Episiotomy scar problems; saw the second gynae, not great news, feeling very sad.

[MrsTittleMouse]

I've posted a fair bit on here about my episitomy scar following a ventouse delivery that I was bullied into, and a series of doctors that were either useless or insulting or both.
I've now finally seen a gynae in another hospital for a second opinion. She was very nice, was very gentle and considerate during the examination, and really listened to me. I also got the feeling that she wasn't patronising and genuinely was concerned about me. So that's the good news. The bad news is that there is very little that she can do for me. She is very reluctant to do surgery, as she's found that it usually doesn't help patients with problems like mind (fair enough), but there isn't much else she can do. She was very apologetic about it, and I cried. She felt that breastfeeding could be slowing down the healing, so she's going to recommend that my GP gives me oestrogen cream to counteract that (I'll be weaning DD off anyway, as the biting isn't getting any better), and she recommended sex to stretch the scar. I just can't do that, I can't face painful sex again. It's so counter to what sex should be. So she gave me some dilators (which are basically dildos of graduated size) that I can use first. She said that they're not as good as penetrative sex, but could help me get to that stage. We've given it until DD 15 months (she's 9 months now) but when I asked her what we can do if it doesn't work, the answer is nothing. She said that most people are OK by then, even if sex isn't the same as it was before childbirth, but I'm really really scared as I know that 95% of OP babies turn during labour, and that 97% of women can have sex a couple of months after an episiotomy, so my luck has been quite bad. Also, my Mum told me that her scar still gives her problems from my birth (would rather not have known that frankly), so I know that my family heals really badly.
I'm so angry with the OB, I know my body, I knew my family history of bad scarring and his snap decision might have ruined my sex life forever. Oh bugger, now I'm crying again. I keep thinking of him, and how he was smiling at me when I was trying to argue with him. I want the gynae to get in touch with him and tell him what women like me go through.
DH is being lovely and wants to do anything to help. He came with me, and is now looking after DD so that I can type this. I feel like he only has half a wife. Sex was so important to both of us.

Oh you poor thing. I don't have any practical advice but maybe the Sheila Kitzinger birth trauma place might help?

I bet someone knowledgeable will be along in a minute.

here

oh honey

am glad you saw a sensitive and helpful gynae

but am sorry that you are no closer to getting cured, as it were

can you look into something else to help with healing? maybe some complementary medicine? and help with relaxation so that the thought of penetrative sex is not so terrifying? some of the pain must also be due to tensing, in expectation of pain, IFYSWIM..but no doubt there is pain anyway

i am just so sorry you are going through this

remember, there are other sexual and sensual things you can do with your DH , whilst penetration is off the agenda

Hi MrsTitleMouse

My DD is 15 months old. I also had a episiotomy and is still struggling with the scar. I can count on one hand the amount of times me and DH has had sex after the birth. The scar still hurts when we try but it is getting better and easier.

I also went to see my doctor and she said that it will propably be a life long problem.

As the saying goes ignorance is bliss when I was pregnant I never read any of the bits in my books about episiotomies because I just believed that I would not need it. If I knew then what I know now I would have kicked the doctor into his next life when he came closer with the scissors.

I hope things will get better for you, it will be a slow road ahead but I believe that eventually we will get back to great sex without pain!!

DH is glad that at least now we can do something to help, i.e. the hormone cream and the gradual dilation. Contrary to the hideous Mr "I can fit my finger in, therefore you're fine for sex" previous gynae, this gynae told me that my capacity is fair, but not great. And DH is better than fair! So dilation should help with that, as well as massaging the scar. We've also decided to have an "in bed by nine" rule. At the worst we'll get more sleep, at best it might help us feel a bit more physically connected.
I can't help thinking back to the arguement with the horrible OB, if only I'd been tougher and refused to sign the consent form(after 3 days of prelabour and 13 hours first stage and 4 hours second stage, so I wasn't in the best position to fight my corner!) but it would have saved me at least 9 months of problems and potentially saved my sex life forever...

Just wanted to send you a big virtual hug, Mrs Tittlemouse.

The way you write reminds me totally of the way I felt for a long time after the birth of my dd. You sound in a state of shock and trauma.

I don't know the details of what you've been through (haven't seen your other threads), but it sounds like you had a pretty tough experience of labour (as I did) and unexpected lasting physical consequences (I did too). I also had a very painful scar from a tear, as well as pelvic floor problems. My physio recommended all the stuff they've told you to do. Actually, what i needed most was LOTS of time. It was many, many months before I felt able to approach the idea of sex with my husband and we had to take things very gently indeed. It was well over a year before I started to enjoy intimacy with him at all. Now, things are actually fine (dd is 2.5). I would never have believed that at the time, but your body WILL heal. Even if it happens slowly.

