Continued support for SPHINCTER INJURIES, FISTULAE and other CHILDBIRTH INJURIES - the Ragged Bits Thread

[Jacksmama]

Hi all,
old thread here.

Cyee started this thread in May 2008 after her op, and it's been a haven of support for so many of us who have injuries to our bits from childbirth. Especially with respect to sphincter injuries, fistulae and incontinence after childbirth, there seems to be such a lack of support for women, and the entire subject seems to be taboo. It's as if most MD's think that "a certain amount of damage is to be expected after birth and you just have to live with it". Well, that is simply not the case - and this attitude is unacceptable.

There are all kinds of Ragged Bits stories on this thread. Be aware that THERE IS NO "TMI" HERE - this is the one place where you can spill it all. If you read through the old thread, which is nearly full, you'll see that someone, somewhere, has probably experienced it - whatever it is! So don't be embarrassed or ashamed... we'll tell our poo stories if you'll tell yours.

And also - there are success stories here. Several of us who have been through the medical mill have been successfully "repaired" and are "fully functional", so to speak or even expecting again. In those cases, please join us for Pervwatch - the "after action" report for anyone who is once again venturing into marital relations!

Welcome everyone. We're sorry you had to find us, but we're glad you're here.

I don't mind at all. This thread is way too big to read all the way through from the beginning. Never mind that it's the second one of this nature. Cyee started the first one, which is the one I found and was first able to really pour out all my bodily (and mental) miseries on.

I had Jackbaby (JB for short... he's now 3 1/2 so really it should be Jackboy, not Jackbaby) in Feb 2008. 36 hour labour, 4 1/2 hours pushing, finally episiotomy and forceps, resulting in massive haemorrhage and 3rd/4th degree tear. It took about an hour to sew me up, while I was merrily going into deep shock, with both midwife (who was responsible for most of this fiasco) and OB with their heads together trying to figure out how to best put Humpty Dumpty back together. I spent a couple of hours in the critical care unit after, with blood expanders and warming blankets, while everyone else was getting acquainted with JB. I still can't look at the pictures of everyone holding him while I was in CCU. I will never get those hours back. That's time he should have spent with me, skin-to-skin, getting to know each other. Instead, I was strapped to a gurney, barely conscious. The nurses, admittedly, were lovely. One spent a lot of time holding my hand trying to talk me into coherence. I don't even know her name, never heard what it was. Anyway.. everything took for-bloody-ever to heal. 6 months after I still had pain all the time. Broke down at my GP's, she said "let's take a look", took a look and went "um... that's not good". Bless her, she's so great :o
She referred me for counseling (it was plain I'd developed PTSD and post-natal anxiety) and to a specialist surgeon. When JB was a year old, I had my internal repair. They opened everything back up (I tore along the entire right wall of my vagina, and back into the anal sphincter) and re-sutured it. Apparently some of the original stitch job hadn't actually held, so there were pelvic floor muscles to repair, too. A year ago I had another op, this one to revise the scar tissue that had formed along the episiotomy. And try to pretty up my torn-rubber-boot looking bits. They were shredded, and really uncomfortable.

It was the shit to go through all this, so I really know where you're coming from. It sucked.
I will say I'm as "fixed" now as I'm ever going to be. I still have occasional pain, especially during my period. My entire perineum aches at that time.

The mental aspect was harder than the physical. I don't know if I will ever fully "get over" what happened. It was a clusterf*ck of bad decisions. I'm obviously glad that nothing happened to JB - I think I'd have killed the midwife if he'd been harmed - but I don't know if I'll ever be able to forgive the faulty decision-making, and disregard of me and my wishes. PTSD seems to be one of those gifts that keep on giving. I struggled hard with a bad recurrence of anxiety and depression this past summer. I think I've got a grip on it now, at any rate, I feel better than I have in a long time, but equally I have no doubt that I haven't seen the last of it. I wish :(

So that's my story. It looks grim, written down. I read over what I write and it's hard to think "that's about me". What helps me, and yet is horrifying too, is that mine isn't the wrist story out there. Several posters on this thread - ThingOne comes to mind, as does KellyKettle, and others - have gone through, and are continuing to go through worse than this. It's horrifying to think that with all the science and medicine we have access to, women still end up with birth injuries like this. It truly baffles me that there are many more stories like mine, and worse.

