MNHQ here: the impact of birth on women's bodies, wellbeing and sex lives

[RowanMumsnet]

Morning all

Today we're launching the next phase in our campaign for Better Postnatal Care, highlighting the impact of birth on women when it comes to things like prolapses, genital and/or anal wounds, and continence.

Figures we're releasing today reveal how many mothers are struggling with physical symptoms associated with prolapses or wounds, painful sex, and problems with continence, months or years after their babies were born.

You can read more detail about our survey here, and The Pool has this morning published a piece based on our stats if you fancy having a read.

The Chief Medical Officer’s Report of 2014 found that ten years after giving birth, around 20% of mothers will experience urinary incontinence and around 3% will experience faecal incontinence as a result of their pregnancy and birth experiences. And according to the NHS, up to half of women who’ve given birth will experience some degree of pelvic organ prolapse. You can read more about the current picture in the NHS here.

What do you think we need to be calling for to tackle this issue head-on? Do we need the collection of long-term data? Do we need to bring back the six-week check for mothers (which has become postcode-dependent now that it's no longer included in GPs' contracts)? And what can be done to encourage mothers to overcome taboos, shame and embarrassment associated with these symptoms and proactively seek help, and ask for second opinions where necessary?

We've made some suggestions here, but we'd love to know what you think. NHS England is actively looking at how to improve postnatal care at the moment, and so many healthcare workers we've spoken to are aware of the problems and looking for solutions - it feels like the right time to come up with concrete proposals.

So, as ever, do please let us know what you think!

If you'd like to join our mailing list of campaign supporters so that we can keep you up to date with the nuts and bolts of the campaign, please email us on [email protected] with 'Campaign Champions' in the subject line.

Thanks
MNHQ xx

PS We very much welcome thoughts from everyone on this bit of the campaign, but for those wondering where experiences of CS come into all this - we will be doing a piece of work on that next.

[RowanMumsnet]

@londonloves Really hope the physio improves things for you

@gizzymum thank you! That's really useful. The stakeholder day is part of this study into implementing pelvic floor exercises into antenatal care. The organisers have been inundated with people wanting to take part I think but we will report back here after the stakeholder event

Thought you might like to have a listen to this: we went on to the Standard Issue podcast to talk about the campaign (my first podcast experience, so please be kind...)

Just a reminder also that if you want to be added to our crack squad of campaign supporters please email us on [email protected] - you get all the campaign news direct to your inbox.

Thanks

MNHQ x

[londonloves]

I have gone private for postnatal physio as nhs wAit is three months for a group session. I'm very fortunate that I can afford this, as nhs help is basically shit here ( south east London).

I haven't read the whole thread so apologies if this has also been covered but there's a huge mental health impact. I feel like my body is wrecked and disgusting and all I get told is "well this is what childbirth does to you". I'm terrified of having another baby. I cried when I watched the London Marathon this morning as it was on my bucket list but I've pretty much been told that running is out of the question for me, forever.
And it's also had a massive impact on my relationship. I don't want to have sex, and I am SO SO angry that my partner doesn't really understand, says "oh I'm sure it will be alright" when it probably never will be alright, actually. He can still exercise, he hasn't put on three stone. He gets to enjoy this amazing baby and he hasn't suffered at all, and I'm afraid that sometimes that makes me really mad because it's so fucking unfair.

[Gizzymum]

@RowanMumsnet

Re: self referral to clinics/physio I'd expect you'd have to nag DoH. Individual CCGs commission services from the different NHS Trusts which can create the "postcode lottery" you hear about, but I'd expect the DoH is the only organisation which could demand that all CCGs commission the level and type of services etc being discussed/suggested for post natal care. (I used to work in finance for a Primary Care Trust before the change to CCG's).

I'm intrigued about the stakeholder group you mention linked to postnatal physio - are you able to share any more info? (I'm now a physio myself).

[LineyHasntLeftTheBuilding]

Thank you @RowanMumsnet - I hope Emma Hart MP will be a good ally in this campaign.

