I write this to all women. Ones who have had babies and ones who haven't. It is relevant to all.
I do believe that maternity care is a feminist issue. It is underfunded and too many women are becoming damaged mentally and/or physically due to health practitioners having to practice within a lot of red tape and quite often following old-school science. The industry needs to change. It needs to become more woman-centred and with a lot more information and support both pre and post birth.
This is a very personal post, but I share it to educate others. Without speaking out, nothing can change.
I am writing this in late 2018. I did write my birth story within a year of having my first baby, but it is quite raw & emotional so I thought it is best to write another one now, with hindsight and more of a level head.
I became pregnant in Feb 2015. I remember finding out at work (I took a lot of pregnancy tests as I have PCOS and my cycles are very irregular) where I was alone with a male colleague and had no one to tell. I ended up calling my boyfriend (now husband), who was also at work. I do regret telling him over the phone, but I just couldn't wait all day! We got engaged quickly, before the 12 week scan & pregnancy announcement. We also put our flat up for sale and moved in June (5 months pregnant). Then it was a big rush to get the house "ready". Decoration, furniture, paperwork etc etc, you know the drill!
I was/am very into all-things-natural, so it wasn't going to be any different in this pregnancy. I did pregnancy yoga, saw my chiro, acupuncturist & osteopath regularly. Ate super well. The pregnancy was actually really easy. At 37 weeks I drunk raspberry leaf twice per day, did perineal massage and even splashed out on buying an 'Epi-No', a device that is designed to help against perineal tearing. So of course I wanted the "all natural birth", no pain meds, no caesarian...it is what our body is designed to do, right? It's been doing it for thousands of years...so I planned an NHS homebirth.
It soon became November, I was due on the 2nd. As with all expectant mums, those days were long and boring and uncomfortable. I had reflexology & acupuncture on the 8th and went into labour that night at 3am (9th at 41+0). I remember the morning being pretty calm, we woke around 6am, set the pool up in the living room. Then all I remember was that by lunchtime, (and I remember as the food in the oven was making me feel sick to hell!) I was in quite a lot of pain. Then time didn't even occur to me. It got dark, for a long time (being November). There were fireworks and it was a very stormy and windy night. The midwifes seemed happy and thought that baby would be here by 9pm. Well my contractions that were every 3 minutes, lasting a minute each, continued well into midnight. That's when things started to go a little downhill. My waters hadn't gone, the baby's heartbeat was fine but my temperature went up very slightly, for a while, then back down to normal again. Then for what seemed like forever, we debated going in to hospital (a 20-25 min ride away). I declined for I don't know how long, then the ambulance was called. Not sure why? They say because of my temporary spike in temperature.
As soon as the ambulance arrived, my waters broke and there was fresh meconium in them. The MWs wanted to see whether baby would come imminently as I was 9cm dilated. At this point the atmosphere changed, there was a panic in the air and I remember sensing it. There were also two male paramedics in my kitchen that I could hear while I was labouring. At this point, my calm homebirth went out the window. Even the MW said she was going to be "a tough midwife now". On came the 'coached pushing instructions' from the MW during each contraction (you basically hold your breath and push for 10 seconds at each contraction). But at this point I remember not really feeling the contractions, they died off a bit, which I now know was due to panic/stress. It felt really unnatural to me to be told when to push.
So after 45 minutes of pushing, where we could see my daughter's head but she wasn't moving down any further. The MWs made the call for me to go into the ambulance. I remember putting on my gown, and walking outside and that was when I felt her coming and I literally said "she's coming out!". Quite comical looking back. At this point I was told to hold her in. This was the worst part of the whole birth. Just in case you are reading this and you haven't birthed before, it is a bit like someone telling you to hold in diarrhoea! It is tough/near impossible. That 20 minute ambulance ride was awful, every 1-2 minutes during each 1 minute long contraction I had to hold her in, when I felt I could have birthed her quite easily.
We arrived after what seemed like an eternity. My husband following in his car behind, probably gained 3 speeding tickets on the way. I remember being wheeled in, screaming. Going past the maternity reception with lots of MWs looking at me like I was insane. We got to a private room where we met another MW who told me to get onto the bed. I proceeded to go on all fours, holding the back of the bed when she told me to go on my back as I needed monitoring. With my exhausted breath I asked "why?". She didn't have an answer but seemed slightly pushy about me being on my back. I felt like I had no confidence or energy to stand my ground (you don't in labour, that is when you need a voice on your behalf, like a doula) so I reluctantly lay on my back. Within 10 minutes the two MWs helped ease my daughter's head out, telling me when and when not to push. After some stinging, her head was out. Pause. Next contraction came and then she was out.
