Impact of birth injuries/prolapse etc

[QuentinSummers]

Just read this article in the Guardian and am shocked by just how prevalent prolapse are. This is a feminist issue surely?
Timely for me because I have some kind of issue and don't want to go to the doctor
amp.theguardian.com/us-news/commentisfree/2017/dec/28/vaginal-health-post-partum-maternity-rectocele

lilamal1 I’ve never given burgh/been pregnant but I have prolapsed organs.

It’s a design flaw with the female human body. We have a void/cavity and ligament/muscle weakness is quite common. I know several women - myself and sister included - who are childless but have had both uterine and rectal peolapse without warning at 40-odd years old when orherwise slim, fit and healthy.

It really isn’t a design flaw with women’s bodies. Women’s bodies are perfectly designed to keep the pelvic organs in and sitting nicely on top of the pubic bone. That is why women have that curved lumbar spine at the back, tilting everything forward.

If you look at young girls you’ll see the curve is even more pronounced and that is because they haven’t yet gone through years of being told to tuck their tummies in and bottoms under.

Our lifestyle- sofas, cars etc- have tilted our pubic bones backwards.

The feminist issue is that medics based their skeletal models on men, ignoring the way in which women differ.

Medics have also ignored women’s complaints to a disgusting degree. If you read the stories on Kath Samson’s Sling the Mesh Facebook page you will see that these women had been repeatedly robbed off by their doctors and recommended the Mesh surgery even though Johnson & Johnson hadn’t properly tested their product and were being sued in the US by thousands of women The incompetence and lack of care beggars belief.

The ignorance and the taboo around women’s bodies stops them from joining the dots and seeing this as a collective issue that affects women. It’s all ok to have our tits plastered across newspapers and our bodies used to sell all kinds of shit but to talk about the reality of women’s bodies is considered gross.

And now I must apologise for this rant. It’s just my mum was caught up in this and it has affected her everyday life for years. And it makes me rage .

That is why women have that curved lumbar spine at the back, tilting everything forward.
I never knew that! Been told on many occasions to try to straighten my curve out as it's bad posture

I was talking to a friend the other day who was explaining that it wasn't that medical science is / was sexist, but that women's bodies are inherently deficient.

Patriarchy really has done a number on us.

Yes Quentin, me too! When I found this out it was a revelation. The traditional notion has always been that there a kind of “hole” at the floor of women’s pelvic area where the organs will fall out if the muscles weaken and that’s why we need to “pull it all in”!

But our natural posture is to tilt forward. And yet we are continually advised against it. That’s why even women who haven’t had children also get prolapse. But childbirth makes it worse. Think of the reclining position they put us in whilst we push! It’s so bad.

I never knew that about our spines.

Girls are always being told to straighten up as the curved lower back thing is considered not right for some reason.

Fucks sake.

Yep. I was always under the impression that women’s bodies were somehow defective. Add to that the whole Eve a variation of Adam

... psychodrama and it’s no wonder we think it’s a burden we’re destined to carry.

Here’s a good blogpost on how Dr Kegel and other gynaecologists got it wrong if you’re interested:

wholewoman.com/blog/?p=1528

This all makes total sense. I've been wondering how our foremothers manages before modern medicine. It is so ridiculous that so much of our medicine is based on men's bodies. I am going to try those modern kegels.

"It really isn’t a design flaw with women’s bodies. Women’s bodies are perfectly designed to keep the pelvic organs in and sitting nicely on top of the pubic bone. That is why women have that curved lumbar spine at the back, tilting everything forward."

Loss of lordosis (the curvature) is considered to be a factor in prolapse development, but I think that's quite a simplification when looking at the role of levator ani injury during labour, connective tissue disease, oestrogen and hormonal problems/deficiencies etc. and not least the anatomy of the female pelvis. Men do experience prolapse, but there's in the majority of cases there's a different aetiology (obviously because the role of pregnancy and birth in women). It's often seen in men that lift heavy weights/into high impact activity.

I think that observing things like the "obstetric dilemma" of the female pelvis/birth canal vs. the size of the infant head, as " design flaws" isn't necessarily bad (at Uni, we were taught these were design trade offs). Being "perfectly designed" isn't really a concept that I'm on board from a feminist perspective as well as a clinical one.

It's the step beyond an observation of why and how things go wrong, to "oh well you're inherently flawed" that's so damaging as it's that that reduces the clinical importance and also clinical interest.

Our foremothers suffered from pelvic organ prolapse, as well.

@IfyouseeRitaMoreno that's absolutely fascinating. Thanks for linking to it.

I had a maternal request elcs because of a previous sexual assault. Trying to persuade the consultant that I was able to understand the risks of the procedure was absolutely hellish. And he behaved as if there were no risks at all to a vaginal delivery. In the end, dd's birth was very positive, but I don't think I should have had to fight tooth and nail to get it, in the way that I did.

Being "perfectly designed" isn't really a concept that I'm on board from a feminist perspective as well as a clinical one.

Indeed! I didn’t mean to sound like a proponent of Intelligent Design (perish the thought!) but was using the colloquialism commonly used when describing the ways in which our bodies have evolved to adapt to the challenges thrown at them.

