Guest post: "Women are expected to go home with life-changing injuries after giving birth and just get on with it"

[JuliaMumsnet]

For Birth Trauma Awareness Week, Jen Hall from the MASIC foundation, which supports women who have suffered serious injuries during childbirth, writes about her experience of childbirth and the MASIC's Foundation latest findings:

"When I gave birth back in 2013 I had no idea what lay ahead of me. I’m not talking about the sleepless nights, breastfeeding battles, or any of the other aspects of new motherhood that are widely talked about. What I had to cope with alongside new motherhood is something that is rarely spoken about - yet is a major trauma for the thousands of women affected each year.

Severe birth injuries, or third- and fourth-degree tears, are injuries that extend from the vagina into the anal sphincter and are a leading cause of bowel incontinence in women - alongside pelvic floor dysfunction, pelvic organ prolapse, nerve damage and impaired sexual function.

My birth injury was caused by being left to push for three hours, causing a traction injury to the pudendal nerve, followed by two failed attempts with the ventouse and a brutal forceps delivery where my baby’s head and body were delivered in one contraction. Long term it has left me with many of the symptoms listed above. I’m a shell of the person I was, my confidence has been deeply affected, and I no longer feel like a woman who has control of her body.

My experience of motherhood was deeply affected by the injuries I sustained. I didn’t walk into hospital at 33 years of age to have my baby and expect to come out unable to run for the rest of my life or to carry out the most basic of bodily functions.

At The MASIC Foundation we carried out a survey at the beginning of the year to try and assess exactly what impact sustaining a severe birth injury can have on your experience of motherhood. We knew women would find this difficult to talk about, so the survey was completely anonymous. The survey ran for a month across our social media channels, and we received responses from 325 women who self-identified as having suffered severe perineal trauma when giving birth.

• 85% of women who sustained severe maternal perineal trauma said it impacted on their relationship with their child.
• 49% of women said they doubted their ability to mother because of the injury.
• 46% said the injury affected their relationship with their partner and wider family.
• 34% felt their relationship with their child was affected because they associated their child as the cause of their injury.
• 31% said they wondered whether their child would be better off without them.
• 24% of women affected regretted having a child because of the injuries they are left with.

The results we have gathered are shocking and heart-breaking, and show in stark reality the impact these injuries are having on mums and babies each year. These injuries can lead to feelings that no woman expects to feel or wants her experience of motherhood to be. The results are hard to comprehend. But if you have suffered a severe birth injury, I’d wager you can relate to some of these feelings.

I felt that I was a failure after my birth, that there was something wrong with my birthing body that had led to this. I spiralled into a deep depression, unable to comprehend that a) having a baby could leave you like this, and nobody tells you and b) women are expected to go home with life-changing injuries and just get on with it because they are mothers now.

And these feelings led to a complete rejection of motherhood in the early days. If my body could be treated so casually as collateral damage, then why did either of us matter anymore? What good would I be to my son if I couldn’t ever lift him, play or run around with him? I fixated on the time before my pregnancy and birth, before everything ‘went wrong’. I’d unwittingly given permission for an assault on my body that had profound implications for my future.

If I tried to speak out about how I was feeling to the health visitor or to my GP I felt like I was being judged on my ability to parent. I was told my injury was ‘all in my head’ on numerous occasions and another health professional suggested that maybe it was because ‘deep down I didn’t want my baby.’ The ignorance and judgement I faced only worked to compound my isolation and distress and I feared I was a bad mother because of the things I was being told every single day.

The feminist inside me was raging.

My feelings are echoed in accounts we have heard as a charity, from other women who experienced severe injury during childbirth:

“My confidence, my me-ness, the essence of who I am, has been destroyed, my relationships with my child and my partner have suffered.”

“With my son, I love him dearly, he is the best thing in my life, but his birth caused the injury and it is difficult to square the two,”

“Every year I dread his birthday and the reminders of my traumatic experience. It is not fair on him or on me – his birthdays are not a happy occasion, but every year I have to pretend it is.”

“I am ashamed to say that at times I wished I had never become a mother and I grieved for the life I had before, I paid such a high price to have a baby.”

I know these feelings are controversial to express. But I feel they are important if we are ever going to get the NHS and policy makers to sit up and take notice of women whose bodies and lives have been deeply affected by childbirth injury and trauma. As long as women are expected to endure poor treatment while giving birth, these injuries will continue. Motherhood should not become an identity that disregards womanhood, and women should not feel afraid to speak out about the physical, emotional and psychological effects of birth injury."

