3rd degree tear/forceps- bowel control issues

[Itsrainingfrogs]

Hello,

I am nearly 5 weeks postpartum following a forceps delivery with episiotomy and 3b tear (DD came out with her hand on her face!).

Know it’s still early days but since the delivery I’ve had wind incontinence where I can’t hold in farts at all which is so embarrassing, and also bowel urgency which has made me afraid to leave the house. The urge to go comes on extremely quickly and I have to get to the toilet in 30 secs. I’m so worried about the effect this is going to have on my life going forward- I’m only 32! I’ve been doing pelvic floor exercises using the NHS Squeezy app and had a telephone appointment with a pelvic floor physio but I haven’t seen any improvement in bowel control as of yet.

Has anyone experienced anything similar and been able to make a full recovery? If so, any tips? I do have an appointment with a perineal clinic at the hospital end of Jan, so hoping that will help but it just feels like such an unknown at the moment.

(Currently also have a 1cm open wound where episiotomy stitches came undone which is painful- have had antibiotics for an infection and been told “it will heal from the inside out and eventually come together”. Probably need to post another thread but if anyone else has also experienced this would love to know how long it took to heal/any tips)

Thank you!!

It was a long time ago for me (over 20 years!) but I had a 3rd degree year with DC1 which was judged to be a 4th degree tear by a consultant who viewed it 18 months later.

I don’t remember having any major bowel or wind issues afterwards (certainly not of any significance) and went on to have 3 more DC. The second was an elective c-section due to the advice of the above consultant but the other two were vaginal deliveries with no problems. I’m putting this here in case you were worried about future pregnancies/deliveries.

I may have been lucky in this regard but hopefully for you, it is just a temporary thing. 5 weeks is not very long to recover when you consider what your body has gone through. Maybe in the meantime you could have a look at your diet and identify less windy and more solid foods? I hope it settles down soon.

And congratulations on your DD!

I have suffered bowel problems since giving birth. I was only 19 at the time of my daughters birth so nobody really took me seriously for a long time.

I would ask for a referral to the colorectal department if you don’t feel an improvement. I’m still under their care now and have found them to be better than the pelvic floor nurses who can only really recommend PF exercises. (At least that’s my experience of them).
The colorectal team can arrange for you to have tests to check your bowel control and an ultrasound to see how well your tear has healed. For me it revealed that the sphincter was damaged internally and externally so I think I was just one of the unlucky ones.

However it is still very early days for you. In a few more weeks you may find that your control comes back as you continue to heal. Have they recommended you to take Loperamide at all to help with the urgency?

I know how upsetting these symptoms can be so I’m glad you are being seen soon. Congratulations on the birth x

Ah you poor thing. I had that - 3C tear, forceps, episiotomy. Just did what you’re doing - squeezy app (was quite slack with that!) and women’s physio which you have in Jan. I took my baby to that as no childcare, try and arrange some if you can! It’s really handy but does involve doing keigels while the nurse has a finger inside you so errr somewhat tricky if the baby needs something! Oh, also couldn’t have sex as my vag was traumatised to had to use vaginal dilators (again from the physio appt), not as scary as it sounds!

I was 25, 9 years on I am not the same as I was 10 years ago and never will be but don’t have a problem day to day unless jumping! I do have urgency with poos but luckily my brain seems to know when I’m out of the house. So I only ever have to rush while I’m home.

I also had 3b tear, episiotomy and forceps. The bowel incontinence was distressing but I recovered over time. It did take longer than I expected though, it was a slow and gradual process and it was 6-12 months before I felt fully normal again. I was late 30s though so perhaps age was a factor.
I did have NHS physio though - do request this when you have your appointment.

That was me 18 months ago.

I fully recovered, took about 3 months for wind incontinence. I also had bowel urgency, that took a bit longer to settle.

I did kegels and had one of those egg shaped machines that check if you are doing them correctly through an app.

