Impact of birth injuries/prolapse etc

I had an emergency c-section but started labour. I can't recall it all but it appears after the fact no one checked my cervix etc. I was left with severe scarring to the cervix and a prolapse both of which mean I can't even have a smear without general anaesthetic or an epidural. So every time I need a smear I have to take a whole day out and take up a hospital bed. The thing is every freaking time they query it again and I go through at least one failed (and painful attempt) to take the smear - EVEN THOUGH the specialist told me I have to go into hospital for the smear they can never take me or my notes at my word. Wasn't so bad this time as my doctor now is excellent (and female). The hospital experience this time was ... interesting, but that's another story.

Not as bad as some examples here but this kind of thing is very much a feminist issue. I'm pretty damn sure more would be done if it was men going through this kind of thing.

Two really bad tears here - 3rd degree but nearly fourth. Severely damaged sphincter.

I remember being pleased that a female surgeon stitched me up twice. Thank goodness I had a good team with regards to the repair of the tears. Also they did allow me to talk through the traumatic births in each occasion with my medical notes.

Severe blood loss meant I could really walk properly and I lost all strength in my legs and still can't squat for example I can't get off a floor by myself need someone or some furniture to lean on. I can't sit down and get up easily unless I can lean on something to transfer my weight.

Not making it to the toilet nor being able to control bowel movements has really been awful at times. I always need to know where the toilets are and they need to be close. I can't be stuck in a queue for toilets.

I also remember going for tests where I had to pee myself in front of a group of medical staff and they also inserted balloons in me and so on. During this whole fucking bullshit episode I was called "Mum".

They couldn't even read my name even if I asked them to say my name.

This infantile way of addressing me meant I could really be bothered trusting them about any operations as I figured if they could met actually read my notes and address me by my name I couldn't trust them. Thank god given the vaginal mesh fiasco I didn't trust them.

The best help I had was from a medical specialist for a different bowel problem. His advice was quite good, especially about how pelvic floors weaken more after menopause.
I manage my condition well. my pelvic floor may strengthen a bit after breastfeeding - it did and also this good specialist told me not to listen to the colerectol Surgeon who told me not to go running

I could never stay at someone's house for example as urge incontinence isn't pleasant but I manage it.

Yes I think the risks should be detailed to women.

I also remember reading a book by Naomi wolf where olive oil was used on the perineum on the recommendation of midwives to help skin not tear - wish I had read stuff like that and been informed before I gave birth.

The only thing I can tell you is that from looking things up to have my rectocele repair, it would appear that the pelvis is full of connective tissues, such as ligaments and fascias, that are all interconnected with the muscles. I think you need to hold everything in and be tall, but not worry so much about the standing - you need to move and do a wide variety of movement and enjoy doing it. Running, walking, climbing, jumping, bending, reaching, balancing etc. I have done a variety of dance classes over the years, and yoga and pilates. Some are better than others. Belly dancing is supposed to be good - if you are not keen on the come hither sort there is the tribal sort.

The physio I saw post of said If you do pelvic floor exercises, you also need to do pelvic relaxation exercises. (sniff, drop, flop or something )

I am convinced fell walking is the thing. They always look very wiry and have good core strength. It is all the difficult surfaces. I cannot get up the hills though .

Jogging and planks are not good for pelvic floors or continence.

I would love to know how ditch the tena if anyone has any tips?

I know it's minor compared to a lot of the problems on here but if pelvic floor exercises aren't they way to go what is?

yesterday I was happily letting my spine curve rather than trying to "stand up straight" and I've got to say it was lovely and comfy. Not that I stand up straight obsessively but I think subconsciously my posture has been altered over the years.

Dr Phil Hammond just retweeted a new analysis of the research done on ‘Pelvic floor muscle training for prevention and treatment of urinary & faecal incontinence in antenatal and postnatal women’.

There is a plain language summary included, which concludes:

“Overall, studies were not large and most had design problems, including limited details on how women were randomly allocated into groups, and poor reporting of measurements... Evidence quality was generally low to very low.”

onlinelibrary.wiley.com/doi/10.1002/14651858.CD007471.pub3/abstract?utm_content=buffer89cf8&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

The maternal death rate even in the 1930s in the UK was 40 per 1000 live births!

And I think that during the 1600s & 1700s it was even worse. In Freakonomics it stated that the average woman’s lifespan has only just taken over man’s as death in childbirth lowered the average considerably.

I’m not sure (current Mesh/prolapse scandal aside) that it’s overt sexism but more of a general ignorance and tendency to look at men at the default.

Take the history of hand-washing and that poor doctor who noticed that in the maternity clinic the mortality rate was as high as 1 in 5 (which was also incidentally the street birth death rate!) when doctors came straight to the ward from touching cadavers.

So he suggested the doctors washed their hands. There was such an outcry they committed him to an insane asylum.

www.methodquarterly.com/2014/11/handwashing/

NotAgainYoda: "Keep up the good work!"

Thank you! Even though I read lot of accounts by women about their traumatic birth experiences, this thread has still been jaw-dropping. It's unbelievable that severe birth injuries are just dismissed or trivialised.