Anyway - this turned into a bit of a rant, I guess it needed to come out :o

ever to heal. I don't think I was able to stand up straight for 6 weeks after JB's birth. 6 months after, having had flashbacks, nightmares, panic attacks,

Whoops, ignore that last paragraph. I'm on my iPhone and editing is a bit tricky :o

Hi all. Have been out of things for a few weeks. Loobsie - I totally understand your frustration with staining. I get it a lot - the thought of nice underwear is a wasted one! I am hoping that this will all get better after the surgery. I also know EXACTLY how you feel re the tear and not being told.

Long story but in a nutshell had undiagnosed (by 2 midwifes, 1 was 36 hours before labour!) breach, supposedly home birth until foot popped out at 2nd stage. Transferred to hospital (a nightmare in itself) for birth. Various symptoms and pain over last 3 years and have since been told I probably had 3/4th degree internal tear during birth which has never been picked up despite all my notes clearly displaying signs of probs. Going under general anaes next week for exploratory work before surgery in the new year for repair work on sphincter and potential fistula.

I am so so angry that no one picked this up, including gynae cons, colorectal consult and physios. I have taken the legal route with the midwives as there has been such a long period of cock ups which could have all been totally avoided if people had taken more care and realised dd1 was a breach. I am left with not just physical scars including a cs from dd2 but big mental scars. I have become a much more introverted person, hate public events even with friends because of the side effects of the damage, have zero sex life with my husband, am ashamed and sickened by my own body and don't know how I can get this all back. I would jump at the chance of counselling - I am planning to have some once surgery is sorted and I can address all the issues.

Really hope the counselling works for you and you get your head back into a lovely place. XX

OMG jacksmania you tore along the internal right vaginal wall, as in the wall parallel to your right hip? and back into the rectum? Holy MOly!

you poor thing not being able to stand right for first 6 months, and having to have repeat op. you are making me feel my problem is not so bad.

flitterfly i can't imagine what it would be like to give birth to a breach baby, jeepers normal birth is bad enough! is your baby ok? did you have to do physio on baba's neck or anything?

i'm relieved and glad that other people understand the repercussions of such bad tearing. yet i am incredibly sad that we have these problems, is it not enough what we put our bodies through just to give birth, nevermind having such drastic aftermath effects?!

i cancelled counselling today as i got a phone call yesterday from a physio in the maternity hospital where i had both my babies ( i live outside the region so was refeered to physio in my own district, but pelvic floor specialist overrode the "red tape" and got me PRIORITY apt with hospital physio) and its at same time today that counselling would have been on.

last friday (day after 4th was confirmed) i could have written a long, moany sob-story post that would have had you all unsubscribing from your membership here (instead i did on a secret FB page to women who never had this problem!! tut!)

i am going to book apt with gp to find out why they never told me either, despite checking stitiches every 2 weeks, and between visits when i went in complaining my anus was sore and felt a lump inside like a stitch!

i am just soooooooooooo fed up of the constant staining, its driving me around the twist. i get hopeful and think there's none and yet there's always some! actually 3 days ago i had a great day where i lived a former "normal" life for 1 day only and had no staining. it may have been due to reliving the actual tear and the thought of a colorectal surgeon that head me clenching ferociously that helped

do any of ye ever feel envious or jealous of other women who never even had a stitch... i HATE them!
(there its out, and i am not ashamed of this dreadful sin)

as for my birth story... labour and delivery was 2hrs 38mins in total! i did it all myself with no pain relief. baby was born in just 3 pushes and she came bursting out of me.

i am haunted by the ripping sound my body made and the gush of near-black blood on the floor under me. i am traumatised by the memory of the 3 different people who took turns in running their fingers along my opened flesh, in my just-birthed vagina and up my just torn bum (which i didn't know had happened until last week!) all without anaesthetic!

i have a feeling the midwife is to blame (or at least i am happy to blame her) because i was put on a birthing stool which i insisted i didn't want to use and had expressed this concern in antenatal visits too. she also never told me to breathe the baby out to allow my perineum to stretch, in fact she told me to PUSH, PUSH, PUSH and "keep it coming, keep it coming, keep it coming" when i told her i could feel the head crowning.

so i have the comfort sanctitude of knowing i can't blame intervention, just my own body for failing me like this :(

Hi Ladies,

I'm a newbie here, just been to see gynae today. I am 8 weeks post-natal with DC2 although childbirth with DC1 is probably what did the damage (3 hours of pushing, episiotomy). DC2 was average weight, normal birth, very little pushing.