My midwife recommended Pilates and I am still doing that (online classes.

You can get better! I know how scary it is though.

Oh gosh OP that sounds uncomfortable. I had the opposite issue to you to be honest at around 6 PP I told my doctor and I was prescribed stimulant laxatives. Maybe you could get something to help with opposite issue?!

So sorry to hear this. I had similar (forceps, episiotomy, tear) with wind incontinence and some bowel urgency. I was too embarrassed to speak to anyone which is really silly in hindsight. Mine did right itself mostly but took a long time, 9months or so if I remember. I'm not the same as I was but I am okay now. I went on to have a vaginal second birth which was an amazing experience BUT if I had my time again I'd have chosen a section - although the birth was great my recovery has been slow and I now have vaginal pain from that birth adding to my problem down there! Just a thought for the future I wish someone had shared with me. Good luck op.

I had no idea we could suffer from these sort of problems until I did.

When I was pregnant and had a newborn the midwives only mentioned doing pelvic floor exercises to stop our bladders from leaking. There wasn’t a single mention of bowel problems.

I had the same, forceps birth a episemotomy. I then had bowel incontinence for a year. Not every time, it came and went but the last time I didn't make it to the loo was 4 days before my daughter's first birthday. It just sort of went away by itself after that which was for the best as I went back to work! Luckily I was always at home whenever it happened as it tended to be very first thing in the morning. But I remember the last time was in the evening and my husband and dd were on FaceTime with granny and I had to be like "emergency!!!" And he could tell by the look on my face I wasn't messing around and hung up 😝 luckily toilet humour is a bit of a love language for me and DH so it was okay between us but I can see that it may not be like that for everyone.

I didn't tell anyone or do anything about it because I was so overwhelmed and had ddp so pooping myself was the least of my worries it felt like. But pregnant again and mentioned it to the midwife and she thought it was a big deal so definitely talk to a midwife if you can.

So sorry it's happening to you, it's one of those things people don't warn you about really.. we all know about the wetting yourself thing but not the pooping but it's surprisingly common.

Thank you so much for the advice and sorry to hear of your situation too!
I’ll definitely request a referral to the colorectal dept if things don’t improve with time. Have they suggested any treatment pathways for you as of yet?

They haven’t suggested Loperamide (they said it’s important I don’t get constipated while healing etc so that might be why) but would be good to have that on hand for emergencies!

Thank you so much x

Thank you so much for sharing your experience and also sorry to hear you had such a tough time!

I’m so relieved to hear that you don’t have a problem day to day anymore- it definitely gives me hope for the future!! Thank you

I only had an episiotomy with my second birth (ventouse) but I had wound breakdown too, and I experienced some bowel urgency and inability to hold wind early on which I presume was related. It was all completely back to normal by 12 weeks I'd say. I have recently had my third baby and presumed I would experience the same (or worse!) again, but I haven't this time at all. Actually the opposite issue instead which is still a problem with a tear (2nd degree) that again had some wound breakdown.

My DD also decided to come out with her hand on her face, causing me a similar grade tear. Those first few weeks I had v similar issues but 7y on I can confirm all is well.

Many congratulations.

Physio will help; I wasn't discharged til 9mths and that was on their advice.

Also I know it's the last thing you'll be thinking about but I did opt for a section 2nd time around because of the increased risk of a similar experience.

Similar issue here 8 years ago after a episiotomy and a ventouse delivery. I've since had a planned csection. I continue to have urinary and bowel urgency now and again, but I generally make it in time. The most annoying thing is after a bowel movement, I never seem to empty fully and then struggle to clean completely (sorry for tmi)! I did have NHS physio and a scan on my backside to check for spincter muscle damage which I believe there was. I notice when I'm slack with pelvic floor exercises or when I'm exercising alot/ lifting weights, everything weakens. Trying to use the squeezy app daily!

For the most part I control mine by my diet and loperamide.

It will get better 🙂