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Original poster

Childbirth injury risks

11 replies

BackInTime · 01/06/2018 23:42

A discussion among friends about our childbirth experiences has made me think that not enough information is given to women about the possibility of injuries and long term problems as a result of a vaginal delivery. Almost all of us have ongoing incontinence, some had bad tears and one has had a prolapse needing surgery. These things are impacting women’s lives years after giving birth. It seems to be a hidden problem with many women suffering in silence.

AIBU to think that women need to be more informed about risks of a vaginal delivery especially in situations where there’s a high risk of injury like with a big baby?

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MNHQ

RowanMumsnet · 07/06/2018 10:46

@Yarnswift

I do think that women are talking about issues like prolapse more and more

I’m fighting for a repeat cs at the moment and I think I have found data that shows this. It’s in Swedish, and it’s the latest from socialstyresten ‘Komplikationer efter
förlossning: Riskfaktorer för bristningar, samt direkta och långsiktiga komplikationer’

There’s a table on risk of anal sphincter injuries that shows that they are more common in women with higher education. Now after we’d had a chuckle about rarified arses, DH and I discussed that, because we are both scientists, and we know that when you get a result like that, it’s generally necausevthe higher the education level, the less crap women put up with, the more likely they are to complain etc.
And that means if you think about it that all the other rates are probably under reported.

Anyway, tucked right at the end in appendix three of that report is a table that shows thirty year outcomes. The highest incidence of complications is for women who have had BOTH vaginal and cs births.

Incidentally, when he was reading this and helping me translate, DHs main observation was that ‘why on earth isn’t there more data on this?’ To which the reply was ‘because it’s womens health love, no one gives a fuck.’

Hello!

Just happened to spot this thread on Active (and must admit I haven't read the entire thing yet) but wanted to highlight that filling this data gap is something we're campaigning for as part of our Better Postnatal Care campaign. There's a full update on where we are with that here - we'd love you all to support and follow along if this is something you're interested in. (If you want to be added to our email list for updates about the campaign - with an absolute No Spam Guarantee - drop us an email on [email protected]).

Our developing thoughts on this are that it could be tacked by something called PROMs (patient-recorded outcome measures - will be familiar to those of you who work in healthcare), which would involve women who've given birth being asked a standardised set of questions about their pelvic/anal/vaginal wellbeing at regular intervals when they see their GPs. This info could be anonymised and collected centrally (along with info about their birth modes) and could build up over the years into a useful data set that could help HCPs to give pregnant women better info about risk.

Would love feedback on the idea!

Thanks - off to read the whole thread

MNHQ

MNHQ

RowanMumsnet · 07/06/2018 10:58

@Yarnswift

I think that would be great - it’s clear from the Swedish data that these things are underreported. I think there’s a definite attitude of that just how it is. actually asking the question of women will make them realise it isn't inevitable and that it is an issue. I’d be all for this.

Brilliant campaign MNHQ, really hope you get somewhere with it.

Thank you! Good luck with your efforts for the birth you want - Birthrights might be able to help if you haven't found them already

MNHQ

RowanMumsnet · 07/06/2018 11:30

@tiddlyipom

www.mumsnet.com/Talk/mumsnet_campaigns/3211564-MNHQ-here-the-impact-of-birth-on-womens-bodies-wellbeing-and-sex-lives

Didn't post the first post after all.....
Everyone should read and get involved in this campaign.

Ah thank you @tiddlyipom Flowers

I should say, the call for universal offer of postnatal physio is v much part of the campaign too - and lots and lots of other organisations and some MPs are very much on board with this one

MNHQ

RowanMumsnet · 07/06/2018 11:43

@MrJohnReese

In my area all pregnant women and those up to 6 weeks postnatal can self refer to women's physio. I refuse to believe we are the only area where this is possible.

