the reality of living with the condition.

Apart from affecting one in 10 women, the stats for endometriosis are dreary.  For starters, it takes an average of 10 years and several doctors to get and confirm a diagnosis of endometriosis. It is a very painful condition, that leaves its sufferers in some form of pain, almost on a daily basis. Endometriosis can cause infertility in about 50 percent of women living with it, no thanks to any of these issues:

  • scarring of the tubes and ovaries from endometriosis
  • problems with the quality of the egg
  • problems with the embryo travelling down the tube and implanting in the wall of the uterus due to damage from endometriosis
  • change of the organs in the pelvis such as adhesions with scarred pelvic tissue and blockage of the fallopian tubes

In the other half, who manage to get pregnant, their experience of pregnancy is somewhat different. In fact, their doctors are more than likely to put them under close-monitoring, because the painful condition can, at times, be exacerbated by pregnancy. But in some instances, pregnancy actually alleviates the painful condition, because higher progesterone levels can suppress endometriosis.

Akpo is a mother of one, who knows first-hand what being pregnant while dealing with endometriosis is like. For her, the first trimester was rough, not only because she was nauseous and couldn’t keep any food down, but because she was also cramping badly and bleeding intermittently.

She spent more time in the hospital than at home, because she always had one complaint or the other. When she crossed the first trimester with her precious cargo still intact, she wept with relief. Finally, God was answering her prayers, but she still had hospital appointments every other week.

Surprisingly, the second trimester was a smooth ride, except towards the end, when the cramping returned.  She was told it was Braxton hicks contractions, but the intensity of it felt like full blown contractions.

That was what Akpo endured throughout the third trimester, until her doctor suggested they induce her at 37 weeks, when the baby was still a no show and she was in a lot of pain.

After nine hours of labour, she was just 2 cm dilated, and was asked if she wanted to wait it out, but her husband said no and she was taken to the theatre for an emergency C-section, which went very well.

Today, her son will two years old in May, and already, Akpo is considering another baby, even though her endo has returned. However, she is hoping that she will have a spontaneous conception, just as she did the last time.

While endometriosis often makes conceiving a baby more difficult, it by no means prevents it, according to a review published in 2014 in Frontiers of Surgery and in Akpo’s story above.

Surgery to remove endometriosis lesions is one option. But risks with this approach include the possibility that endometriosis symptoms will actually get worse, and interfere with blood flow to the ovaries. Surgery can also create scar tissue that’s worse than the original endometrial growth.

That said, surgery is also often successful, leading to pregnancy in 30 to 80 per cent of women, though success depends in part on the severity of the condition.

Damipe is 32 years old and has been living with the condition since she was 16 years old.  She was the odd one out of her friends, and she had a lot more drama associated with her menstrual period. Her doctors had some treatments, which only served to suppress the symptoms, not necessarily address the root cause.

It took Damipe almost ten years before she was diagnosed with endometriosis, and it was chance discovery, which was confirmed by further tests.

Between the time she was diagnosed and now, Damipe has undergone at least four surgeries to ease her pain. The idea of a hysterectomy has even been pitched to her, and she was hysterical about it. She cried that the doctor would even think to suggest something like that to her, when she is yet to have a baby. She wondered if her case is that bad, that her doctor would be considering removing her womb completely.

Anyways, it was that moment that made Damipe shift the focus of her treatment. It was now all about fertility preservation, rather than just pain relieving treatment.


Because her organs have been very scarred, she had to resort to IVF.  After plenty of heartache, Damipe is now an expectant mom, who truly enjoys being pregnant, because for once in a long time, she wasn’t in pain on a daily basis.

While pregnancy can alleviate symptoms of endometriosis in some cases, it can present some other challenges during childbirth. Several studies have shown that endometriosis is a risk factor for:

  • the baby being born early – before 40 weeks
  • bleeding after the 24th week of pregnancy
  • high blood pressure (pre-eclampsia)
  • delivery by caesarean section (really?)

However, once baby is born healthy, there is really no side effect of the condition on the baby. And this is comforting.

Infact, it is comforting to know that endometriosis doesn’t put paid to the motherhood dream of moms living with the condition.



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