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.

very mild hijack here: I'm also suffering from (very minor compared to you, Mrs T) scar trouble - Spink: what cream/gel did you use? I looked at the Weleda page, but I can't find anything - could you post the name of the stuff? Thanks!

MrsT, I do hope things improve - might be worth really pushing for cream, ultrasound etc, as my experience is that doctors never really know what will work and how your body will respond.

Hi, sympathies from me too, I couldnt bear the pain of sex after dd until about 8/9mths, and only now (13mths on) am starting to enjoy it again.
My dd was in OP position and back to back, I delivered naturally but placenta didnt come out and I ended up with a 3rd deg. tear and and epis. by the time they'd finished with me in surgery...I am totally put off having any more, but I know in a few more months I could feel very different.
You have to give your body time to heal, even if you havent got much time left for a 2nd pregnancy. You come first otherwise your health will suffer.
Best wishes for the future, Im sure in a few more months things might look a bit more positive.

Mrs T - your story is very sad, I'm so sorry.

As for complaining - 'consent' when you are free from pain (y'know, like in an out-patient appt) and 'consent' when you are in extreme pain and labouring are at opposite poles. In labour, you are also vulnerable, so you can definitely complain and argue that you were bullied, and that the consultant took advantage of your vulnerability, despite your protests. You were not able to confidently voice your reluctance, and he clearly did not take this into a/c. As part of your complaint, you should get rapid access to a Clinical Psychologist who can help you work through your anguish.

Please be careful of private counsellors - check qualifications.

Good Luck.

I had awful trouble like this after birth of ds 13 years ago. Suffered a lot of pain for 3 years afterwards. However no pain at all now, and can't really remember when it stopped.

Dp and I split when ds was 18 months old, and when it came to next relationship 9when ds was 2 1/2 years old) was really worried, but found it a lot easier than I thought.

I had elecetive section for dd as could not face all that agin. It was much better and less painful. What sort of **says a c section and episiotomy are the same thing. Completely different in my exp and episiotomy was much much worse......

I hate episiotomies, and have read some stuff comparing them to female circumcision, and have to say I agree.

Hope this helps, it will improve in time....

"I can fit my finger in, therefore you're fine for sex"

Obviously he has a very small penis.

My scar (episiotomy plus 3rd degree tear) hurt during sex for about a year I guess. It did get better (I now have 3 children after all). Hang on in there

Littlefrog -
It was called 'Keloid Gel' - you can see it if you go here: www.weleda.co.nz/store/index.cfm?fuseaction=showitem&item=3342&storeDept=10&category=506
This is a NZ site though, and I couldn't find it on the uk weleda site. But maybe there is someone who imports it? A friend got mine from germany (I think Weleda is a german company?)

littlefrog - There are contact details for customer services here, if you're interested:
www.wala.de/english/international/index.php?country=g1

MrsTM

I utterly sympathise. I had a ventouse delivery, which i agreed to after 18 hours labour and 3 hours of pushing.

What i didnt know he was going to do was an episiotomy (which thankfully I didnt feel because I'd had an epidural). Turns out, having had to go back after 12 weeks due to pain that I had torn all the way up the back too, and I believe I had been stitched too tightly inside, and slightly twisted outside.

The gp was very sympathetic, and suggested similar to your gynae (although no dilators, just dp and lots of KY). She also said that scar tissue doesnt stretch, unlike normal tissue.

It was awful, in that it had to be worked at, etc. Totally depleted any drive I had. But we stuck at it. It did take a few months, but, it slowly got better. Then 15 months post natally I got pg with DS.

Had a much more normal labour, and delivery, with just a 'graze', 2 years on. Things are so much better now. The only problem i have is where the stitches were 'twisted', and so I dont have as good a 'seal' anymore

MrsT! HUGS!!!!

I have had an emCS and then a VBAC with forceps assist and episiotemy, so have had issues with 'them' cutting me twice! Fortunately I've not had as much to deal with as you but did have infection and haematoma... but psychologically can understand the trauma you feel.

Anyway you can make a complaint, it doesn't matter that you signed a form as it was in duress! The HCPs don't tend to give you the full pros and cons to make an informed decision so therefore the signed form is worthless.
See www.aims.org.uk/complaint.htm (See Point No 6 in particular)

www.patients-association.org.uk/onlinewebmanager/downloads/Medicalrecords.pdf

Wow! So many messages!
I was referred to the counsellor through my GP, so I think that she's OK. She has suggested that DH goes to see her too, as he was very traumatised from the birth. When the subject comes up he said that he feels sick to his stomach, and he always changes the subject. He's not really a "counselling" person, too British!, but he said after the gynae appointment yesterday that he would go if I really want him to. I think it would help me if he gets less defensive and stressed when I'm upset, not including helping him.