Read the MASIC Foundation's full survey findings here.

Follow MASIC on Instagram: @masicfoundation
Facebook: @MASICFOUNDATION
Twitter: @masic_uk
If you're looking for support or to talk to someone about your experience, please call the MASIC 24h freephone Birth Injury Support Helpline 0808 1640 8333.

Jen will be coming back onto the thread on Tuesday (time tbc) to answer your questions.

I had to persevere with my GP for 2 years before she actually referred me to a gynecologist. But she told me not to expect any help because there was 'nothing wrong with me'. When I eventually did see the gyne he could not believe i had been told for 2 years that there was nothing wrong with me. He instantly diagnosed me with grade 3 cystocele and rectocele, and booked me in for surgery right there and then. I hadn't been able to walk, laugh, cough, sneeze, dance, pick my child up, walk up the stairs or do any excersise without being wet to the knees with urine. My GP had told me to just wear pads and never excersise again the surgery has changed my life for the better but I know so many women don't get that chance. I bet there are so many women who present to their GP with the problems I had and are also told they are fine, and they just accept that answer as they don't want to be a nuisance. Disgraceful.

[quote WhoKnew19]Has anyone read this very timely article on the BBC about failings in maternity care? Those poor families!
BBC News - Nottingham maternity scandal: 'The pain never goes away'
www.bbc.co.uk/news/uk-england-nottinghamshire-57864446[/quote]
@WhoKnew19 Absolutely, the stories emerging from the recent maternity scandals highlight what is going wrong when normal birth is prioritised 'at all costs.' Scores of avoidable mother and baby deaths and this is without factoring in maternal injury at all in any of the findings so far.

@KittyKel

So pleased you’ve sparked this discussion. Birth injuries are not discussed enough. I had a theatre delivery with forceps and episiotomy, 3rd degree after a good 3hrs+ of intense pushing. 2 years...totally numb on the scar tissue, a bit leaky, occasionally prolapse esp if I’ve been lifting, plus my DD has scarring to her face and nerve damage to her eye.

No one ever checked how I was recovering. I honestly think the recovery was worse than the labour, and the standard line you hear ‘you forget the pain when you hold them in your arms’ meant in my emotional wreck state I felt a bit of a failure, somehow being weak or mardy about it all that I stIll was in pain weeks after.

@KittyKel Thank you such an important discussion and thank you for sharing. Thank you to all the women on the thread who have been open and honest about their experiences.

@shreddednips

I'm so furious reading all of these comments, you are all so brave to speak out about your appalling experiences.

I wasn't left with physical injuries, but terrible mental health problems after DS was born. I was left alone for what must have been nearly 24 hours with no monitoring or pain relief, because despite contracting every 2 minutes, I wasn't dilating. I was told that I wasn't allowed gas and air until I reached 4cm. When I finally reached the 'magic' 4cm, they decided to have a listen to DS's heartbeat and discovered he was in severe distress.

I can't remember his birth because I ended up with PTSD and I've blocked it out. All I can remember is asking if my baby would live and no one would answer me. The only thing I can remember is screaming and begging for them to let me die as long as they could save my baby. Until I had therapy, I was unable to fall asleep because I could hear flashbacks of myself begging the doctors to save him. For some reason, I felt terrible shame at having been so out of control.

After the section, I was told by one of the midwives not to take the strong painkillers unless the pain was absolutely unbearable in case the doctors reviewed my medication records and thought I was taking the oramorph when it was offered because 'I liked it too much'. This made me think that if I took it as often as it was prescribed, the doctors would think I was taking the painkillers for fun and would question my ability to be a responsible parent. So I refused the oramorph despite being in terrible pain and just took paracetamol.

Sorry if this is a derail, I know it isn't a birth injury as such. But almost every woman I know who has given birth has suffered physical injury , psychological injury, or both as a result of their births. I had a conversation with a friend recently where we both said how invisible we felt when giving birth- like we were there as a vessel for producing the baby and that the baby's safe arrival was the only thing that mattered.

@shreddednips "Sorry if this is a derail, I know it isn't a birth injury as such. But almost every woman I know who has given birth has suffered physical injury , psychological injury, or both as a result of their births. I had a conversation with a friend recently where we both said how invisible we felt when giving birth- like we were there as a vessel for producing the baby and that the baby's safe arrival was the only thing that mattered." Not a derail at all. Very important point to make. I felt invisible giving birth too and that baby's safe arrival was all that mattered. Women must not be treated as collateral damage.

