Forceps Delivery, Need Surgery and want another baby

[Emsmom]

I had a terrible forceps delivery 20 months ago. I suffered with complete incontinence for two weeks and was on a catheter. Since then I suffer with incontinence when walking briskly, running, jumping, sneezing etc. I went through two supervised cycles of pelvic floor physio and this is as good as it will get I believe. I finally got an appt to see some senior doctors at the hospital for a series of tests in December, to be told that nothing can be done until I completely stop breastfeeding. I am now booked in for more tests in June. It looks like I will need surgery. One dr said I wouldnt even get booked in for surgery for a few months after June and then I would need to wait a further few months to try to get pregnant. Another dr I saw said he would recommend having the surgery after I have finished having children as if I suffer from this problem again the surgery to fix it will be much less successful. I am worried though that the pressure on my bladder from a pregnancy might cause me to become fully incontinent again? I would like to have another child sooner rather than later and wonder if anyone has any experience with this problem? Any advice appreciated.

No advice to offer, I'm afraid, but bumping for you...

My friend suffered 4th degree tear (no forceps though) and was told all subsequent children to be born by CS.

Although I don't usually have a problem with pelvic floor, due to pressure on bladder in late pregnancy does mean that if I sneeze and bladder is fullish I can suffer from a few drops of leakage - I'm sure thats relatively common at the end.

Hi

I had forceps and longterm bladder damage 15 months ago. I haven't been told I need surgery but I think it might come up at some point in my future.

My bladder is worsening now I am pregnant again but I had got it back to manageable with uyrogynae and physio work for 10 months post birth. Now it is starting up again with the urge incontinence I had after the birth- I know its the weight on it and the hormones, so I am expecting it to eventually be ok again some time after #2 arrives (due June).

I am going with an elective this time to protect the pelvic floor from another huge stretch and to protect the bladder from the possibility of forceps again. I am also worried about damage to my bowels which are fine at the moment; bladder incontinence is one thing but double would be such a nightmare for me.

Would you consider an elective? Could you talk to your Drs about whether surgery could be done and then an elective to protect it? Or is it the sheer hormones and weight of pregnancy that might undo your repair?

I know someone on the sphincter repair thread in general health (childbirth injuries) recently had a baby after a lot of surgical repair; she was told she had to have an elective and it seems to have protected her fine.

Thanks for your responses. I guess I am still so disappointed about the whole thing really. Just going down the stairs starts a leak, and if my bladder is full at the time I sometimes cant stop the flow once the leak starts. I suffered bowel incontinence in the beginning as well and although that is much better, it is not 100 percent. I think an elective may be a good option for me, although not what I had hoped for. I have other problems from the delivery as well including a lot of vaginal pain and the drs I have seen dont seem very sympathetic or responsive. I am worried that the NHS will not schedule me for surgery for another year and so that really sets me back as far as trying for another child. However I have real concerns about the pressure on my bladder in a pregnancy without the surgery.

Wanted to write, because I had a very similar experience to you. Forceps delivery (the bastards) after 4 hours pushing. Thankfully dd was fine, though head was very cone shaped!

I suffered with horrendous pain for about 14 months afterwards, and eventually got a diagnosis of interstitial cystitis, brought on by damage to bladder tissue. I took amytriptaline for a year, to manage the pain, and found a very good physio who stretched out my pelvic floor. I'll never forget the pain, or having to go to the loo every 5 mins.

I write to give you some hope. I managed to get pain free enough to have sex again, and had my dd2 by elective cs 2 years after my first. Though the urge problems reared a bit, along with the pain, it was really not bad at all. Certainly I leaked a fair bit when laughing/coughing, esp. towards the end.

The section was brilliant. I was terrified it would make my problem worse, and it didn't. I was utterly traumatised by my first birth, and the midwife referred me straight to the consultant. I saw her at 20 weeks, and she was understanding and reassuring, said she would take special care to avoid the bladder area during the section.

I have never had a return to the state I was in after that first birth. Please don't let this stop you having another baby. My section was really special, and my dd2 is wonderful.

Sorry for super long post, I really feel for you. Good luck x

Hi - sorry to hear how distressing it all is. I do think people write off so much childbirth damage as insignificant when it isn't!

Also - big empathy here on not being able to stop the bladder emptying once it starts. The muscle crunching positions I get myself in trying to gain enough control to hobble to the loo in time are probably comic viewing. Tena. Tena. Tena.

Would you consider stopping bf? I understand the hormones released have the same effect as pregnancy ones in relaxing the muscles.

I would pursue both options. Leave the June tests in the diary, maybe plan to end bf weeks before then to allow your hormones to settle, AND get another appointment to discuss with urogynae how to manage incontinence while pregnant if you do go for another child first.

Perhaps they will just say big tena pants (very comfy). Perhaps a valve catheter (no bag but a valve you go to the loo and open to empty bladder as if peeing every 4 hours). Perhaps other options. I think if you knew it was temporary and part of pregnancy hormones (as I do right now at 24 weeks) it wouldn't be so depressing. Frustrating still yes, but not so lifelong knowing it will have surgery later.

How many kids do you have? What was your ideal family size? What age are you? When did your mum start the menopause? All these might help you decide.