Another quick question for all those who have gone through something similar: the skin on my perineum seems much thinner and looser than it did before. There's a really baggy bulge of loose skin that bothers me. I had a swollen bulge there just after birth that I asked the MW to check. She said that it would be OK when the swelling went down but I remember the skin being smooth and taut there before. Is that bagginess normal?

Heven't read all the messages but felt I had to post. i suffered in silence after my botched forceps/episiotomy with dd. Sex was nigh-on impossible and I could feel healing pains sporadicall for 4 years after dd was born. However, by the time she was 5 sex was fine again and I was more or less completely healed. so please give it time (it may take a few years) things will improve, it just takes a lot of patience and once you just relax about the whole sex issue it doe get a lot easier.

Mrs Tittlemouse: So sorry, I remember your posts from before. As I said in previous threads, my gynae says it can take up to two years for "deep tissue healing" to occur, and as others here have said, it can take even longer. 9 months is REALLY NOT VERY LONG and I know it feels like ages but at 9 months I was still REALLY sore with no. 1 and also had unsympathetic GP who said to take paracetamol before sex and have lots of sex or another baby to rip it all open again and see if it healed better

Anyway DON'T feel as though there is 'nothing that can be done' and that you are going to be like this forever. I REALLY think that in a few months things will improve - very gradually. I do think it's important to have some sort of sex life - that doesn't mean penetrative sex if it's painful but just learning to enjoy POSITIVE feelings around that area again is really important. Slowly slowly.

Physically - well I may have mentioned kebabs or the meat counter at Sainsbury's but as long as you don't have any plans to frame it for the dining room then I just recommend embracing it as part of your fantastic fertile womanliness.

Fab post MP.

MrsTM - I think, (and obviously aside from the soreness, pain, discomfort etc), it is very much a case of coming to terms with the fact that you just wont have your pre-pg body back. That includes maybe saggier boobs, stretchmarks, and in some cases - different vaginas, vulvas, labias and cervii(sp?)

I know my cervix is now slightly more prolapsed, and tilts to the left. My pelvic floor is shabby (yes, i could improve it with exercise, but even so....).

Whilst I'm not suggesting you just get on with pain and deal with it, i think a certain amount of acceptance is needed. There arent many women who's body reverts to exactly how it was before they got pregnant.

I really do think you need to give yourself time, as mp said.

whose bodies...sorry!

I was forced into hospital and into theatre and had a ventouse delivery with a third degree tear after having my daughter ripped out of me. So I do know where you are coming from even though you must have suffered far more with your tear from reading your post Sending you {{{hugs}}}

TMI but I found that if I was on top (and could control the depth that the pain was just about bearable and lots of lube and we just keep trying.

First few times were very painful but 11 months later it is a lot better and lots more fun I hope in another year or so will be totally painfree but I am not holding my breath on that one.

I really hope things improve for you.

Oh, we are still breastfeeding too and my DD stopped biting as suddenly as she had started.

Sorry to post again, need a good rant. I've not had a good week, for obviously reasons, and I've been a bit depressed. I've mananged to keep the basics going, and looked after DD, even though today I just wanted to burst into tears all the time, but I hold it in because it's not fair on her. Today DH came home, and saw that the washing up wasn't done, and went into a complete sulk. I offered to do it, but he went into martyr mood and did it himself, completely grumpy, then he stormed upstairs leaving me to sort out a freaked out DD, who couldn't understand why Daddy didn't want to play with her today, and why he was knocking things about. Then we gave DD her bath, and he isn't talking to me. Just two days ago he was willing to do anything to help, but he can't understand why I have a day when I'm depressed and just looking after DD is a major job???? He thinks that I should just get over the birth trauma because "it's in the past" and that I'm dwelling on it. He also thinks that counselling is a waste of time. There's no-one else I can talk to when I'm feeling down, and now he has given up on me.

what a shitty day. sending you a hug..
Hopefully HE is just having a grump on and will see the error of his ways tomorrow. Maybe he needs reassurance from you that he CAN help, and that you need and want his help - just in case the grump is to do with him feeling helpless. My dh's grumps when I am having a bad time often are because he doesn't know what to do and feels lost and useless..
In any case. You deserve a big squeeze.

Maybe he's just having a bad day too? It happens to the best of us.

Oh ((((((((((((((((((((((MrsT)))))))))))))))))))))

Poor dh doesn't understand at all does he?

Have you been to www.birthtraumaassociation.org.uk/ and contacted someone there?

What you are feeling is entirely normal but very hard to live through, even you can understand it, so how can anyone else? Well those of us who have been through similar can totally understand and sympathise. You MUST get help and whether it's medication or counselling or both depends on you. I personally cannot see how you can possibly come out of this without counselling, you HAVE to talk it through and deal with it. Speakign to a counsellor is best cos they are trained and also not personally involved.