What a HUGE relief. My painful contractions stopped. My big (9lbs 3oz) slippery baby girl was here on my chest. I felt so happy. She scored a perfect APGAR score and I rested. I got my delayed cord clamping (30 mins). Then the placenta was birthed. I jokingly asked "so what is the damage down there then?", knowing that tears can occur. She wasn't sure and I didn't like the worried look on her face. She said "I am going to get the doctor to take a look as you're bleeding a bit but I think it is 2nd degree".
The doctor came in shortly after, and examined me. She said something like "I think you have a 3rd degree tear. We need to take you up to have surgery now". My heart sank. All that happiness & elation, gone.
Suddenly the anaesthetist was in the room with consent forms and whether I wanted a spinal or General. I opted for the safer spinal. I'd never had an operation before, but I was so tired and without time to really think about it...I didn't worry too much at that point. They took me upstairs, I sat on my very uncomfortable bottom while they gave me the spinal. The OBs team were really lovely, but nothing can quite prepare you for having your legs in stirrups with 6 or 7 people staring at your "ruined" nether regions. About 30 minutes in to the op, the doctor said that they were going to have to call the consultant in (who was at home as it was 4am at this point) because my tear was complicated. "Great" I thought to myself.
After the operation I went into the recovery room. The doctor came out and said that the repair was successful and that the tear wasn't as bad as they'd originally thought. I had a 3b tear & had lost 1.5L of blood. She also said that the majority (60%) of women feel 100% by 12 months postpartum and that I would be offered an NHS women's health physiotherapist within 6 months. I was given a leaflet on kegels (Pelvic floor exercises) and that was that.
After a very painful journey home in the car (far worse than my later caesarian) it took about 2-3 days for it all to really hit me. Then I fell into baby blues, or perhaps even a depression. Google was not my friend but I spent hours on it looking up the prognosis after a third degree tear. I didn't find any useful info just blogs and forums of women writing about their long-term problems after tears: fistulas, incontinence, prolapse. I mourned my pre-birth body. I felt angry that this happened to me, "why me?" I'd ask. My husband was really supportive but he never truly understood, and how could he? Being a first time mum is a huge shock & rite of passage at the best of times with hormonal swings, breastfeeding challenges & a tiny human to look after, but to have a severe tear too it can become extremely overwhelming.
Nothing can quite prepare you for a severe tear. It isn't like a non-complicated 1st or 2nd degree. I know because the ladies on the Birth Tear Support group who have gone on to have milder tears say so. You can't sit or sometimes walk without pain for weeks, maybe months. Sex can be painful for months or even years or indefinitely for some unlucky ones. Recovery can take longer than the caesarian recovery. Going for a poo is a nightmare to say the least.
Due to my profession and interest in holistic healing, I did all I could to encourage optimum healing. I took liposomal vitamin C, zinc, flower remedies, iron, serrapeptase, psyllium husks for fibre, magnesium and probiotics (as I was on strong antibiotics). I did 'sitz baths' twice per day with epsom salts, lavender and tea tree. I also made a peri-spray made of witch hazel and colloidial silver. I do believe this all helped as I didn't get any infection and according to my Gynae my tissues healed very quickly & neatly.
Two weeks after my tear, when things started to feel slightly better I found what I (Google) thought was a mild prolapse. It was confirmed by my GP, who said it was very common after vaginal deliveries and most resolved within a few months. Again I felt even more angry & depressed, why doesn't anyone talk about this? IT'S COMMON?! I am 24 years old and have a prolapse!?
In fact, the statistics are that 1 in 3 women have a pelvic floor disorder (incontinence, pain or prolapse). That’s around 6 million people in the UK alone.
Women who deliver vaginally are twice as likely to experience these injuries as women who have a cesarean or who have not given birth. You don't hear that at your NCT class.