The other thing I'd say is that I think that there was a lot of emotional trauma underlying my fear of getting back into my sex life. I felt betrayed by my body and my experience of childbirth. I have done a lot now to try to overcome this. I've been through my labour notes at the hospital where I had dd. I've also had a year of amazing therapy with a specialist psychotherapist at the same hospital (referred as an NHS patient after the labour debrief). I had to battle hard to get this help, but I'm really glad I did. The therapy is helping me to come to terms with what happened and gain the courage to try it all again.

Best of luck - you won't feel like this forever.

This might be a long shot, but I used Keloid Gel (the one I got was made by Weleda). It is a homoepathic scar treatment and helped me to heal incredibly well. Apparently it is best if used on new scars, but also helps older ones too, if applied regularly.
Good luck, Tittlemouse. I really feel for you. And I'd second what pregnabrain says. Maybe talking to a therapist or debriefer would help you to manage the (understandable) feelings of sadness and anger?

I agree that I need to sort out the emotional problems as well as the physical. In fact, I'm seeing a counsellor tomorrow. I had set up counselling sessions before, but I only had two before the counsellor went on sick leave. So 56 quid down the drain and now I have to start with someone else. I have strong suspicions that she knew that she would have to drop me, and mixed feeling about it. On the one hand she is self-employed and it must be very difficult when you're ill. On the other, she was obviously not doing very well when I was with her, and as we're on one income we can ill afford to waste so much money. As well as the fact that I have to explain everything all over again. Ho hum, hopefully the new counsellor will be better and I'll get somewhere. At the moment I have an overwhelming urge to have someone slice into the OB's penis and see how he deals with it...
Spink: can keloid gel be used "inside"? My problems are with the scar in the muscle, not the skin, and extend quite far up, if you see what I mean.

Mrs Tittlemouse, I'm sorry to hear about this. Sound really difficult to deal with.
Are you in/near London? There is a fantastic perineal clinic at King's, if you are - and you can refer yourself.

I'm not in London, but willing to travel if it'll help sort things out. I'm willing to do pretty much anything to have a sex life again. We have some money set aside, and we're willing to go private if we really need to, it's plan C basically, although we don't want to unless it's really necessary, as I'm not working at the moment and it's not easy on one income.

Going back to the Keloid thing: it seems that everything is better on a fresh scar. The gynae told me that ultrasound was only good when the cut was recent. So why did nobody help me when I knew that things were healing badly at the beginning. It seems as though my options are severely restricted now. I feel really let down and frustrated that I had to fight so hard and for so long for anyone to belive me.

Hi MrsTittleMouse.
I am expecting my first so have no experience about tearing. But I had a traumatic time last year after having a miscarriage (2 ERPCS that brought me in life-threatening conditions) and I understand your hate towards the OB. I think it is good that you invest into counselling -- it helped me. It also helped me to write complaint letters and contact the PALS at my hospital. I think the not-being-taken-seriously in the situation is very damaging (after all we know our bodies much more than especailly male doctors expect) and starting a complaint process put me somewhat back into control. I am still in the middle of the process but i think my consultant isn't smiling any more and declaring me for a hypochonder...
I wish you a lot of strength and hope that your wounds will heal with time.

sorry to hear this i had trouble with an episiotomy scar after ds1, it was awful

the drs checked etc and said nothing could be done, what i found helped a bit was too massage my perinium with a plain oil, like you can do before birth, i did this and dp did it for me we also too things very slowly, lots of non penetrative sex and used a dildo to get used to that feeling before having full sex it took a while, over a year but it did get better, and i have had two more, no episiotomies, i did tear slightly but healed much better and things have been fine since, tho i do occasionally still feel the old episiotomy scar.

Start a complaint process and see if the NHS will give you some counselling on their bill. I think we are both entitled to this. Also check out the report at news.bbc.co.uk/2/hi/health/6269508.stm

Oh MrsT, really sorry that the gynae didn't think surgery would help.

I didn't have an episiotomy, but tore during first labour. The stitching became infected, then got better but when I went to my post-natal check up my lovely female GP said instantly that in her opinion I was too tight. Tried sex, but really painful. Was referred and had a cut / restitch. That, thank goodness, healed well and was able to conceive ds. Incidentally, had much better labour (i.e. shorted) with him, but a more significant tear, possibly because was quick and had had 2 previous stitch-jobs/scars. But was stitched, healed well and all OK this time round.

I hope that the stretching and creams help you, and that in time things improve. Have to say though, that once things did improve for me, I forgot (in so far as is a distant memory) the heartache involved, and was really positive about ds's birth (had hypnobirthing) and would love another.

Fingers crossed for you.

