One And Done – The Invisible Pain Of Recovery After Birth
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I want to talk about physical healing after birth. In fact, I have to talk about it. And so do you. My journey through recovery after birth wasn’t so smooth and I had no idea why. I couldn’t understand why there was so much pain for so long, worse than birth it seemed. I eventually learnt I wasn’t the only one.
I’ve been a Midwife for years. I’ve seen a lot. But in becoming a Mama I stumbled upon a secret of women, an unspoken reality. I had no idea what was wrong with my body post birth, and I assumed I just didn’t cope as well as other women do.
When it came to the birth of my first child I did all the right things in pregnancy to prevent perineal tearing. I birthed my son with no more than a labial graze. Albeit deep. I sighed with relief – I didn’t need stitches.
Time and time again I’d seen women in the same circumstance bounce back. Birthed their babes no more than an hour ago and they’ve confidently showered, gone to the toilet with no pain, and seemingly get on with life.
Here’s where it began for me… Up I got to go to the toilet for the first time soon after birth. I tried to pass urine and it was horrific. ‘Worse than birth’ is my memory of it. Though I hadn’t passed more than a few drops. My Midwife-brain told me to try to wee in the shower instead. The water could help.
I got in the shower and tried again. Same thing, barely a drop and I experienced the most horrific pain I’d ever felt. Yep, hours after birthing a baby, and THIS was the worst pain I’d felt. I gave up, hoping it would be better soon.
Any Midwife knows how important it is to have a decent wee after birth. A full bladder prevents the uterus from contracting down to settle blood loss. Six hours after birth, laying skin to skin with my squishy fresh babe, I could feel my uterus was high and not contracted. My pads were heavy. I gingerly shuffled to the bathroom, and lost a large blood clot as I stood.
I knew I needed to get serious about this and just push past the pain of urinating so my bladder would empty and my uterus could contract down.
Again I tried the shower, but it didn’t help. I forced myself to urinate, and I let out a silent scream, not wanting to disturb the other mothers. My body trembled from head to toe with shock. I’ll never forget that moment. I loved labour and birth, as hard as it was, but for me, postpartum was traumatic.
A few days later I asked my Midwife to check the area. It just didn’t feel right for someone who had no tears or stitches. I couldn’t sit, I walked hunched over, my entire pelvic area throbbed from standing, and I still couldn’t urinate without horrific pain. Everything looked OK. I thought ‘it just needs more time to heal’.
I became very good at managing it, whatever IT was. But it wasn’t easy, or normal, and in my postpartum haze of trying to learn to breastfeed and care for a newborn, it just didn’t occur to me how serious it was.
For three weeks after birth, I would only urinate once before bed and once when I woke up. I’d hold it all day because I could only manage to go in a bath. Sounds gross, but desperate times. It was a meticulous procedure of getting the water temperature just right, positioning myself awkwardly and holding a chamomile tea bag (healing herb) on the graze to cover it, then urinating only for a second at a time, taking a moment to catch my breath each try as the pain was so bad.
I knew it wasn’t normal, other women with just a graze are fine – as I’d always see at work. Not once in my career had I seen unexplainable postpartum pain like this. I told myself I just mustn’t cope as well as other women do. My body was broken, screaming for help, and my mind was ignorant and dismissive.
3 weeks postpartum, living over 2 hours from family, I was mortified to ask my husband to cancel a visit we’d planned. How could I stay the night at someone’s home whilst needing such a ridiculous procedure just to urinate, and still painfully. How do you say “my fanny is sore, sorry you wont get to see your grandchild”?
5 weeks postpartum, I didn’t feel healed, not even the slightest. The alarm bells finally started to ring. I had in my Midwife-brain that 6 weeks would be the magical number for healing, and here I was, no where near it. I had my Midwife check the area again. Everything looked fine. ‘How have friends had sex so soon after birth?’ I thought to myself. I could barely sit.