Anyway, I am lucky enough to have private medical insurance through DH's work so GP referred me to a private gynae. I saw him today and the verdict is I have "bulges" in vaginal walls from both front and back passages. Hence some incontinence/urgency. Womb slightly prolapsed but not too bad, although he didn't rule out eventual hysterectomy. Overall, everything is red raw and he predicts that sex will be painful (nice!). I'm only 36, FFS!

Although I've said our family is complete, he doesn't want to operate yet, something to do with hormone levels (oestrogen?) not returning to normal until 12 months post-natal. So am being referred for intense physio in the meantime, in the hope this will sort it. He didn't give me a pessary due to impact on sex, but said I can go back for one if it feels worse.

Questions for you:

Has anyone successfully avoided surgery by having physio when things are this bad?

Do you think I'll end up with a hysterectomy?

Do you think I should get the pessary? How much does it help?

Any tips for a successful sex life? Lubricant? What else?

Does anyone have experience of claiming for this to Axa PPP. Will they pay up? Gynae said they try to avoid issues caused by childbirth.

Thank you! Sorry haven't been able to read back on thread (yet), too busy with newborn.

P.S. Another couple of questions, sorry.

Should I be carrying things? For example, 3 yo DD often demands to be carried, and DS is very heavy in his car seat already. DH works ridiculously long hours and isn't around much to help, and no family close by, although I could request more help from family if needed.

Lately, I feel very sore after the examination today. Is that normal?

I should have had a relaxing bath tonight but, even though DH was home, he had loads of work to do, DD threw a tantrum about going to bed, and then DS kicked off (colic). Just feel awful...DH has been working loads since DS was born, so I've been dealing with DCs lots by myself. Am sure this has had a part to play in my failure to recover from childbirth. Also had a debilitating cough soon after the birth, which caused a lot of discomfort. Sorry, just needed to vent as I can't walk for pain this evening!

hi mrsbloodytroll
congratulations on the birth of your new baby! :)

i'm sorry you are feeling so poorly, i do understand, trust me. i'm 29, have 2 children aged 3, and 11 months. i had 4th deg tear which means i tore from vagina through to anus and rectum. i have minor bladder prolapse. i'm not finished my family yet but am not ready to have any more additions yet either.

i go to physio every 2 weeks for faecal incontinence, so i understand completely your feelings of life not being fair.

i can't answer your questions directly i suppose but i can tell you what i do know for sure. i too live a home life where i am sole carer and rear children practically by myself, due to DH working 16hrs a day 7 days a week (SERIOUSLY). it sunds to me like you have bladder and rectal prolapse. these will make sex painful in most cases. even with potential hysterectomy on the cards, you are still better to have physio first as it trains your pelvic floor muscles to strengthen up. hysterectomy won't do this. yes its true that pregnancy hormones can take up to a year to leave your body postpartum. i am crippled with sacroiliac groin pain because i still have preg hormones readjusting my muscles and joints.
go to physio and exercise your pelvic floor muscles. don't try to do too much too soon, it is a lengthy process, so let your muscles build up over time to become stronger and then you can keep working them to bulk them up and make them tighter.
yes i would advise you to try something to correct the bladder prolapse (bulge in front vaginal wall). you can take estrogen pessary (which will have the added bonus of making sex less painful) to stregthen the wall to try and correct the bulge. my advice is to book an apt with a urodynamics specialist who will determine exactly how minor or severe the prolapse is and can advise corrective action. your gynae should be able refer you to urodynamics.

the rectal prolapse is trickier, this really can only be corrected when your family is complete. i am open to criticism here but its what i have been told. i am due to see colorectal surgeon to see if my problems are severe enough to need treatment, but have been told if i had a prolapse it wouldn't be corrected until i was finished having children. (ps 2 physios and a pelvic floor specialist have confirmed i don't have a rectal prolapse).
all in all, you must continue to live life as normally as possible, however difficult. lifting is not advised at all if possible, and if you do, pull in your pelvic floor muscles before you lift. it helps!
i too found carrying dc2 in a car seat to be troublesome, so i converted buggy to pram and used to take baby out of car seat and put her lying int he pram so i wouldn't have to carry car seat. as for 3yo dc1, i encouraged to hold her hand to walk with me (she likes to be carried everywhere) and if she fell or needed comfort, i got down on my knees and pulled her into me so i could kiss and cuddle her. or i'd sit on the sofa and ask her to climb up to sit on my knee.

i have no experience of claiming on insurance etc so someone else can advise you on that. i hope the information i've shared with you can/does help. it means re-jigging the way you do things but it can be done and you will benefit from it.