Does dh feel that by talking to a counsellor that yet again you are not involving him, cos I bet that he feels useless and guilty after having seen what you went through. Tell him that you would not be rejecting him by seeing a counsellor instead of talking to him, he's too involved and could use some counselling himself but I bet he's too manly for that.... Actually it takes a bigger man to accept and go for counselling.

I also understand how bad you feel that dd is aware of how you are and that you feel you are letting her down again. If you don't deal with this then you really will be letting her down so follow these first steps that you are taking by (talking to us) and get more help.

Call your HV, and NOW! Your HV will come out to your house and talk to you for however long you need, then she can refer you to whatever services are available in your area.

You HAVE been traumatised but YOU deserve support and help. You are no less worthy of it than the next person.

Call HV now, >

I send you a great big hug!!!!!

I had a horrid first birth and ended up with over 60 stiches as the episiotomy was left until DS1 was stuck and there was a samll degree of panic about 'lsoing the baby' in the labour ward!!

I sat on a floaty ring for weeks it always felt like it was pulling and when we did try sex it burned sooo badly......

As it turned out there was extensive damage and I had to have a pelvic and bladder reconstruction!!! Sex is fine now but it was a very long time until it was and still to this day if we have a 'my session' a nice long lasting one that is, I still get a little sore along the scar.

BUT big thing is that there SHOULD be light at the end of the tunnel and when it call comes back it's kinda special cause he gets to learn some more foreplay and enticement tricks

good luck and hope all goes well youa re not alone and are being thought of

Thank you so much for the messages. The bad news is that DH read my message. And wanted to know why I was telling a load of strangers that he was an arse.
The good news is that after I'd explained how I felt we both calmed down and we're friends again. DH is going to phone me from work to make sure that I'm OK and so that I have a bit of human contact! I think that part of the problem is that we're in a new area. So I have the issue of needing to make new friends, which can be a bit tiring, and also there is no-one here that I can turn to when I'm feeling down, I don't know anyone well enough yet. I did point out to DH that by telling a bunch of strangers, I avoided an uncontrolled outburst in front of people we know!
I've made a counsellor appointment for a couple of weeks time that is at a convenient time, so that we both can go. Hopefully that will help.

Well done to you for talking it all out. Men often feel very guilty for not "protecting" their partner during the birth and of course guilt comes out as anger and all sorts of other emotions.

I've got no research on this one but I wonder if perineal massage would help with your scar?
I also wonder if writing to your former obstetrician, even if you don't send it would help with your anger. If you do want to send it or to complain then AIMS are lovely people who can help, see www.aims.org.uk

People who suggest sex as a "cure" for scar problems really worry me, why don't doctors realise how much of our self image is scarred along with our bodies after poor experiences of birth? If you do decide to conceive again I strongly recommend an an independent midwife who can work with you to try to prevent further injury.

Lots of healing hugs.

Well, I never read you saying that he was an arse! You may have felt like that at the heat of an argument or in the depths of your despair but all I can see is a couple who are struggling to deal with PTSD or PND as the result of a botched episiotemy. It's not your fault! Either of you!

I'm so glad that you've had the chance to clear the air. Healing will be a hard, slow process, with good days and bad days, don't be too hard on yourself or expect too much.

I'm glad that dh has listened to you but when it's hard to understand yourself when you're going through it how can he be expected to understand when it's not happened to him and it's not his hormones affected.

All he can see is the woman he loves in pain, physically and emotionally, he feels powerless to do the right thing, frustrated, guilty, sad, all sorts of emotions and he realy was not prepared for it!

He's not psychic, you must tell him what you feel so that he can support you, and good for him for trying so hard, I'm proud of him, and of you for telling us, the first steps are the hardest!

Counselling is emotionally draining, you must be totally honest and it will not be an overnight success but it will begin to help given time.

I'll be thinking of you. (((((((((MrsT))))))))

I had a tough time in labour and had to have a episiotemy. I had to be stitched front to back, and after a couple of days my stitches got infected. I had to make several trips up to the labour ward afterwards as I was concerned that things were all mucked up down there. I was in constant pain for 3 weeks, and its only this last week that I have started to feel better and managed to walk with the pushchair. I felt that the midwifes fobbed me off and didnt seem to want to help me, the antibiotics they prescribed didnt work either. I went to see a duty nurse who was very sympathetic with me and explained that I might be able to have surgery if things don't improve. Im due my 6 week check up next week, so Im hoping the GP will say things are healing well, as me and my partner would like to have sex again, I am really scared about doing it as I know its going to be so painful! and I really don't want to go through any more pain down below! I wish I was informed beforehand what to expect if you do need a episiotemy, because it was a total shock to go through what Ive been through.