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.

[Littlecaf]

Following my second baby last year I thought I’d had a prolapse. The GP said she couldn’t see anything and proscribed thrush treatment. This helped but the ‘slipped tampon’ feeling was still there.

On my third visit to the GP she refered me to the UroGynae - and he tentatively diagnosed a Urethral Diverticulum. Tomorrow I have an MRI to see if that’s what it is. It’s then back to the UroG and possible surgery.

Two things.... post natal health is about physical issues not just mental. It’s not all about prolapse either. I’m pleased my GP listened and refered me.

[PositiveVibe]

Just to say that a 6 month check might not necessarily be the best idea (although I am all for standard postnatal checks and proper follow ups).
My understanding is that if there is nerve damage, it will have the best chance of recovering during the first 6 months following injury. This is means that the sooner pelvic floor exercises and other treatments are started following birth the better.

I saw my surgery midwife (ie she was not one of the hospital based midwives) a couple of times antenatally. Could these midwives be more involved postnatally and offer a stronger follow up?

[Littlecaf]

Just wanted to add, my parter has been supportive & understanding, esp as we are 7m post partum and no sex yet. He hit the nail on the head when he said “sex isn’t the be all and end all of a relationship but it’s a big ask for both of us not to have sex again, ever.”

[SleepyHeadThisTime]

For post birth injuries to be taken more seriously by medical professionals. I had an infection which was left untreated for 3 weeks post birth as my midwife said everything looked 'fine' and ended up back in hospital with a temp of 42 . I've just been told I probably won't be able to have surgery to remove the 'significant scarring' left behind which is painful and uncomfortable as it's considered a cosmetic issue.

[SleepyHeadThisTime]

And yy to a stronger follow up by midwifes - they need to be allowed more time to look after patients properly instead of rushing through the bare minimum of basically checking mum and baby are alive

[IfyouseeRitaMoreno]

This is an excellent campaign. Thanks MNHQ! I've suffered the things already mentioned. The incontinence I was expecting, the prolapse was a surprise. Then it turned out my mum and auntie had suffered the same but of course no one wants to talk about.

There's such a taboo surrounding these things. It's ok to display women's tits across newspapers but to discuss the real issues concerning women's bodies is hush hush because it's considered gross.

[Movablefeast]

It really is outrageous that women are left to suffer so much.

[Arthien]

I've been reading MN for a while but registered to post on this as it's a topic I feel really strongly about. I'm currently child-free but DH and I have talked about TTC in the next year or so, and to be honest the prospect of birth injury and long-term effects on my body terrifies me. Three of my friends have all had terrible birth experiences but seem to have just been expected to get on with things because that's life when you're a mum and that's just how it is.

I really think that if men were the ones who gave birth and one went to his GP and said his penis had been cut during labour and he couldn't control when he peed and couldn't have sex without pain, it would be a totally different scenario. It seems that women saying the same thing are just ignored (because hey, not being able to control your bladder is normal after pregnancy, and women aren't really supposed to enjoy sex anyway, right?). It also ties in with the long waits around diagnosis for endometriosis as 'bad periods' are just dismissed as 'women's issues'.

[Balearica]

Three DC, all vaginal births, forceps birth with first, completely knackered bits with double prolapse. I have no perineum to speak of. I have sought help a couple of times and just been told to keep doing kegels which frankly is a waste of time as there is nothing to tighten up. I have given up seeking help and given up riding, running, aerobics and sex.

There definitely needs to be much more follow up (ideally one month, six moths and two years) and a recognition that this adversely affects women's quality of life.

[AliTheMinx]

My son is now 6 and I am still utterly traumatised by his birth. The pain hasn't faded and the emotions are still so raw. He was 2 weeks overdue, and I was induced. I was so tense and frightened I needed gas and air just to be examined. The gel did nothing and it took 4 different attempts for doctors to break my waters, which were full of meconium. I wasn't coping at all and felt so out of control. I had 2 failed epidurals and the pain was untouched. I was finally hooked up to the awful drip, which gave relentless artifical contractions and my baby was very distressed and his heartrate kept plunging. They gave me an episiotomy, which was useless, as I still ended up with a severe 3rd degree (bordering on 4th degree) tear after a panicked ventouse delivery. I then waited 11 hours to be stitched in theatre with a spinal block, and had an infection for 3 months postpartum. It was hideous.

My body has been utterly ruined. My pelvic floor muscles are now lifeless and I have a very leaky bladder. Sex repulses me as it's so painful and I feel so disgusted by my body and embarrassed. I could quite happily never have sex again. Smear tests are agony and my vagina is now grey and misshapen. I feel as though every inch of my dignity and femininity was stripped away.