[AuntyElle]

‘I became incontinent at the age of 30’

by Luce Brett in The Pool:

www.the-pool.com/health/health/2018/16/luce-brett-on-being-incontinent-aged-30

[sjpPOP]

I can't figure out how to get info to you on that link. Here is the link to APOPS POP Risk Factor Questionnaire page on our website. Give me a shout if you have any questions.
www.pelvicorganprolapsesupport.org/pop-risk-factor-questionnaire/

Sher

[RowanMumsnet]

Hello

Back with some updates for you

First off thanks very much for the recent comments and input

Emma Hardy MP - great (we'd missed this) - we'll contact her and see if she wants to do any further campaigning on this

@sjpPOP we'd love to talk to you about the assessment tool if you're up for it - you can find us on [email protected]

@JohnnyMcGrath sorry you didn't get what you needed (and deserve).

@antiGrinch Self-referral is on our list! Just working out who we need to badger about it.

@TigerTown thanks v much for that link

And in terms of what we've been up to:

We've asked the RCM to feed back on some of the points touching midwives' roles, information dissemination and training. We're mindful that midwives don't exactly have the most leisurely roles as it is but on some of these points (eg giving info to women antenatally as well as postnatally) they do seem to be the obvious contact point. They're looking into it and we will report back.

We had a very interesting convo with MASIC - a charity that supports women with anal sphincter injuries incurred in childbirth - and they're doing lots of work in similar areas. We're going to see if we can work up an action plan to support some of the stuff they're already doing. Any MNers affected by anal sphincter injuries might want to take a look - they are launching support groups and have information for women.

Some MNers and I are going along to this stakeholder group focused on postnatal physio and we'll report back on that in June.

We've also been invited to a pelvic floor stakeholder day at the Royal College of Obstetrics and Gynaecology and will report back on that too.

[louharrisismyhero]

Isaw the Emma Hardy MP debate coverage - and the call for physio - specifically comparing against the (much better) provision in France!

[LineyHasntLeftTheBuilding]

Emma Hardy MP calls for physio for all new mothers, cunningly hidden in an equally important article on vaginal mesh debacle. Parliamentary debate, no less. On business. Go figure.

www.theguardian.com/science/2018/apr/19/vaginal-mesh-surgery-exposed-women-to-unacceptable-risks

[AuntyElle]

I’m surprised this has gone quiet, there must be so many more MNs with experience to share and/or desperate for help.

[AuntyElle]

Such a vital campaign by MN. I had no idea about the extent of this until reading threads on here. I’m lost for words at the suffering described here, surely so much of it avoidable.

[sjpPOP]

This is a priceless campaign taken on at MN, and the timing could not be more pivotal with the mesh issues causing so much hooplah in the media. It is imperative women not only have access to women's health, but also the KNOW about the issues that may occur. Engaging multiple organizations that address women's pelvic health in the UK will spread awareness and engender change. Priceless. Zero doubt PT eval post partum is a priceless tool that should occur globally, but currently only occurs in France. Here is a tool APOPS built to raise awareness of POP issues, POP Risk Factor Questionnaire.

www.pelvicorganprolapsesupport.org/pop-risk-factor-questionnaire/

[freegazelle]

I refused forceps - my mum (a GP) says that was irresponsible, but my baby was born fine after 40 mins of pushing (so not sure why they wanted to use them so early). Looking at this thread, so glad I did.

The lack of research into instrumental delivery is absolutely shocking.

[SianRunner]

TinaTop, absolutely agree. As I've said earlier, the difference in aftercare regarding my two birth experiences and my recent hysterectomy has been huge. Fucking huge.

Hysterectomy rightly is treated as major surgery, even when performed laparscopically - so I've had quite full on care from both GP surgery and Gynaecology.

Give birth? Forget it. I know my births were a while ago but that mind set is still there, isn't it, that women giving birth are just fussing about a natural process? Even when they'd had medical interventions ...