Oh! @MrJohnReese if you'd be up for emailing ([email protected]) or PMing me to tell me whereabouts you are that would be really useful

MNHQ

RowanMumsnet · 07/06/2018 11:46

@FluctuatNecMergitur

If it helps Rowan the figures I quote come from here static.cnsf.asso.fr/wp-content/uploads/2018/05/R%C3%A9%C3%A9ducation-pelvi-p%C3%A9rin%C3%A9ale-2014.pdf If anyone at MNHQ reads French there's a brilliant questionnaire at the back. It bears repeating, ALL new mums in France get this automatically.

The report also states that 25 to 45 percent of women suffer urine incontinence and over 20 percent of women anal incontinence.

Can anyone tweet MD in Private Eye? I bet he'd be all over this.

I

I'm a hopeless monoglot I'm afraid but yes, all the organisations lobbying for universal postnatal physio talk about the French experience a LOT. I haven't got to your previous post yet (still reading from the beginning) - do the French stats show long-term outcomes? I know one organisation is trying to track down outcome studies for the French postnatal programme to use in persuading the NHS of the benefits

MNHQ

RowanMumsnet · 07/06/2018 12:01

Durr sorry Fluctuat, it's right there in your post a couple of posts back - sorry. The women at Pelvic Floor Patrol will be very grateful!

@RowanMumsnet

[quote FluctuatNecMergitur] If it helps Rowan the figures I quote come from here static.cnsf.asso.fr/wp-content/uploads/2018/05/R%C3%A9%C3%A9ducation-pelvi-p%C3%A9rin%C3%A9ale-2014.pdf If anyone at MNHQ reads French there's a brilliant questionnaire at the back. It bears repeating, ALL new mums in France get this automatically.

The report also states that 25 to 45 percent of women suffer urine incontinence and over 20 percent of women anal incontinence.

Can anyone tweet MD in Private Eye? I bet he'd be all over this.

I

I'm a hopeless monoglot I'm afraid but yes, all the organisations lobbying for universal postnatal physio talk about the French experience a LOT. I haven't got to your previous post yet (still reading from the beginning) - do the French stats show long-term outcomes? I know one organisation is trying to track down outcome studies for the French postnatal programme to use in persuading the NHS of the benefits[/quote]

MNHQ

RowanMumsnet · 07/06/2018 13:24

[quote blacklister]@MNHQ - This thread might be interesting in light of your recent campaign regarding post-natal care. It's very relevant. [/quote]

And thank you @blacklister!

MNHQ

RowanMumsnet · 07/06/2018 13:28

@FluctuatNecMergitur

Here you go Rowan, this is another useful link you can pass on: www.hal.inserm.fr/inserm-00370068/document

Happy to lend my language skills to the cause if it helps.

Brilliant, thank you - I'll pass that on

MNHQ

RowanMumsnet · 07/06/2018 13:32

@Yarnswift

The very recent (may 2018) Swedish data - happy to translate any bits of it you want:

www.socialstyrelsen.se/publikationer2018/2018-5-20

Long term follow up data is in appendix 3.

If you could bear to translate the 30-year outcomes table that would be amazing (I had a try at the summary with Google Translate and I think it got most of it, although there were references to 'emperor' rates - not sure whether that's an actual statistical thing or a Translate error!)

MNHQ

RowanMumsnet · 07/06/2018 13:40

On litigation costs - one measure being taken by NHS England at the moment is that in order to qualify for a discount on their contributions to the central litigation insurance scheme (NHST Resolution), maternity units have to reach Birth Rate Plus staffing levels (a staffing rate designated as safe and calculated individually for each unit by a specialist team, as I understand it).

Not strictly relevant to the topic, but thought I'd pass it on as it struck me as interesting when I heard it - and when we stand back and look at the bigger picture, it seems likely that staffing rates on maternity units affect lots of the issues being discussed here.

(Disclaimer: as a civilian I'm only half-understanding what I hear in some of these meetings, so it's possible I've mangled this information somewhere, although I don't think I have...)

MNHQ

RowanMumsnet · 07/06/2018 14:10

@Yarnswift caesar-cut!

Thank you so much for this, that's brilliant

Also want to thank @CatchingBabies and @Shrimpi, it's so helpful to get a glimpse of how HCPs approach these things and what the limitations are

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