This led me to more Googling. I found Prolapsehealth.com a brilliant support website for women with all kinds of prolapse from mild to severe. This started my healing journey. I learned about pelvic health. Something that isn't talked about at all! But I feel I've become some sort of semi-rookie-expert on it now. I went to see a local women's health physio at 7 weeks postpartum. All she did was tell me to do kegels and that the prolapse was mild. Which I knew, but it still gave me issues with bowel motions. Moreover, from my research on Prolapsehealth.com I had a feeling that her examination wasn't thorough. I had been told that there is much more to it than just kegels, and with my holistic training I thought this to be true.
In early 2016 I created a 'Birth Tear Support' group on Facebook, as there were no groups or support sites anywhere online for women who had been though what I had.
2.5 years later (2018) and the group has over 1000 members. I also spent 9 months writing a free information website at www.birthtearsupport.org.uk
At 6 months postpartum I was having less symptoms, hurray! However, sex was painful which is very common after severe tears and episiotomies. So I went to see Tracey Miles in Kent, as I was recommended to see a physiotherapist who had been trained by the Herman & Wallace Institute. She was great. As I had to travel far to see her, I had a two hour appointment. She gave me internal release (yes via the vagina), as I had a tight muscle in my pelvic floor, which she thinks was there from years prior. She said to massage my scar tissue and that would help it to not feel so painful. It was a fab consultation and Tracey was very empowering. I was very positive after that. She still did reiterate how important kegels were, however.
By 12 months postpartum, I started to get new symptoms. It felt like something was in my bottom constantly. Through my Birth Tear Group someone recommended a physio local to me (45 mins away). So I thought, "why not".
I met Ruth Jones early 2017 (16 months postpartum). She changed everything. She said I have Pelvic Floor Dysfunction and that my prolapse was pretty much non-existent and wasn't the issue. My pelvic floor was. It was too tight, too overworked which was causing tightness and pain within my whole pelvic cavity & lower back. She told me to stop kegels (and actually I haven't done one since!). She gave me internal releases for about 45 minutes, which felt like labour pains! I bought a Therawand (from her recommendation), so I could do my own releases at home. I saw her a few times in 2017, and still on the odd occasion now. I barely have issues now though. Hurray to the wand! This was a huge turning point as I found someone that could actually help me and could explain why I was having symptoms and potentially why my labour contractions were so painful.
I also found Hypopressives. This exercise worked wonders on my abdomen, posture and pelvic floor. I had quite severe diastasis recti (tummy gap)
after birth (4 fingers & relatively deep) that didn't fully repair until I started hypopressives at 16 months postpartum. I found them very easy to do. Due to the breathing involved I found it very relaxing as well, which is always a bonus!
A friend, Lucy Parker happened to be doing some extra training in Birth Trauma Hypnotherapy. I had a few sessions with her. Before seeing Lucy I used to dwell and feel a lot of emotion around the birth of my first. When friends had 'easy' births I felt jealousy and sadness. I hated it and felt guilty. But hand on my heart I can say I no longer feel those feelings. It is what it is (or was). Lucy helped me find peace.
At about 22 months postpartum I felt like me again, mentally and physically. It is hard to explain in words how that feels when in early postpartum I thought it would never be possible to feel so well again. It was then that I decided I was ready to try for another baby, again something I thought I'd never want to do after my first birth.
In August 2018, almost 3 years after my first, I gave birth to my second daughter via planned caesarian section (ELCS). This took time to decide. I investigated all options. I had an endoanal scan (which is free within the NHS for all 3rd and 4th degree sufferers) to see if there was any major lasting damage (which there wasn't). I also asked all my practitioners their opinions (physios, gynaes & midwives).
In the end I felt an ELCS was 100% the right choice for me and thankfully I have no regrets with that decision. It was a wonderful birth experience. A feeling I hope all woman have from their own births.
I hope this post encourages women to learn more about their birth choices and about their bodies. There is help out there. You can improve on your body's functionality. Even further down the line than you think.
For expectant mums, look up the facts on your birth options. There are steps to avoid injury. See here.
Thank you to all my family, friends & practitioners (including the NHS) that helped me through this difficult period of my life.
Useful websites & practitioners that have helped me through my journey:
www.birthtraumaassociation.org.uk
https://www.sydneypelvicfloorhealth.com/
http://www.traceymilesphysio.com/
www.ukhypropressives.com
https://www.facebook.com/lucindaholmanibclc/
https://thepelvicexpert.com/