[TinaTop]

What shocks me most is that anyone is having surgery with no checkups afterwards! Forget about female/male and the fact that the surgery happened during birth - no person should undergo any type of surgery without subsequent follow-ups to make sure they've fully recovered. And as far as I'm aware, there is no other type of surgery where this would be considered to be anything other than a serious breach of care?

[Astrabees]

Going back a good few years to when my two were born my GP did an internal examination both times as the 6 week check, and so far as I'm aware it was routine. I knew her through work as she sat as a magistrate too, so it was a bit embarrassing. I still remember her telling me to keep up with the postnatal exercises as I still needed to do more work on my "front wall".

[neonyellowshoes]

NCT- good for making friends. Bag of shite in most other areas.

The classes are filled with pointless fluff which does nothing to prepare you for birth.

[sunshinestorm]

My area doesn't even do routine 6 week postnatal checks with a GP. I had a six week baby check with the health visitor and that was it. No kind of check up for me at all. Think this is the norm in other areas too.

[mamasiz]

Following with great interest having just given birth for the first time 6 weeks ago - 30 hour labour, an hour of pushing and reduced fetal heart rate resulted in episiotomy (2nd degree) with forceps delivery. I asked for a c-section as I was so desperate to get my little boy out but this was refused on the grounds that I was fully dilated and he was too far down the birth canal. My son was delivered with only a very faint red line line next to his right ear and a little bruised earlobe. I lost a litre of blood and it took about 30-40 minutes to stitch me up. My stitches have healed well but I got more aftercare information after having my ears pierced than I did with an episiotomy. After a fortnight I still had a heavy, dragging feeling and ended up passing some retained placenta at home in my bathroom - a 10x10cm piece. I was not informed at all that a piece could have remained so you can imagine I was pretty surprised and grossed out! I went into hospital and was checked over by a consultant that day but since then I have paid privately to see a gynaecologist who did a thorough examination of me as I was so concerned about prolapse/tilted womb. Thankfully I understand that what I’m feeling is normal laxity and with pelvic floor exercises this should improve. She could not have been more caring or interested in how I am. I felt listened to which has massively improved my emotional well-being. She lamented the fact that there is little aftercare for women through the nhs. I’m seeing my GP next week even though my surgery do not do the 6 week check - which I think is appalling given what we women go through and the physical and mental effects of birth. I’m currently looking for a women’s health physiotherapist and will pay privately to see them. It’s all going on a credit card. I shouldn’t be getting into debt for my health but I need to be physically well for myself and my son.

[Hypermice]

Not saying that you are overweight btw.

I have put weight on, although not crazy masses (currently pregnant so a tad spherical) I’ve gone from an 8 to a 14 which is more than enough to be annoyed about (and yes entirely avoidable if I’d have reduced my calorie intake but there you go) but what’s worse is the lack of fitness. I used to be able to run a half marathon distance on no training. Yesterday my husband had to help me down the stairs. :( that’s what’s upsetting. Loss of function and fitness.

[Hypermice]

"Oh," she said blankly, "I don't think we have time

Bloody shocking.

I’m just pushy these days. ‘Ok, so when is best for you to look at it? I’ll book another appointment before I leave, yes? Or are you not the best person? Who is? What’s their contact method?’ Etc etc.

And any back-pedalling is met with relentlessly polite bulldozering until you get an appointment.

[HelenaDove]

?" I used to run, bike, climb, everything. Not any more. What’s the long term cost of that to my health"


And then they start moaning about weight.

Not saying that you are overweight btw.

[JustWanderingAbout]

Totally appalling. How come your health was not included in the 8 week check?!! Book another appointment Johnny. Don’t be fobbed off.

[ChickenMe]

Forceps here with a back to back baby
Still find my genitalia scary to look at. I'm sure I have a rectocele but a creepy male gynae was v dismissive

[JohnnyMcGrathSaysFuckOff]

Update - went for my 8w check today. They checked Twin 2 but didn't need to check Twin 1 as he is still under hospital paeds and had a check up there earlier this week. So appt was finishing earlier than planned. I asked if the GP could look at my potential prolapse.

"Oh," she said blankly, "I don't think we have time."

So that's that, then.