Perineums can be functional after childbirth

Like Mears, I've also had four babies. I had three episiotomies, escaping the dreaded scissors for my last baby. I've never had any incontinence problems despite being remiss about PFE's.

Would also like to add words of reassurance. Two children, both vaginal delivery. First high forceps, ventouse, epi and tearing. Second, natural delivery but bad 2nd degree tear. Lots of stitching on both occasions.
Two years on lower regions in great shape: absolutely no leakage whatsoever even under the serious strain of hacking coughs, violent sneezing or having children jump on my stomach. Also, don't know whether it is fantastic stitching or doing pelvic floor but I am 'tighter' than I was pre-babies!!!

Oops - I meant "stress OR urge"! And I can be a camel, not going for ages!

No leaking - stress of urge - but apparently a kanckered pelvic floor!

It seems the two muscles that are still "working" are doing such a good job, plus I have developed good "coping" mechanisms, such as automtically "bracing" before coughing or sneezing, that I don't experience a problem.

Thnak you Pilates for that small mercy!

The only reason that I realise that I DO have a problem is (and sorry to be graphic) is that I can no longer hold a tampon in properly - if I go to the loo and strain at all, it just pops out.

Thanks to Mumsnetters telling me that this was not normal, I did arrange a referral to see a physio and am finally getting "treatment". (Much delayed, first by waiting lists, then by pregnancy, then miscarriage, then not getting round to making a new appointment o)!). Ds is only 3.5!

It turns out that the forceps and/or the episiotomy (probably the former) caused some damage - or it could have been ds' weight (over 4kg) or his big head (91st centile). 4 out of the 6 muscles (if that is the best way to describe them) are wasted and I have lost the "cough" reflex.

The point is, the exercsies that I have been given are just the standard pelvic floor exercies - I am just having to do more of them, plus once a day, do them with a bit of "biofeedback" (o) - a wee pointer that moves the right way if you are doing them right - at the moment, I can only get it to move a tiny bit).

I had compensated in my Pilates class and had developed good abs (beneath the layer of fat!) and very strong "back" pelvic floor muscles. My technique is apprently fine, I breath properly - it's just 4 of the muscles are wasted.

I'll find out in 2 weeks time (ie 4 weeks after my first real appointment) if there is any improvement. I hope so! This is hard work - although I do try NOT to go cross eyed!

Episiotomy plus 3rd degree tear with huuuge DS1, "elective" episiotomy with DS2, no pelvic floor exercises and no leaking!

My perineum is fully functioning, and thinking of signing up for an Open University Course....

surely perinea???

Mine is rubbish and I didn't even have a VB!

I'm with you Mears, I have lawys done pelvic floors, not as often as I should and after two vaginal deliveries, have not really had any problems...
Nor any other problems, even the piles went away ish LOL

sTRIPYMOUSE

I do them waiting for the bus or the train, or at home, or doctor's surgery. DIdn't do much with first baby, and even though I only had a minor tear, but still have stress incontinece after 3 years! Mind you it started in pregnancy, and I thought once I had the baby it would get better, so taht's why I was so laid back about it.

I'm now 14 weeks with second baby and I do them everywhere, anytime I remember!!!

JJ to answer your question: I did!!!!

Just a question: how many of you have read these last few posts and done the exercises? I now must do them crosseyed and with all sorts of sucky-inny tummy stuff happening.

Freelance journalism is VERY glamorous, eddm, as you can see.

MI, I've now got a mental image of you sitting on your desk, going cross-eyed, pulling your navel in while simultaneously typing posts on MN!
Stripeymouse, I feel the same way but do do them in lifts when I'm alone - always wonder if there's a security camera in there though (just because you are paranoid doesn't mean...)

I do them at my desk. At home, though

I do PFE when I'm standing in queues... helps to absorb the frustration I feel at slow staff on shop tills!