I'm so sorry my time is up and I've not had chance to get to the later comments on the thread.
Please do get in touch on our socials or by getting in touch directly with us at MASIC. I feel like this is a birth injury 'me too' moment and we must keep banging the drum to improve care for women.

My child’s birth resulted in a double shoulder dystocia after 6 hours pushing (with epidural thankfully) , followed by emergency forceps and 2 second degree tears. I was still bleeding a few hours later so had general anaesthesia and further surgery for them to figure out why, resulted in more stitches but I lost over a litre of blood. Couldn’t feel anything down below and had incontinence and pissed my self several times in the hospital. I could barely move and didn’t make the toilet several times. I did have ok follow up care though. The GP actually called me in for a visit once I was home on reading my notes as she thought it sounded horrendous and to see how I was doing ( I think the midwives thought I was at risk of pnd as really struggled to breast feed initially due to delayed milk and I was so tired and anxious about everything) Still couldn’t feel my arse for months, couldn’t hold in pee or poo so if I felt I needed I had to go straight away. Eventually feeling came back and I can hold poo again. I can hold pee but not as well and if I’ve a really full bladder and sneeze or laugh I pee :o so I know to avoid holding for too long. I’m a runner and it took ages before attempting a run again.

No one else really bothered though, except the gp. The midwifes kept saying I’ll be back in 2 years but I categorically do want another and I think birth was part of it. I Iove my daughter dearly though and wouldn’t change it. People kept saying to me to not let birth traumatise me (Fil several times) and I wanted to scream at him to fuck off. It really annoys me how we are expected to not make a big deal about birth and keep popping out kids and in fils case so he can boast about X number of grandkids.

Thank you so much, @JenHallMASIC and @JuliaMumsnet.

Can this thread please stay open for further discussion? It's so important.

Thank you so much @JenHallMASIC for taking the time to answer questions and to everyone else for joining the conversation. Clearly a hugely important conversation that is much needed. Jen has kindly said she will try to come back on to answer more questions at a some point soon.

In the meantime the thread will stay open @SpindleWhorl.

Had to have a little cry after reading this thread. My first DC was a forceps delivery after a 36 hour labour, epidural, drip, two hours of pushing, etc. I had a 3c tear, episiotomy and a haemorrhage.

Afterwards I was given six sessions of physio on the NHS and was told never to run again. But I was never told I had an enterocele or a rectocele. I only found out what those things were from Mumsnet. Those words were literally never mentioned to me by any health professionals, ever. There was a fantastic and very informative long-running thread and I figured out what was wrong with me from reading it. Luckily I had private healthcare cover at my work, so I was able to have surgery to repair the birth injuries when DC1 was 3.

My second DC was born via ELCS, which was an absolute dream birth by comparison. And my recovery was much quicker. I was up and about within a week, compared to still shuffling about and being semi-continent and needing physio for months after my first birth.

But like PP have said already - even after my ELCS, I couldn’t believe that I’d had such major surgery and then as soon as I was back on the ward, I was given a newborn to look after and basically left to get on with it on my own. Can you imagine if a man had had his appendix removed and then immediately he was out of theatre, he had a newborn put in his arms and told to crack on?! It just would never happen.

I did antenatal classes and all the information was about hypnobirthing and aromatherapy and doulas and home births. Medical births were only mentioned as something to be avoided at all costs and a sign that you had ‘failed’ to give birth ‘properly’.

Giving birth is brutal and often deadly for sadly still too many women and children. But there’s a denial around how damaging and dangerous it can be, and midwives, HVs, etc seem really invested in pushing this narrative that having a baby is a fluffy, gorgeous, wonderful, cutesy wootsy experience and the worst that might happen is you might poo yourself (but we just won’t mention it hun).

It’s weird that ante and post-natal HCPs just never mention this stuff.

@JenHallMASIC thank you for responding to my post, and you are welcome to quote any of it!

The silence and shoving all these issues under the rug so as not to scare new mothers actually angers me! My sister is pregnant for the first time and my mom keeps telling me all these possible, terrible side effects she could get from the pregnancy and the birth but always says "now don't tell your sister." "don't tell your sister or she will be scared." I however can't bring myself to tell my sister, also cuz then my mom will be mad I did. I think it's to protect my sister? Plus, she is pregnant so if it's bad, well too late now type of mentality?

