Malone antegrade continence enema (MACE) procedures are an effective treatment for both intractable faecal incontinence and constipation of neurogenic aetiology and have traditionally been used in a paediatric setting. MACE procedures are now being performed more commonly in adults suffering idiopathic chronic constipation where they are also effective. Increasing use in otherwise healthy adult females raises concerns about the durability of the appendiceal conduit should the patient become pregnant. We report the first case of successful pregnancy after a MACE procedure with an umbilical stoma and discuss the impact of the pregnancy on MACE function.