Courtesy of Steph Montgomery

Can We *Finally* Start Taking Childbirth Injuries Seriously?

by Steph Montgomery

For the most part, everyone I know who has given birth has physical reminders of the experience. I'm not just talking about C-section scars or stretch marks, either. We were injured during childbirth, and suffer from things like chronic pain, scarring, incontinence, sexual dysfunction, and dislocated joints, months and even years after we brought our babies into the world. I had no idea these injuries could happen, and now I feel like there's nothing I can do to fix my broken body. So I think it's time we start taking childbirth injuries seriously. It's time women stop suffering in silence. It's time to publicly address our pain and discuss how people can support us better... or at all.

Before it happened to me, I really didn't know that a "childbirth injury" was, or that they even occurred. When I was pregnant I honestly thought the worst thing that could happen to me during delivery, medically speaking, was a C-section. So, I chose a certified nurse midwife (CNM) and told her that I wanted to avoid a C-section at all costs.

I assumed that vaginal birth would be less than pleasant, sure, but I figured the unpleasantness would be worth avoiding a scar. I didn't realize that vaginal births can be traumatic, too, and can alter a woman's body for the rest of her life. My CNM told me there was a possibility of tearing or having to have an episiotomy, but I had no idea that it was likely. According to Parents, 95 percent of first-time moms experience tearing of their vaginas, labia, and perineums. My CNM simply gave me a bottle of sweet almond oil and a brochure about perineal massage, so I thought I was in the clear. Unfortunately, and despite my efforts, I tore during two out of three births, and my vagina will never be the same again.

Courtesy of Steph Montgomery

I also experienced incontinence. A year after I had my baby I was still peeing myself when I ran, coughed, jumped, and sneeze. Turns out, I'm not alone. A 2015 study of 1,574 new moms showed that 77 percent still had back pain, 49 percent had urinary incontinence, and 40 percent had both symptoms 12 months after childbirth. Many of the moms surveyed felt like these complications seriously impact their lives.

My sex life isn't the same either. Sometimes it still hurts when I have vaginal sex, especially in missionary position. And, again, I had no idea how common this was. One 2015 study found that almost 90 percent of moms have pain the first time they have sex after giving birth, and 25 percent still have pain during sex 18 months later. It makes me feel better to not be alone, but it also breaks my heart that so many of us are suffering alone and in silence. It want to tell every mom and mom-to-be I know about these potential side-effects of childbirth, too. We deserve all the information we can get our hands on, if only so we can prepare ourselves.

I think practitioners take childbirth injuries seriously, but as a whole, our culture does not discuss the reality of it.

I mean, why isn't everyone talking about childbirth injuries? Is it because we're understandably embarrassed to talk about super-private things like peeing your pants, not enjoying sex, and vaginal pain? Or do we think it's somehow our fault? I know I didn't do enough kegel exercises during my pregnancy, and perhaps I pushed wrong during birth. And would talking to providers actually help? Would they even take our pain seriously?

Courtesy of Steph Montgomery

Romper talked with new mom, Erin, and her midwife, Anette Ferrell, MSN, ARNP, CNM, via email, to get a better understanding of just how this culture of silence has persisted. Erin's experience of childbirth and postpartum life was remarkably similar to my own. She writes, "I experienced a second degree tear as I gave my final push to get my daughters shoulders out. I’ve had a couple of instances of incontinence, and urinating after sex is my nightmare. It still burns, four months later."

She thought Ferrell did a great job of explaining the risks, but she also thought she'd be back to normal by now. She adds, "She said everything healed beautifully at my four-week postpartum visit, so I took that as my vagina will feel normal once again, but it still hasn’t happened."

It turns out that childbirth was pretty traumatic for my pelvic floor, hips, and pubic symphysis joint. I had no idea, but now I have some answers.

Part of the problem, she thinks, is how we romanticize childbirth. Erin writes, "I think practitioners take childbirth injuries seriously, but as a whole, our culture does not discuss the reality of it. People view childbirth as this beautiful, natural phenomenon. If we share birth stories that are anything other than perfect, we are perceived as weak and not the warriors we are."

Ferrell agrees, and also believes that providers need to talk about risks with their patients. She told Romper, "Many women believe a C-section is the worst possible outcome for a birth. Unfortunately, vaginal birth is not without risks. Third and fourth degree tears, and even some second degree tears, can cause incontinence, chronic pain, pelvic floor dysfunction, pelvic organ prolapse, and dyspareunia (pain during sex)."

Courtesy of Steph Montgomery

As for solutions, Ferrell believes providers need to both explain risks and let women decide how to proceed. She adds, "Some women request an elective C-section out of fear of experiencing pelvic floor damage and that is a very fair and valid choice." Also, moms in pain like — like Erin and me — need to be taken seriously by their providers. Ferrell writes, "When women experience complications, it is important for providers to listen, evaluate their concerns, and refer them to pelvic floor physical therapist or urogynecology specialist."

It's time that we all — providers, pregnant people, and new moms — start talking about the risks of childbirth and our injuries afterward. Women deserve to be prepared, and to know they aren't alone. And providers need to listen when childbirth injuries get in the way of moms living the kind of lives they want to live.

As for me, a few weeks ago I finally saw a physical therapist for my postpartum pain and incontinence issues. I'm not going to lie, it was was super embarrassing. but I'm really glad I did. It turns out that childbirth was pretty traumatic for my pelvic floor, hips, and pubic symphysis joint. I had no idea, but now I have some answers. More importantly, though, I now have a provider who takes me seriously, and some hope that my childbirth injuries will eventually heal.