The silence and not telling women things is a big issue. Also goes for other women-related things too (menopause, periods, also sex)

I feel so sad for all you women! I have never had kids and refuse to have any for many reasons, this issue being one of them. However, my little sister is pregnant, and I've been worried about her birth experience. Hopefully it won't be too bad.

Women/girls are hated, loathed on this planet, I'm convinced.

I agree it’s really strange the silence about it all. They do tell you to do pelvic floor exercises, but it’s not that clear why. They don’t warn you that your pelvic organs could literally fall out of your vagina and require major surgery to correct and you will never be able to run again or lift heavy items. They just give you the impression that it is so you can control urine. I didn’t think it that big a deal as I could just do lots of kegels to strengthen urine control and this would be fine.

@stairway

Legimumclip, this is a post about terrible vaginal birth injuries and not receiving the right care before and after, it is not about birth in general. Im not sure how posting a positive csection experience is helpful when it’s obvious you can’t get these types of birth injuries if you only had csections. I’m not sure how useful this would be to first time mums either. Although anyone has the right to request a csection it’s never guaranteed. The NHS discourages it, probably because of money and resource issues they can barely cope with the level of csections at the moment.

The fact you recognise that these injuries are extremely unlikely if a woman has a c-section is exactly why c-section stories (positive and negative) are relevant to this thread. Stop banging on about 'most posts are this or that so you're not welcome' - who are you? The MN police? Ultimately, we are all discussing and replying in relation to the OP, which is about the horrendous injuries and after effects of vaginal birth. The OP lends itself to discussing birth options as well as sharing anecdotes, imo. I'm someone who has yet to give birth and it's useful to hear all sides of the story rather than an entire thread of 'yes, women should give birth vaginally but you're potentially in for this world of pain' - it is good to know that there are options, even if ultimately someone decides they do want a vaginal birth.

Labyrinth, I thought some of the comments were very I sensitive that is all and I explained why ( if you bothered to read)

@stairway

Labyrinth, I thought some of the comments were very I sensitive that is all and I explained why ( if you bothered to read)

I did actually read the entire thread. I was heartbroken and fuming reading the horrendous experiences that women have endured at the hands of medical professionals. However, you did come across very rude to people who were merely stating there were alternatives. I can see how some posts may have come across as smug but you and a few other posters kept saying that the thread wasn't for discussing birth options and that is what I objected to. In fact, the lady from MASIC stated she requested a c-section and was turned down in 2013. I have looked into this a lot and it seems things are changing, with the help of Birth Rights, and that could be very useful information for other people reading this thread. By the same token, there is value in women sharing negative c-section experiences to provide a balanced argument. Ultimately, there is no entirely good, safe way to give birth and women need to be able to make informed choices and be mentally prepared for what could happen, whichever delivery method they chose/end up having.

Labyrinth, I said would bow out of this thread as I don’t what to derail it which I have. The thread is primarily about traumatic birth and birth injury. Whereas discussing birth options could be included sensitively , I think going on to this thread with the sole purpose of telling everyone how wonderful your own birth and recovery was is really insensitive given what the IP and many others have been through. Anyway I’m definitely going now. I hope your own birth goes well as it does for most women.

It's not only physical injuries but mental ones, nobody told me I would be left with PTSD after having a baby. I was in induced labour for 60 hours & nobody bothered to check if my baby was in the right position, he wasn't, he was back to back & after an emcs the midwife told me there was no way I would have delivered him naturally. I was in HDU for 48 hours as I was seriously ill with HELLP syndrome & pre eclampsia, my organs began to fail & during the night after ds was born I was screaming & begging the staff to ring my mum & husband as I thought I was dying, I just got told to shut up because no matter how ill I was they weren't going to ring them. After 4 days I discharged myself, I felt like I wasn't receiving any care, I went home & thankfully my lovely GP came every day until I was well enough to go to the surgery. It should have come as no surprise that I have bad PND, I was suicidal & without the care of my midwife, my GP & my mum I don't think I would be here now.