Thank you so much, loobsie. 29? Wow, you poor thing! I am feeling less sorry for myself this morning and have spoken to a friend IRL who has dealt with similar childbirth injuries and got back to normal. I think the key things are for me to take things easier than before, sit down more, not carry my toddler if I can help it, and not expect too much from my sex life for now!

I haven't yet had my 6-week GP check so may well ask the GP about pessaries and other options for NHS treatment. DH is already having physio we can't really afford for a knee injury. Shelling out £80 a week for two physio appointments (one for DH, one for me) isn't really an option if the insurance won't cover it.

i'm not living in the UK, so is physio not part of postnatal health care treatment there? it is here where i live.

woops.. posted too soon.

you're only 8 weeks postpartum, so def don't rush into the sex thing yet. did you have any tears or stitches this time?

I've heard that the post-natal physio from our local NHS trust (it varies by Trust meaning by administrative area) consists of a class for multiple women. I'm not sure what there is beyond that. Presumably something, but it's how long you have to wait. Going private would give me instant access to 1:1 help.

I had a 2nd degree tear this time, and stitches. DC1 was definitely worse, which is why I think the damage was done by her and DC2"s birth has merely aggravated the injuries. DC1's birth resulted in episiotomy and much more stitching, internal and external. It could be that the internal areas that were stitched after her birth are what have ruptured now ( just a guess!).

Hi ladies. I posted on here a year ago but thought I'd check in again and see how everyone is. So hi

A quick recount of my story: dd 17 months, 28hr induction, unassisted birth, 3a tear, mrop, pph followed by full restitch and grade 1 rectocele repair 14 months ago. ExH left me when dd was four weeks.

The stress of being suddenly single with a newborn and then all the gynae issues unfortunately left me in a bad way emotionally. I lost my appetite and became ill with an eating disorder, my bmi dropping to 16.8.

Anyway, that was 17 months ago and I've dug myself out a huge dark hole. It was a horrible place and I vow to never go back there.

I've met someone! Well been "seeing each other" since June and here is my ish, yep you guessed it, sex. Phah!

We have dtd so I know I function ok per se but I can't help but tense up. I've tried excess ky, wine, kalms, seen a psychosexual counsellor but I just can't help it. Do any of you lot have any magic tips? X

Hello, I was wondering if someone could help me... Or at least give mr some indication to what on earth is wrong with me!

I had was cut in labour and stitched last July was in agony for months and although it healed ok albeit wonky. I now have extra skin which a mw said could be fixed by surgery but they only do it when we have finished having children. I was so sleep deprived and drained from the pain and a newborn I stupidly didn't question anything.
The pains went away and all was ok... This july I had another baby and tore but it was small and healed well by itself.
I think I have a pile but I have no idea what one even looks like!
I now have more skin down there and what kind of feels like hole under the skin... Thank you if you are still reading and or following.
My pelvic floor, I think is buggered swimming and getting out the bath and I just wee everywhere.
I have this pretty much constant dragging feeling, the one where you either about to ovulate or come on? I can't stand up for too long either.

I have made a doc app but feel really well stupid! My problems so not even pretend to touch the edges of some of you poor ladies who's experiences have been horrific.
I don't even know what's wrong with me :(

Sorry for the whinge!

Gentle bump as I have now worried myself into a state now

hi pwb (whatta name!!)

i don't think you should feel stupid going to gp, nor do i think you should be getting yourself overly worked up. however, and i'm no gp, it sounds to me like you have a prolapse. symptoms such as weak pelvic floor, urinal incontinence, dragging feeling and a skin fold seem to indicate a prolapse. where is this extra skin/flesh? is it in your anus where you think you may have a pile, or is it vaginal? with regards the "pile" do yo uhave any pain/discomfort when pooing? do you have any accompanying slime, or does your anus itch?
sorry for asking graphic questions, i just wanna help if i can xx

first1, whats mrop and pph?

i'm afraid i've not got much advice for you on the sex issue. i can only imagine that you tense up because of anxiety or paranoia in relation to your tear. i can't imagine having gone through my post-recovery turmoil, lose a relationship and then try to form a new (casual/sexual) relationship with someone different and my first time having sex again since the tear. i think i'd be like you and would find it all overwhelming tbh. kudos on getting out there and trying to find someone to be happy with again.
maybe the tension you are experiencing would dissipate a b it if you talk to your new lover, if you haven't already, and just explain that the recovery from your baby was tough physically and emotionally, and you need more time to relax into the sex thing again, and see if that helps?

