Failed smear/birth damage

[9YearsOfPain]

I had my lovely daughter almost 15 years ago. It was a traumatic birth at 40+13 and she was eventually born (after a 3 day labour) via forceps. They had to grab her so hard they permanently dented her cheekbones.

I was left with PTSD and an episiotomy that didn’t heal. At all. After 18 months I was finally referred and made an urgent case when it split open completely during a smear (3 years post-partum). I was then told that instead of being cut across the muscles, I had been cut down between them. The muscles had gone into spasm, pulling the 2 sides apart. The tissue had granulated. They gave me 3 lots of Botox over 18 months hoping that stopping the muscles from being in spasm would allow it to knit together. It didn’t. They couldn’t give me any more botox.

Back on the waiting list and 2 years later they decided their only other option was surgery, but this would likely cause huge issues because of how much tissue they would have to remove.

I couldn’t climb stairs without pain. Couldn’t have sex. They referred me to a psychiatrist in the pain clinic. By this point it has been 7 years. They couldn’t deal with the PTSD, and couldn’t offer anything for the pain.

It was so fragile that when DD was 8 years old it tore completely again and I ended up in A+E. It actually helped as a “bridge” of skin formed which gave me some more flexibility (and I could go for longer walks and climb stairs again) but the scar tissues remain hard and tight still.

I saw my GP about starting HRT last week and she noticed that I hadn’t had a smear for 12 years (but I also haven’t had sex). She tried and failed twice to do the smear. It was absolute agony. She examined me and said that she couldn’t even reach my cervix because it is so high up and my vagina has a tight curve on it because of the shape and position of my pubic bone (which is why I couldn’t get DD out on my own). She would have to angle the speculum in such a way as to have to press against my scar tissue, which is what was so painful for me. It’s been 5 days and it’s still so painful to pee and sit down and I couldn’t take the dog for a walk earlier because it was so painful.

It’s brought it all back mentally too.

I feel so alone. I can’t imagine there are many women that have experienced this or have these challenges. It stole my sex life in my 30s. My daughter will never have siblings. Any menopausal atrophy will make it worse and there is no help beyond my GP.

What a horrendous ordeal for you, I can't begin to imagine. Could you refuse the smear in future? My story is of a similar nature but not nearly to this extent. Double prolapse and incontinent, followed by the TVT mesh sling which gave me lifelong UTIs and chronic pain. There used to be a thread on here about these sorts of issues but I haven't seen it in a while. I hope you manage to get some rest, it sounds a horrible ordeal for you.

I’m sorry for all you’ve been through
I can’t offer advice on anything else other than that you can get HPV tests to do at home and that’s all smear tests are now. If you test negative they don’t look at the cells anymore .

I’m so, so sorry for all you have been through and for what has been stolen from you. 💐

And if I tested positive……….? Any treatment would invariably involve splitting me open again.

GP did say that she could refer me to have a smear in hospital where being in stirrups might help them to get to my cervix. I feel like that would utterly destroy me mentally given the PTSD.

:(

I’m sorry for what you’ve been through as well.

I can, of course, refuse the smear. But that still leaves me at risk of cervical cancer that I don’t know about until it’s too late.

💐 You should not have to live like this. Could you seek a second opinion from gynecology with regard to your options? If the consultation is a few years old it may particularly be worth revisiting.

I don’t know. I have no faith in the local service. Maybe I could see someone privately, but I can’t imagine there are many options at this point.

GP thought it might be worth retrying after 6-12 months of oestrogen treatment.

Has anyone suggested a smear under general anaesthetic? I was offered one for inserting a coil, as I found the previous one so traumatic. I know you would still be left with pain afterwards, though possibly less, as you would be less tense.

Not yet. But I’m more concerned about maintaining the integrity of the outside than them accessing the inside at the moment!

Get the home HPV test and fingers crossed it will be negative which is highly likely to be .

Gosh OP. My heart breaks for you reading this.

I too have a 15yo dd. I had a 3a tear requiring emergency suturing in theatre. Twelve weeks later I was still in agony to even sit. I went privately and was put under GA to be opened up again and re stitched. Also woke up to find I had a rectocele repair I had no idea I needed.

Sex is still painful but I’ve had two further children via elective sections. My perineal scarring is and I quote, “the worst I’ve ever seen” (GP practising 20+ years). The way it’s healed has caused a few awfully painful abscesses since.

Here to handhold if you need one. I’m 37 by the way.

Thank you @qwerty36 and I’m sorry for what you’ve been through too.

I’m 10 years older than you and just don’t see many options now. I’m angry that I wasn’t looked after better. I’m angry that in the 21st century they didn’t spot that my pelvis wasn’t ever going to allow me to deliver DD on my own - I was planning a home birth FFS.

I’m angry that having established that the wrong thing was done during DD’s delivery, more wasn’t done to help me. I had to beg and plead for almost a decade for help and basically got a swathe of male gynaes who shrugged their shoulders and went back to the golf course.

I’ve no idea if there are any options left now. I’m in perimenopause and my GP wants to reduce the impact of any vaginal atrophy as far as is possible, but there isn’t likely to be a fix after all this time.

It's such a sad thing to read and to think that it happened in a highly developed country in 21st century. I'm so sorry for you!
If you want to deal with PTSD the psychiatrist should offer EMDR. I have no clue about the physical side of things but I would not be having any smear tests.
I'm from Eastern Europe and we have smear tests more often than in the UK but I had horrible experience in the UK. Those tests can be done in a painless way (most of the time). No, they're not pleasant but the experience I had in the UK was horrendous in comparison to home. But yes, you need to go into stirrups for that.

Another 6-12 months of waiting and possibly no resolution at the end does not sound very ok though.

If you go back to your GP, and they are willing to refer you for a second opinion, you have a right to choose a team outside of your immediate area. For example if you come across well regarded NHS specialists in a London teaching hospital for example. So it may be worth doing some research as to which UK consultants have a good reputation. See https://www.england.nhs.uk/wp-content/uploads/2019/06/patient-choice-patient-leaflet-easy-read-guide-v2.pdf

In fact recommendations are something that Mumsnetters might be able to help you with. I hope you find a resolution x

I know. But it’s been so long now I don’t know if I can go back there again.

(I’m not in England so I think anything I did would have to be private rather than NHS.)

I don’t have a psychiatrist @notimeforregrets . I had years of counselling for the PTSD and had reached a point where I thought I was doing okay with it. I wouldn’t be without my lovely girl for anything in the universe.

But the GP commented that there was clearly no way I would ever have been able to get her out unassisted and I should have had a c-section (which, of course, is not without risk). When I think how many opportunities there were for my caregivers to have realised that, I can feel it all coming up again.

I hated being in hospital. I hated being in the stirrups. I can just see this taking me back to a very dark place.