The new counsellor has mentioned complaining as part of the healing process. I can't do anything legally, as I signed the consent form, and what I experienced as bullying, he would describe as "explaining to the patient that a C section had risks" if you see what I mean. I think that it would be good to have it in writing that he's an arse though, as it would help any other women who have problems with him in the future - if it's in writing that he has a history of this it will strengthen their case.

I just really want there to be consequences for him, as I'm sure that he went home thinking that he'd done a marvellous job and delivered X number of babies. The patronising smile that he had on his face when I discussed tearing and episiotomies will stay with me forever. He told me that a C section was "like a large episiotomy". Like there's no difference between my abdomen and my genitals!!!!
(Apologies to anyone who reads this who has had a difficult recovery from a section BTW, I know it's no walk-in-the-park either.)

MrsT, you can certainly complain about the consultant's communication skills. However he dresses up what he was saying, there is no excuse for the way he was saying it.

I'm so sorry to hear your story. I, thankfully, had an episiotomy that healed well. However, I have a keloid scar on my neck from a thyroidectomy. I can assure you that regular massage can definitely start to break the scar tissue down. I can identify with your frustration regarding 'it seems that everything is better on a fresh scar.' It was well over a year before I saw the plastic surgeons by which time my options were limited. It has responded well to massage, though, and any sort of oil that hydrates the area works well.

Wishing you luck that this gets sorted to an acceptable situation for you. Good luck with the counselling.

hiya, i truly sympathise. I had similar to you, all very traumatic, and i thought i was the 'odd one out' with hearing about people having sex after about 6weeks.

my dd is 5 but I would say that at about 1 1/2 yrs onwards after it became much better.

I never thought it would, but dont write yourself off yet, because it can change, and it will improve.

I know it is a bloody shock. I am sure it will get alot better 4 u.

It might not feel the same as before, mine didnt, but tbh, the sex was still greatand in many ways better.!!!

Tittlemouse - I'm afraid I don't know if you can use keloid gel internally... you might have to ask a homeopath about that, or contact Weleda and ask them www.weleda.com
Don't give up hope, 'old' scars aren't unhelpable, just take a bit more time. You sound like you are really determined to do whatever you can, and that does count for a lot.

I have a lot of scar tissue from an episiotomy that became infected. Awful as it sounds, I would echo the gynae's advice re penetrative sex. I completely understand why you are reluctant to do that, but I can honestly say that it did improve and I have returned to full working order . It did have some impact on how I felt about sex for a while , but that too has passed. Good luck.

Sorry to keep going on about this!
I do think that one of the problems that I have is that we'd really like another. And on top of the fact that I'm getting on a bit (!), I needed fertility treatment to conceive DD, so we don't have a lot of time to play with. DH wants me to have an elective section, but I don't know whether I'd feel better "doing it right" as 2nd births are often quicker and easier.
I'd much rather take the time to really get over DD's birth and the aftermath, but I don't really have that luxury.

For me, dd was the best way to get over it. Unfortunately I had a miscarriage in between ds and dd, and was really up to high do by the time dd was ready to come. But she was born vaginally, with no problems. Some tearing (midwife said inevitable due to extent of scarring) but a world away from the episiotomy. Healed much quicker and with much less pain.

no advice but am very sad for you.. I hope a solution can be found.

I understand the time thing. Yet i am sure you will go on to have another, and it will be when it is right.

Give yourself a chance .

I am 'older' too, but not with my dh anymore, and as I have spd, prob cuoldnt carry another anyway, both these things are very upsetting and frusstrating.

Makign babies, and having them certainly doesnt feel natural when you have had a rough time of it.

I am certain, that you are doing all the right things, it is a matter of going through the process. You often feel you are doing it all alone, but at least you ARE doing things to help yourself. I saw a psycologist too, which really helped me long term, she was at the hosp I gave birth in.

good luck xx

Another thing...

A friend found sex pretty much impossible after she too was stitched too tight. But she did grit her teeth and bear it a couple of times (not something I could have done) and conceived her second child.

She mentioned the tightness at her booking in and if I recall correctly when she came to give birth vaginally to her baby, she didn't tear and is now back to normal as a result of the stretching.

Good to hear you're seeing a counsellor, MrsT.

My therapist at the hospital is always encouraging me to write to the hospital to air my grievances at the 'care' I received. She thinks it's important as a way for me to regain some control over the situation. She also, rightly, says that too many women simply put up with their feelings of anger at the way they have been treated and don't complain. The only way the hospital will ever know there's a problem is if people speak up about it. So, more than two years down the line, I'm planning to write them a very stroppy letter and demand that they give me the opportunity to come in and discuss how my care will be different next time round.

Fingers crossed...