I had a maternal request elcs because of a previous sexual assault. Trying to persuade the consultant that I was able to understand the risks of the procedure was absolutely hellish.

Let me correct you there. You didn't have a maternal request ELCS, you had an ELCS for psychological and mental health reasons.

The former frames you as a demanding entitled woman who doesn't take the risks seriously and is incapable of doing so, whilst the latter frames your doctor as an insensitive tosser who didn't take your overall well being and health into consideration and doesn't consider you able to make an informed decision about your health care.

Language and framing is important. It creates a totally different understanding and context.

They did, Quentin, but the wastage, so to speak, was astronomical. The maternal death rate even in the 1930s in the UK was 40 per 1000 live births! That's an unthinkable rate - it's come down a hundredfold since then. There are descriptions of maternal morbidity by health visitors in the 1930s that are jaw-droppingly horrifying. A majority of the poor women that they saw had life-changing health consequences from childbirth. Some of the descriptions on this thread probably come close to what used to be the norm, except without painkillers, without access to running water or indoor toilets, without access to contraception to prevent (multiple) further births, and without any possibility of surgical remedy or even basic medical assistance. [disclaimer - this used to be a professional interest ]

This is fascinating. I had no idea about the spinal curve etc.

"how our foremothers managed before modern medicine"

The answer is that they really didn't! The rate of significant morbidity in mothers before the advent of the NHS was exponentially higher than today. I'm fully on board with highlighting the inherent misogyny and clinical shortcomings of the system today, but there's no way in the world we can contrast it to some previous golden age. I'm still bitter from hearing my NCT teacher say 'well women in the third world manage fine giving birth in fields' .

MaudlinMews it must be something genetic with my family. DB has had various problems with his groin since childhood, and has had haemorrhoids since he was about 17. We don't talk in that much detail about our pelvic problems, but I know he has a lot of discomfort in his "gooch" (perineum).

My dad is another long-term piles sufferer and he has a hiatus hernia.

And sorry yes of course, your last paragraph was spot on hinged

Being "perfectly designed" isn't really a concept that I'm on board from a feminist perspective as well as a clinical one.

Indeed! I didn’t mean to sound like a proponent of Intelligent Design (perish the thought!) but was using the colloquialism commonly used when describing the ways in which our bodies have evolved to adapt to the challenges thrown at them.

Of course there is still the problem of the excessively large human head and the dangers this has led to in childbirth but that the female pelvic anatomy has adapted adequately to keep pelvic organs in order and is not defective in that regard was my point.

@IfyouseeRitaMoreno that's absolutely fascinating. Thanks for linking to it.

I had a maternal request elcs because of a previous sexual assault. Trying to persuade the consultant that I was able to understand the risks of the procedure was absolutely hellish. And he behaved as if there were no risks at all to a vaginal delivery. In the end, dd's birth was very positive, but I don't think I should have had to fight tooth and nail to get it, in the way that I did.

Our foremothers suffered from pelvic organ prolapse, as well.

"It really isn’t a design flaw with women’s bodies. Women’s bodies are perfectly designed to keep the pelvic organs in and sitting nicely on top of the pubic bone. That is why women have that curved lumbar spine at the back, tilting everything forward."

Loss of lordosis (the curvature) is considered to be a factor in prolapse development, but I think that's quite a simplification when looking at the role of levator ani injury during labour, connective tissue disease, oestrogen and hormonal problems/deficiencies etc. and not least the anatomy of the female pelvis. Men do experience prolapse, but there's in the majority of cases there's a different aetiology (obviously because the role of pregnancy and birth in women). It's often seen in men that lift heavy weights/into high impact activity.

I think that observing things like the "obstetric dilemma" of the female pelvis/birth canal vs. the size of the infant head, as " design flaws" isn't necessarily bad (at Uni, we were taught these were design trade offs). Being "perfectly designed" isn't really a concept that I'm on board from a feminist perspective as well as a clinical one.

It's the step beyond an observation of why and how things go wrong, to "oh well you're inherently flawed" that's so damaging as it's that that reduces the clinical importance and also clinical interest.

... psychodrama and it’s no wonder we think it’s a burden we’re destined to carry.

Here’s a good blogpost on how Dr Kegel and other gynaecologists got it wrong if you’re interested:

wholewoman.com/blog/?p=1528

Yep. I was always under the impression that women’s bodies were somehow defective. Add to that the whole Eve a variation of Adam

I never knew that about our spines.

Girls are always being told to straighten up as the curved lower back thing is considered not right for some reason.

Fucks sake.

Yes Quentin, me too! When I found this out it was a revelation. The traditional notion has always been that there a kind of “hole” at the floor of women’s pelvic area where the organs will fall out if the muscles weaken and that’s why we need to “pull it all in”!

But our natural posture is to tilt forward. And yet we are continually advised against it. That’s why even women who haven’t had children also get prolapse. But childbirth makes it worse. Think of the reclining position they put us in whilst we push! It’s so bad.

I was talking to a friend the other day who was explaining that it wasn't that medical science is / was sexist, but that women's bodies are inherently deficient.

Patriarchy really has done a number on us.