Last night’s #BirthTraumaChat on Twitter (which you can join in every Monday at 8pm) focused on physical birth trauma – the sometimes severe injuries women can suffer during childbirth which can have long-lasting physical and emotional effects. As a mum who has experienced two perineal tears, the second being more serious than the first, I wanted to share my experience here to encourage other women affected to speak out – as I know I have actually been incredibly lucky in my recovery.
Susanne and I would love to hear from you if you have experienced perineal trauma of any degree, especially if you felt that your injury was not really taken seriously by others, or was just considered an inevitable part of giving birth you should just deal with. You can always message us on Twitter @MaternityMattrs or Facebook, or email me firstname.lastname@example.org.
I don’t imagine there are many women who give birth to a 10lb+ baby and emerge completely unscathed. Despite having the birth experience I had wanted in the birthing pool, the quick progress of my labour and sheer size of Baby Jake at 10lb 2oz meant that I would have a much tougher time of it postnatally. And I did struggle. Jake is now 18 months old and the thought of my physical and emotional recovery still provokes some uncomfortable feelings.
Perineal trauma: the shudder-inducing words that hold horrendous memories for so many women, yet nobody feels very comfortable talking about. Whether caused by a tear or episiotomy, the debilitating pain and discomfort of perineal trauma, with sometimes long-term effects for the worst injuries, can make the postnatal period unbearable for those suffering. I don’t want to not talk about how it affected me for fear of embarrassment or because it makes people squeamish – I want others to know it’s ok to share their experiences, just as they might any other aspect of their birth story. Just don’t read on if you think it will bother you!
I was always afraid I would suffer a tear during my second labour, as I had with my first, but I don’t remember the physical recovery being quite so hard the last time. Maybe it was because my eldest was roughly half the size of his baby brother – only weighing 5lb 9oz – and although it was classed as a second degree tear, the damage was relatively superficial. This time though, there was very real concern after the delivery that I had suffered a third degree injury.
After I got out of the pool, my midwife examined me closely under a bright spotlight as I lay in lithotomy covered in surgical drapes, and said that she wanted a second opinion. Another midwife came in and I looked down at them discussing how serious or not the damage might be. They wanted a doctor to take a look. My midwife told me that if the tear had gone ‘all the way through’ then I would need to leave the birthing centre to be transferred upstairs to theatre, where an obstetrician would suture the wound under a spinal anaesthetic. The thought filled me with dread. I lay there with my legs in the air in stirrups for what felt like an eternity waiting for the doctor. The midwife had already administered a local anaesthetic and used a catheter to empty my bladder for me – we just had to wait to see if she would be able to repair the damage herself or not.
Mercifully, the obstetrician confirmed upon yet another invasive examination that it was a bad second degree tear, not a third degree, and my midwife was finally able to stitch me up. I was given a suppository painkiller which would numb the worst of the pain for a few hours. I was encouraged to try and pass urine to make sure I could, and I did, with no small amount of wincing and mild cursing. I knew then that this would not be easy.
The first couple of weeks were unbearable. I dreaded having a wee as the searing burning, stinging pain brought tears to my eyes every time. I kept a cup in the bathroom so that I could pour warm water on myself as I went, to try and dilute the urine and reduce the discomfort. In the early days it made little difference. Several times I sat there and sobbed and wondered how long I would have to put up with it. Then of course there was the absolute fear of having a bowel movement. After my first birth, I was so scared of going that I made myself constipated – this time I was careful not to allow this to happen and I managed it with a pad pressed against my stitches I was so afraid would burst. Obviously they don’t, but it certainly feels like it.
Even when I wasn’t making horrendous trips to the bathroom, just getting around was hard work enough. Every movement I made was with careful consideration of my limitations – I took small steps when walking, and had to psyche myself up to sit down or stand up. I had to explain to my then nearly 5 year old that I still couldn’t get down on the floor and play with him. I had to rely on my husband to do so much for me – as he is a teacher I was so lucky to have him at home for the summer holidays at the time. The disturbed sleep that is part and parcel of having a newborn in the house made the physical recovery feel ten times harder – I was weak, broken and exhausted.
I gave up all hope of breastfeeding after only a day. I just didn’t have it in me to try.
All of this meant that I felt, for quite some time, emotionally fragile. I was close to tears most of the time, and I had my up and down moments for several weeks, even once the physical healing began. After about a month, the tear was healing well – I could now go to the loo with no issue, and the awful tiring ache of the healing muscle was lessening by the day – but my body felt, and still feels to some extent, like it has lost the strength it once had. I didn’t feel like ‘myself’ for a long time, and that bothered me.
I knew, though, that I needed to be positive and move on from a time which was one of the toughest of my life, but was also filled with so much joy. We spent some wonderful early days together as a family of four, and Jake was, and is, an absolute star. My husband was patient and supportive and Joe did his bit helping to look after me – “You should be relaxing Mummy!”. I tried not to dwell on unpleasant memories when there was so much to be happy about.
I am incredibly lucky to have supportive family and friends, both local and virtual, who helped me feel like myself once again. And of course I have my two beautiful boys. It is a good thing that I only ever wanted two children – I genuinely don’t think I could put myself through another traumatic birth and difficult recovery. I may not be lucky to escape with a second degree, and my mental health, if I did it again.
What are your thoughts about perineal trauma? Do you think such injuries should be treated with the same care and understanding as a c-section? Is there enough support available for mums struggling to recover? Let us know your comments.