Do any of you really, truly, honestly do these pelvic exercises in places like the bus and at work?!! I am seriously impressed if you do manage it and are doing them properly. I am sure I go slightly red, a bit cross eyed and grimace with a "I?m really concentrating hard" look on my face. I wouldn?t dream of doing it in public, esp. not driving - could cause an accident or worry passers by thinking I was having a seisure or something

Now, young mears - just to show I do balanced research :0

I'm sure my sister won't mind me using her story as a good vag birth........

her first birth, in a large teaching hospital, was probably 'good' by NHS standards but she had a bit of really unecessary intervention, instead of being left to it (she arrived at the hospital at 10cm!) As soon as she got there, lots of vag examinations, an oxytocin drip, multiple midwifes - she was terrified after doing sooooooo well on her own at home. Anyway, lovely baby, minor graze, no gas & air or epi etc. But she felt let down.

2nd birth - midwife-led unit in a small hospital. Delivery room looking out to sea, midwifes asking her -'what do you want us to do?', bringing her cups of tea etc. She said she never felt so relaxed and baby popped out no probs with no intervention at all. No damage.

I asked her why she didn't have the 2nd at home if it was so easy and she replied that it was nice to leave someone else to tidy up the gore! (and she was worried the dog might pull the placenta out of the bin ).

After such good births she then felt she had the energy to concentrate on BF, which she did with both for 6 months each.

She's been such a good role model for me - cheers sis

Oh, and this is the exercise we did lots of in my antenatal pilates class which involved the old pelvic floor - plus lower abdomen (I posted it on CD's flabby tummy thread as well).

?Breathe in, and then breathe out ? you do this exercise on the out-breath. The first thing you?re thinking of is drawing your navel back towards the spine, to pull your abdominals in. Then think of pulling your sitting-bones together by squeezing your lower gluteus muscles ? this will automatically lift the pelvic floor. This will strengthen two of your core stability muscle groups.?

You can do this while you?re waiting for the bus, sitting at your office chair, doing the washing-up and so on.

I thought it was the general wear and tear of pregnancy as much as vaginal delivery.

Not good for you, IMO, pregnancy. Bah.

I'm confused... if incontinence is just as common among women who have only had CSections (that's what MN told me recently)... then what difference does your perineum make? I got the impresion it was pregnancy that did the damage, not childbirth.

I had largish tears and episiotomies (because the tears were getting out of hand) with both my sons. The second was ventouse turned and the first was just really big headed. (Still is.) None of it (tears, cuts or repairs) hurt, although I was grumpy at the end and wanted the doctor to go away. (LEAVE ME ALONE ALREADY!) Both times they healed quickly and without problems. No problems with incontinence either and I'm a bit (ok, a lot) lazy with the pelvic floor exercises.

But sex after two weeks? No way -- not due to the damage, but the lack of sleep and drive.

Great thread -- I got quite fed up with reading all the pro-caesarean newspaper articles implying that every vaginal birth results in agony, forceps and incontinence.

I've had 3 vbs, dd1 episiotomy, ds largish tear (v. quick labour, 10lb baby, no time to get upright), dd2 (9lb 5oz), induction, small tear, no stitches.

The repair to the episiotomy was def. more painful than the tear.

Stripeymouse, maybe that's what I'm doing wrong! Find it impossible not to hold breath/suck tummy in. God. How do you manage it?

Mears - you say that pelvic floor are the easiest form of exercise. Not sure if I would agree with you there. I find them really really hard to do and after a nasty wake up call after DD1 was born I am fairly religious about daily PF exercise - have been now for 3 years. Despite this, I still feel like I am going cross eyed trying to "visualise", not pull in my tummy, carry on breathing while tucking in. Mind you, I have never been the most physically co-ordinated person and was rubbish at PE in school!

However, I do agree with you - blimey, are they important and what an incentive to do them...I worked on mine like mad after giving birth and getting a nasty wake up call when trying out that mid urine flow thing...The fear of catching a cold and embarrassing myself in public was the driving force behind keeping me going on those awful, illusive internal muscles. No probs now. Typical - the only unflabby, toned muscles I have in my whole body and they are the ones not to show!

One baby, big head - 98th centile, small tear, told by midwife to keep my legs together that night and should be ok - I was, no stitches. Don't wet myself at all. In fact the only person I know who does leak - am sure there are more but... - had 2 CSs.