Would I do it all again? For my wonderful son, yes - a million times over, but in terms of more children - never ever ever again. My experience was so much worse than I imagined. I did not feel empowered - I felt like a failure, and it still troubles me greatly today.

[Flopsymopsycottontailbuns]

The key thing for me is how quickly you are booted out of hospital afterwards. Women used to get a week or more to recover and now you are lucky to get a few hours in hospital. In that time you are so shell shocked you don't even register certain physical feelings. I know you get post natal midwife visits but they can be sporadic too.
3 years on I know I still need to get my pelvic floor issues sorted, I know a very good female physio I am keen to see it's just time and money. I did go to my GP and they sent me for a scan to see if my bladder was emptying, it was so that was the end of it as far as they were concerned never mind the constant leakage.
So sorry to everyone who has had such bad birth trauma.

[SleepyHeadThisTime]

Totally agree - you are hoofed out of hospital so quickly there isn't time to register what's happened to you. I was unlucky enough to have my first during the hospitals busy period and was in for about 12 hours - not the 3 days the midwife who delivered my baby said I should have had.

Also it felt like the post birth checks were all about the baby whereas there should be a focus on the mother too. My 6 week check for LO2 was carried out by a male doctor - definitely not someone I felt comfortable talking about post birth injuries to (not that it was even mentioned!)

[PussCatTheGoldfish]

Absolutely something needs to improve.

I've also heard of the French system is very good, it's intensive and focused on getting the pelvic floor back to normal both for continence and sexual satisfaction. That's not just physical well being but emotional well being being looked after. And they are treated as women, not just mothers... (Perhaps they don't get the 'So how's mum?' as an after thought at medical appointments?)

My own first birth was a no pain relief forceps delivery, with a third degree tear and a pph. It was truly horrific. Every MW and Doctor I saw over the next 6 weeks was shown my stitches whether they wanted to see or not!

My second child was born by elective section due to worsening continence issues caused by the previous damage.

[Myownwendyhouse]

Mine was so awful I only had one child. Midwives who didn't listen let alone talk to me. I asked for painkillers for tow days after having stitches and no one have me any. I asked for help with my crying baby as I didn't know what was happening and no one came when I asked for help. I had a catheter that had blood in it. I asked for the reason why and just got an eye roll and told not to be dramatic.

I was back in hospital a few days later as I had some stuff left inside me. Was trying to find out what and why this was happening and was totally ignored. I have been left with so many medical problems after and they have been life changing. Pnd. And some very unhelpful doctors and nurses that I decided not to put myself through it ever again.

One of the consultants that I went to to help me with my problems after giving birth told me that I should be grateful that I don't have cancer and just get on with it.

After going to see the physio so many times after giving birth for my back I was told it was a different problem each time. And just gave up.

I live with the consequences of having a baby everyday and I wouldn't wish that hospital or those doctors or midwifes on my worst enemy. It may be an every day occurrence to them. But to me it was a scary ordeal and I didn't know what was going on and I was scared. But apparently being scared means ur over rating and lots of eye rolling is needed.

[2015newstart]

I'd been debating commenting but I'm in a similar position to Arthien - no children and the only thing that is putting me off, and genuinely putting me/us off to the extent that we might be childfree, is this issue. I'm only aware from reading MN and having close friends who have had significant issues. None of my friends 'breathed the baby out' and walked away injury free. Some of them had to be treated privately, had time off work etc and faced additional issues in the workplace because of it (try taking maternity leave then needing loads of sick leave / time off for surgery on top). I'm angry tbh that it's not talked about enough, nor is it discussed by medical professionals as something to improve on, nor is it seen as something to consider ahead of having children, which it ought to be. By the time you're pregnant it's too late - you're on a clock and your options are limited.

Sometimes I feel the attitude from society is "well 100 years ago you'd have died, so why are you complaining?" The same could be said of many other medical procedures but similar attitudes don't prevail there.

to all those who have shared their stories. I am hoping MN will effect change.

[Creatureofthenight]

Just to say my 6 week check was next to useless. GP took my blood pressure and asked about contraception. Only checked my c section scar because I asked him to. That was it.

[Melamin]

Went to the bbc site to read about the controversial you tube shooting and found this campaign trending as number 3, (the first 2 were the shooting).

Well done mumsnet. It is an important campaign. I hope this flags up the problems of not being listened to and the limited follow up care for mothers.