Of course there is still the problem of the excessively large human head and the dangers this has led to in childbirth but that the female pelvic anatomy has adapted adequately to keep pelvic organs in order and is not defective in that regard was my point.

And sorry yes of course, your last paragraph was spot on hinged

MaudlinMews it must be something genetic with my family. DB has had various problems with his groin since childhood, and has had haemorrhoids since he was about 17. We don't talk in that much detail about our pelvic problems, but I know he has a lot of discomfort in his "gooch" (perineum).

My dad is another long-term piles sufferer and he has a hiatus hernia.

"how our foremothers managed before modern medicine"

The answer is that they really didn't! The rate of significant morbidity in mothers before the advent of the NHS was exponentially higher than today. I'm fully on board with highlighting the inherent misogyny and clinical shortcomings of the system today, but there's no way in the world we can contrast it to some previous golden age. I'm still bitter from hearing my NCT teacher say 'well women in the third world manage fine giving birth in fields' .

Yes of course frog. But sufficient numbers of women lived sufficiently long for us to evolve menopause. Which makes me think we would also have adapted to deal with upright position and birth as far as poss.

This is fascinating. I had no idea about the spinal curve etc.

They did, Quentin, but the wastage, so to speak, was astronomical. The maternal death rate even in the 1930s in the UK was 40 per 1000 live births! That's an unthinkable rate - it's come down a hundredfold since then. There are descriptions of maternal morbidity by health visitors in the 1930s that are jaw-droppingly horrifying. A majority of the poor women that they saw had life-changing health consequences from childbirth. Some of the descriptions on this thread probably come close to what used to be the norm, except without painkillers, without access to running water or indoor toilets, without access to contraception to prevent (multiple) further births, and without any possibility of surgical remedy or even basic medical assistance. [disclaimer - this used to be a professional interest ]

I had a maternal request elcs because of a previous sexual assault. Trying to persuade the consultant that I was able to understand the risks of the procedure was absolutely hellish.

Let me correct you there. You didn't have a maternal request ELCS, you had an ELCS for psychological and mental health reasons.

The former frames you as a demanding entitled woman who doesn't take the risks seriously and is incapable of doing so, whilst the latter frames your doctor as an insensitive tosser who didn't take your overall well being and health into consideration and doesn't consider you able to make an informed decision about your health care.

Language and framing is important. It creates a totally different understanding and context.

NotAgainYoda: "Keep up the good work!"

Thank you! Even though I read lot of accounts by women about their traumatic birth experiences, this thread has still been jaw-dropping. It's unbelievable that severe birth injuries are just dismissed or trivialised.

The maternal death rate even in the 1930s in the UK was 40 per 1000 live births!

And I think that during the 1600s & 1700s it was even worse. In Freakonomics it stated that the average woman’s lifespan has only just taken over man’s as death in childbirth lowered the average considerably.

I’m not sure (current Mesh/prolapse scandal aside) that it’s overt sexism but more of a general ignorance and tendency to look at men at the default.

Take the history of hand-washing and that poor doctor who noticed that in the maternity clinic the mortality rate was as high as 1 in 5 (which was also incidentally the street birth death rate!) when doctors came straight to the ward from touching cadavers.

So he suggested the doctors washed their hands. There was such an outcry they committed him to an insane asylum.

www.methodquarterly.com/2014/11/handwashing/

Dr Phil Hammond just retweeted a new analysis of the research done on ‘Pelvic floor muscle training for prevention and treatment of urinary & faecal incontinence in antenatal and postnatal women’.

There is a plain language summary included, which concludes:

“Overall, studies were not large and most had design problems, including limited details on how women were randomly allocated into groups, and poor reporting of measurements... Evidence quality was generally low to very low.”

onlinelibrary.wiley.com/doi/10.1002/14651858.CD007471.pub3/abstract?utm_content=buffer89cf8&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

I would love to know how ditch the tena if anyone has any tips?

I know it's minor compared to a lot of the problems on here but if pelvic floor exercises aren't they way to go what is?

yesterday I was happily letting my spine curve rather than trying to "stand up straight" and I've got to say it was lovely and comfy. Not that I stand up straight obsessively but I think subconsciously my posture has been altered over the years.

The only thing I can tell you is that from looking things up to have my rectocele repair, it would appear that the pelvis is full of connective tissues, such as ligaments and fascias, that are all interconnected with the muscles. I think you need to hold everything in and be tall, but not worry so much about the standing - you need to move and do a wide variety of movement and enjoy doing it. Running, walking, climbing, jumping, bending, reaching, balancing etc. I have done a variety of dance classes over the years, and yoga and pilates. Some are better than others. Belly dancing is supposed to be good - if you are not keen on the come hither sort there is the tribal sort.

The physio I saw post of said If you do pelvic floor exercises, you also need to do pelvic relaxation exercises. (sniff, drop, flop or something )

I am convinced fell walking is the thing. They always look very wiry and have good core strength. It is all the difficult surfaces. I cannot get up the hills though .

Jogging and planks are not good for pelvic floors or continence.