8 weeks postpartum, it was Pap smear time. By this stage I could tell the general area the pain was localised to, around the urethra. I was confident the Pap smear would be ok as it wouldn’t aggravate that area. And it was fine. I asked my GP if she could see any concerns. Again, all looked fine. No redness and the graze was fully healed. So why on earth did I have so much pain!?
At this stage I couldn’t sit in a car or on the couch without a ring cushion, I had to wash my hair flipped over the bath because I couldn’t bare any soaps or shampoos, even diluted in the water, running down my body. I would wear loose clothing and I felt like my fastest walking pace was tortoise speed. My day to day life was affected in every way.
12 weeks postpartum things were finally looking hopeful. I could wear pants, sit on the couch and car seat again, albeit slowly and very carefully, and I’d mastered another meticulous procedure to shower comfortably. Most of the time I was ok. The main thing… I could wee pain free! And I no longer had to scull litres of water to dilute it. I felt it was a safe time to have intercourse – the first time since giving birth. Oh boy was I wrong. I had no issues, until I had to urinate afterwards. Again, worse-than-childbirth!
It took me 12 weeks to say ‘enough is enough’ and truely realise this wasn’t ok. I’m not coping poorly, and there IS something very wrong, even though everything looks fine.
I spoke to my GP again. I was open with her about how my daily living was affected, the embarrassing ins and outs of it all, and she diagnosed Vulvodynia. Vulvo-what? I’d never even heard of it before. A chronic nerve pain condition, it actually had nothing to do with the graze at all.
A Gynaecologist confirmed her diagnosis and prescribed treatments. They were painful and ineffective, and I knew you can only treat the symptoms, not the condition.
I was aware breastfeeding could contribute to the discomfort, due to the low oestrogen levels, though I made the decision to continue breastfeeding my son. The benefits of breastfeeding for him far outweighed my own needs.
I gave up on the treatments and learnt to live with it. I felt utterly broken as a woman. Like I was an empty shell of who I once was. There’s been highs and lows in our marriage. For so long I was fearful that it was the new norm. I would never be ‘normal’ again. And there was no way I could even consider having a second child.
At 8 months postpartum my GP prescribed a topical oestrogen cream and anaesthetic ointment which improved comfort in daily living drastically. Almost 2 years on now and I’m fortunately well on my way to feeling normal again, and breastfeeding is still going strong.
How could I have cared for so many women over the years and never even know this is a thing? It was near impossible to find any information or women’s’ experiences of Vulvodynia. When I searched social media for support groups I realised why. There was one, and it only had 20 members. Fortunately, it has grown a lot since then.
Unheard of, and unspoken about. Long term pain post birth, whatever the diagnosis, is debilitating, personal, intimate, confusing, challenging and yes – embarrassing. It’s not the social norm to talk about our sexual and genital health, and we assume women are fine once the massive feat of birth is over. What that leaves us with is a dark pit that women like myself can fall into, with no support strategies or information to get them self out. For any woman walking this lonely journey, that can mean trauma, relationship breakdown, loss of identity, and loss of confidence.
I have to talk about long term pain post birth. As a woman who has experienced it, knowing the lack of information and support available, and with a platform to educate others, how could I not talk about it?
It seems to be almost some sort of social norm to ask a mother when she is having another baby. In my experience, that started to happen by the time he was one and starting to look more like a toddler than a babe. That’s OK. I am always honest – “never say never, but we are one and done” I’d say. What isn’t OK is the insistence from there. “You can’t do that to him”, “he’ll be lonely”, “he needs a sibling”, “that’s selfish”.
For so many reasons, women don’t have babies. Infertility, psychological wellbeing, birth trauma, physical pain. Women need other women, especially when experiencing ongoing concerns post birth. If you’re going to ask someone when they are having another baby, or a baby at all, be prepared to hear why not. And if you yourself are going through this journey, talk about it, let it be known, and you’ll be helping other women. Awareness is the beginning of change.