anyone else had pelvic floor problems after first baby?

[brokenpelvicfloor]

Am pretty new to Mumsnet and normally post under a different name. Am feeling really down about the state of my pelvic floor at the moment. My dd is 16 months old now and, since she was born, I've suffered really badly with it. It has got a bit better with help from a physio and LOTS of exercises but I'm still not the person I was. There's loads of stuff I used to enjoy doing that I can't do now for fear of leaking. It's really depressing me.
Plus, I'm massively broody but too terrified of doing myself more damage to think about having another one at the moment. Has anyone here got over similar fears and done it all again?

Anyway, apologies for the moan but I could really do with any advice / support from other people with this problem.

I wasn't suffering any major probs until I got pg with no2

Have you seen a gynae?

Have seen gynae consultant a few times since the birth. Saw him recently to discuss the possibility of baby number two. He said my problem would get 'significantly worse' during the pregnancy but, weirdly, he didn't suggest an elective c-section because he said the damage has already been done so there's no point. Seems a bit odd to me - what if i have another difficult labour?
He said that i have to accept that my bladder will be an issue for the rest of my life and that i should expect to have an operation once i've finished my family.
I'm just so scared for the future. It's bearable now but I'm terrified of what's going to happen when i get older.
Sorry for more moaning!

Waswondering - did the operation you had fix the problem?

I saw a gynae today and asked about how best to minimise possible further damage to my pelvic floor

He said he wouldn't recommend a section as the possible benefit to PF was outweighed by the risks/recovery time.
Also said birth likely to be quicker and easier second time round

WW they can improve matters with surgery but they will only do it once you're done having kids as further pregnancies undo the good work of the surgery

Ah. Well that tallies with what the consultant said to me, I suppose. He did mention the increased recovery time / risks from c-section (although the friends I know who had c-sections recovered a lot faster than I did from my hideous labour!).

Am seeing the perinatal psychologist at the hospital next week to talk over my fears...maybe that will help. I just can't make the leap at the moment but am desperate for another one.

Waswondering - glad to hear your prob is less worse (but sorry it's still there at all!). problem down below is right - you have to have the op after you've finished having kids so you don't undo their work

I've had problems since DD 1 & only - some stress incontinence, but particularly bad if I run or jump. Had 3rd degree tear which affects back passage too, although thankfully no actual problems there!

Dr I saw re bowels said he would definitely recommend a caesarian if I had another. Am seeing Gynae now - diagnosed with cystocoele (? bladder pushing down to create a kind of prolapse. I have been put on tablets called Yentreve (duloxetine). These are actually a type of antidepressant that tightens the neck of the bladder so reducing stress incontinence. They took about 4 months before I noticed a real difference, side effect unfortunately is constipation. This gynae said I was too young (43) to have an op just yet as the problem was likely to come back when I got older and muscles weakened again. Still cant run as I dont want to weaken the muscles more than I have to, but am doing Pilates for the pelvic floor.

Hope this helps - there are alternatives to the knife.

The consultant mentioned that medication to me as well but I feel like I'm very young to be considering taking it for the rest of my life (i'm 32). Has it worked really well for you? Is it worth putting up with the side effects (he mentioned nausea to me).
I know what you mean about running and jumping, that's the worst kind of activity. That's what really gets me down - I used to be really active - loved walking and dancing, and now I feel like I can't enjoy those activities any more. I'm doing Pilates too but it doesn't feel like real exercise somehow! I used to love yoga but i'm too scared to try a class in case of embarrassment. Argh!
Tiny upside - I've discovered swimming. I never ever used to go swimming but now it seems an easy way to get some proper exercise.
It's weird that the consultants give different advice about labour vs c-s - am scared now that mine is wrong!

Hi BPF - sorry if I've got you worried about Drs disagreeing. IME they all have different opinions and you probably have to go with the one you have the best gut feeling about. as far as Caesarians gothere are side effects for the child and the mother, but so many of them are performed that it's not exactly a rare occurance. There are some theories that not going thro a normal birth can affect the sensory motor development of the child later on, but that's not really been proven. Obviously for the Mum, it's like having any other major abdominal surgery.

As far as "no point the damage has been done", you've seen the physio and done the exs and got a bit better, so going thro it all again is going to exacerbate the problem. There are still some old school drs out there, I once got told that my period pains would get better once I had a baby!

re the Yentreve - I hope I don't have to take it for the rest of my life! In some ways its good for me to be on it as I was on ADs before, although I believe the dose for treating depression is different. I've been told to stay on it for a few more months and to continue with the PF exs (which youre supposed to do for the rest of your life anyway). maybe I'm really unfit (oh, OK I am really unfit) but my pilates class is pretty hard work, much more taxing than the DVDs.

Anyway I hope this helps a bit - it might be worth taking to your local midwives as they must have come across women who had this problem then had further children. Best wishes

I suppose what the consultant is saying is that the risk of the problem getting worse with a second natural birth is quite low, which is great, and when I'm feeling optimistic I think "surely i've had my bad luck now and can't be due any more??"
On a bad bladder day I get waves of fear washing over me and don't see how i'll ever be strong enough to get through it.
Am going to see this specialist psychologist next week so I hope that will help inform / calm me.
How come they said that you only have to take the Yentreve for a while? Does it have a lasting effect then, even when you stop taking it? Might give it a go if that's the case. Does it improve your mood too? (sorry for the Spanish Inquisition!)

Hi BPF - I suppose when the gynae said he'd review it again I assumed that meant you dont have to take it indefinitely. Maybe if it tightens the bladder neck and you continue doing the PF exs, you get a boosted effect that lasts longer. Ill see if I can find a BNF and look it up, as its quite new.

As to whether it boosts mood - I was coming to the end of a course of Cipramil which I had to wean myself off before starting the Yentreve. I feel OK apart from when DP is going through his latest midlife crisis, but thats not depression!

The psych may have a different opinion to the gynae, so it'll be worth asking them. Good luck!

hello fubsy

thanks for helping me with this info. Not sure what BNF is but it would be interesting to know what it says!

i'll ask the psych what she knows too.

Fingers crossed for us all! Or legs crossed...

HI, sorry for your problems, what about seeing another doctor/consultant for different advice/second opinion. Is your gp a man? I'm an old believer of 'if they don't have one they can't really know how debilitating it can be'! Narrow minded I know but a woman I think can have a lot more first hand understanding of the situation and be a bit more sympathetic. My aunt had 3 massive boys and after them in her late 40s she had surgery to stop leaks and has been absolutely fine since then. Good luck.