My child is now 10. In the days immediately following birth I was doubly incontinent. I had slight urinary incontinence for about 4 years, this has resolved. I have a prolapse which has got worse overtime and is sore. I too, dare not run. My worst after effect by far is the lack of feeling in my bowel. If I try to wait any length of time I can suffer incontinence, I often think I've finished moving my bowels only to find when I stand up that I hadn't. I also suffer from almost constant thrush, which is much worse than any episodes prior to giving birth. After delivery, I heard my midwife argue with the female reg. that I needed to be repaired in theatre. The reg. insisted that I didn't. I often wonder what I would be like if she had listened.

[quote Girlmama3]@JuliaMumsnet could you maybe move this to child birth or post natal health? It's not the thing most pregnant ladies want to see when they're already worried about the unknowns of labour 😩[/quote]
Hi @Girlmama3 - sorry if you've found this distressing. We pin all our guest posts to AIBU and active for a week so this one should be unpinned from the boards very shortly. There is also the option of temporarily hiding different boards in the future.

Threads like this always remind me of this picture.

I've just had a look at MASIC website and see they have a 24 hour birth injury support line. Is there a way to include this in the OP and pin it to help women who are suffering right now find support?

I know when I was in hospital alone at night and literally shitting myself as well as being terrified and no one would help me, it would have been useful to have this number. The most terrifying thing was that there was no one to explain what was happening and reassure me that incontinence is normal with a 3rd degree tear and for most women it will get better.

How do I ask MNHQ, is it by tagging @mnhq

@DanielTigersMummy21 yes I agree this is a great idea to pin the helpline.

I remember being in hospital asking the midwives if it was normal that I couldn’t hold faeces / wind. The responses were that they had never heard of it happening and they refused to engage. One midwife just shrugged and walked away. I really felt that they were avoiding giving me any answers and this added hugely to the emotional trauma and panic about what had happened/ what state I was left in. I was left to figure things out myself on google and then of course came up with worst case scenarios.

Does anyone know why this seems to be such a common reaction from midwives? Is it lack of training? The bemusement/ lack of acknowledgement let alone help or advice, added hugely to the distress involved.

Hi @DanielTigersMummy21 Thank you, that's a great suggestion.

Just to make it clear this is a 24 hour helpline, but it is not manned, you leave a message and a trained advisor will call you back.

It is an signposting service rather than a crisis line, but may definitely be helpful for some of the women here.

Tagging @JuliaMumsnet to see if we can get the helpline added to OP.

Persuaded to have pethidine, but not told that I'd have to lie down. That's what made my first labour go wrong in my opinion. I'd been up on my feet and progressing well up to that point, but as soon as I was on my back, it slowed right down and I had to have the drip to get it going. This in turn led to an epidural, which only worked on one side.

I told the MW I was pushing, but she didn't believe me until baby was more or less out. I had dreadful tears and bled a lot. Had to wait for the registrar to stitch, which was hours later as it was a Sunday evening. No local anaesthetic given for the stitches as I had epidural, but the side he was stitching wasn't numb so I had to use gas and air. The MW failed to catheterise me before sending me to the ward, still numb on one side and no one would help me to the toilet. I couldn't reach my baby, and the night staff said they were too busy to help me. My epidural took 24hrs to fully wear off.

The stitches in my labial tear burst the following day, but the doctor wouldn't restitch; said I would learn to live with it. I didn't, I had surgery 10 years later after my second and final child was born. I've been left with urinary incontinence and a rectocele.

I did have a very quick but tear free second labour. I'm amazed I did it again...

My first dd was born 11 years ago I was only just 20. I couldn't cope was given ga's and air and paracetamol. They was adamant it would be hours and hours. I was kept in because my BP was up and I had gbs so needed ivabx. Anyways they sent my husband home BTW its the day the snow came down in 2010!. Anyways he was called hour later as I was in agony and was going to the Labour ward. I have very quick births which is good but not good as the pain is more intense. I had an epidural that didn't work as I was to far gone. No idea why I was not given diamorphone instead. Baby came and I had a retained placenta stage 2 tear 3 hour 45 min with an hour pushing. I was left in a big lovely private room all alone and numb as had to have spinal block for theatre. The catheter was hooked on bed and I couldn't reach it and i couldn't move up bed. No one helped me was laid in a blood filled bed unable to move. Thankfully my mum came and helped.

2nd time straight forward birth nil issues but the midwife saying it would be hours dismissing my quick birth. Anyways she got a shock when the doctor came as I was in distress and baby's heart rate was down. She said there is no way she can be in this pain at 2cm. Anyways they checked me again and I was 10cm. Overall time from any pain at all to deliver was 2 hours 30.

They don't listen