Loobsie - mrop is manual removal of placenta and pph is post-partum haemorrhage.

And excuse me but how did you deduce my new relationship is merely "sexual/casual"?? How rude.

Hey first! Can you pinpoint what type of pain it is and where it is coming from? You say you're tensing up, but that might be because it starts to hurt you. Is the pain at the entrance or more inside? Is it the scar tissue? Is it the vaginal wall, or does it feel more like the muscles surrounding? Is there a pain somewhere else inside like your insides have been poked? It might be worth asking for a gynae physio referral - if there are any bits of tightness, she might be able to help you with some stretching, or if there are any parts in spasm she might be able to do trigger point therapy to get it to release. Have you had an explore and a feel on your own? Does that also hurt? Sorry if this next bit is a crass suggestion - but would practicing with a dildo/vibrator (probably in the off position!) help? Just to build up more slowly to penetration again? I can't IMAGINE having sex ever again in my life right now and I think it's going to take a long time after I've had all my surgery before I don't feel extreme fear about the whole thing. So well done you! Hugs XXX

first1 you ask for advice and you shoot down the first person who responds to you... there's gratitude! i didn't merely deduce your relationship (and i did state you were in a new relationship) was casual/sexual...read back; you said I've met someone! Well been "seeing each other" since June and said the issue is sex-related.

you also missed the part where i empathised with you and couldn't imagine what it has been like in your shoes, and where i also said Kudos to you for getting out there and trying to meet someone who you could be happy with.

get over yourself!

Carda! Haven't checked in with you in ages, have you sorted the surgery out? You'll feel a million dollars after! Re your suggestion of using a vibrator yep tried it, and it's ok providing I use loadssss of lube and go slowly but even then only like half goes in most of the time . We are having a little break away in the Cotswolds next week so I'm hoping if I "practice" myself I can stretch a bit. Oh lord, just read that back!...

Hello! I've been lurking on here for a while. Total respect to you all for your courage and resilience.

I have a quick question. I had a 3b tear when my son was born 18 months ago (caused by ventouse + 9lb4 baby - born with his hand under his shoulder).

I'm due to have a scan looking at the deficit in my perineum. I don't have any problems but want to get a better idea about the damage to my perineum before embarking on a second pregnancy. If it's all held together on a bit of a wing and a prayer, I might not bother.....

I've had an MRI but am due to have an ultrasound and manometry (testing the strength of sphincter muscle). Can anyone tell me what the ultrasound and manometry will involve? I'm a bit nervous.

Thanks very much.

first - am seeing the surgeon tonight for final discussion of Phase 1 - Burch's colposuspension and uterosacral plication (hoik up uterus and avoid hysterectomy). Hopefully this will be at the end of November - I might still have a bit of infection, and if so that will delay things. Really really hoping I am clear - I just need to get on with this! The remainder of the pelvic floor repairs will be 3-6 months later. My symptoms are getting worse, so I definitely need this surgery. I have bad days and better days and I'm sure one the surgery date is set and it becomes real, I'll start to get pretty nervous!! Hmmm - if it is problematic, maybe do go and see a gynae physio? Can recommend a fab one! Hope you have a nice holiday . We're off to New York and Florida at the beginning of November - it will be lovely to have a treat before my surgery!
Hi ratprincess. Sorry you are having a rubbish time. I've had the scans you are talking about and it's fine. They get you to lie on your side with your knees up and insert a small probe into your rectum and then ask you to squeeze and relax your muscles so they can take different readings of the muscle strength and different points. Didn't hurt at all - don;t think I even felt it! The ultrasound to check the integrity of the anal sphincter and the perineum is also fine. Lay on my back for that one - I think it was an internal vaginal probe, again a small one. I've had so many scans and probes that I lose track a bit of who has stuck what where and when..... Again it was fine - and you can watch that one on the screen, which gives you something to do.... The scans are fine! Where are you having it done? I had mine at St Mary's. Good luck! X

ratprincess - there's no preparation like enemas or anything grim like that....

Cardamomginger - thanks so much. That's really helpful. On the scale of things, it doesn't sound too bad. I'm having it done at Kings College Hospital btw.

PS good luck with your surgery. Sounds like you've had a really rough time.