[PaulDacreRimsGeese]

We need ELCS on request. The risk of prolapse is higher following vaginal birth than section. There's no getting round that. And before anyone sweeps in to tell us how it would be more expensive, save yourself looking silly and do some research first.

[Vickxy]

I am still waiting 3 years later for help with my prolapse. Have brought it up multiple times, GP insists that it will be any day now. My labour was pretty decent, could not have asked for better midwives and such, mind they did laugh at me when I said it felt like there was a balloon blowing up between my legs (had had an epidural after 20 hours)..which in hindsight I think they probably should have checked me then. Anyway, when I did get checked it turned out the balloon feeling was actually the babys head. This is when it got a little shitty. After a bit of pushing, it turned out that babys heartbeat was dropping with each contraction. In came doctor who told me forceps was needed and if this did not work then CS. Of course I wanted baby out ASAP too if she was in distress. Everythings a bit blurry for a bit but luckily DD did come out with the forceps with nothing more than a weird dent in her head from them. But it turned out I had also been cut, which I was not told. I would have consented anyway as..anything to get her out safely really. But it would have been nice to be actually told what was going on.

Post natal care was kind of ok except for being told I was starving DD as I could not get her to latch properly or for very long and being told that its dangerous for them to only have little bits for 24 hours after the birth and I needed to formula feed. Something I have found out later was an utter lie. Ended up spending months and months pumping and waiting to see lactation consultant etc in order to BF as I had wished and still never managed it tbh. But besides that, great.

However, I also had a prolapse. Still unsure which kind but I have to kind of push with my fingers in order to poo and I can feel something bulging out of my vagina also. And thats when care got really bad. GP at first brushed this off as just something that happens in labour, Months and months I got the brush off with not even a physical examination. Eventually, a new GP joined out surgery and I got an appointment with her, she examined me properly and put in a referral. Unfortunately, she left again pretty soon after that and I have been stuck with the normal doctors, who are back to brushing me off all of the time.

So yeah, a mix of positive and negative

[Vickxy]

Just to say my 6 week check was next to useless. GP took my blood pressure and asked about contraception.

Yes, same here.

Only decent parts of my care seem to have been the midwives tbh. The ones there during my labour (both couples, as it was a LONG labour, 36 hours overall) and the one who came out after I gave birth to check stitches and such too.

[HunterofStars]

I'm childfree but just wanted to say that this is a fantastic campaign. It's shocking that so many women have been treated so appallingly at what should be a positive time and are left with pain and life changing injuries so many years later and doctors fob them off.

to all those who have shared such horrible experiences.

[Imbluedabadee]

Fantastic campaign, good work MN! I was turfed out too early and had no checks at all despite an episiotomy (which I didn't even know about until I read my notes) with dc1 and 2nd degree tear with dc2. I asked at every mw visit if they could please take a look at my stitches but every time they said no it'll be fine. After dc2 I phoned them a few times because I was in agony with my stitches to the point that peeing had me in tears, I couldn't sit and I had got constipated through putting off going for a poo still no one came and they were so patronising with how they responded to me. I was told to make a gp appointment and he prescribed antibiotics but still no one checked me and then I was signed off from mw care. It's only looking back on it now that I can see how neglectful that all was, the mother is totally insignificant in postnatal care and that is not right at all.

Maggie I was almost in tears reading your post, I hope you get fixed soon and manage to heal from your awful experience.

[Anatidae]

We need ELCS on request.

Yes. I agree completely. And I’m sure I’ve read work that shows that it doesn’t increase costs or drive up levels past the point they are in some areas anyway. It seems to level out at low 30%s if I remember rightly.

A simple ELCS can in the long term cost less than decades of incontinence and issues. And the emotional and wellbeing cost can not be quantified. We should be being railroaded into ANY method of birth that isn’t what we want after we’ve understood the clinical context. I know too many women who are suffering awful complications after begging for, and being turned down for, elcs. It should be granted on request.

I am pushing for an elcs for my second delivery in a country with no right of request and an obsession with ‘natural’ everything. And gosh - an obscenely high birth injury rate to go with it. I am worried.

[LineyDancer]

I recall my partner had to physically place himself between me (flat on back on delivery table) and the midwife when he realised she was about to cut me with a scalpel without my consent or knowledge. (And I didn't have or need the cut.)

When and where else is behaviour like this by medical professionals allowed?

[Heregoeseverything]

Fantastic campaign Mumsnet.

to each and every one of you who has suffered. It is shocking and outrageous what so many women go through and how little it is discussed, it truly upsets and angers me.