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Episode 211

Bernadette Lack

In my first interview of the year, I chat with Bernadette Lack a midwife, personal trainer and mother of two boys. Bernadette’s unique story involves incontinence before pregnancy and she details the debilitating experience of consistently wetting herself as her pregnancy progressed. Her empowering first birth encouraged a new sense of self-belief so she delved into research and reminded herself of one basic fact: the pelvic floor is a muscle and like all muscles, it can heal.

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Image by Erin Matthews Photography

Subsequently, she created her own program which has helped over 2000 women with prolapse and incontinence issues and continues to be a fabulous resource for those dealing with the shame and discomfort of a weakened pelvic floor. Aside from Berndette’s abundance of knowledge, she talks in detail about her two beautiful homebirths, what it’s like to labour as a midwife and the shift in family dynamics as the firstborn tentatively welcomes the new baby. An absolute must-listen for all women, but especially those who suffer incontinence in silence. Please know that you’re not alone!

Bernadette’s newborn, Aloysius, is only two weeks old when I chat to her so she’s very much in the bliss and exhaustion of the fourth trimester. However, she has a wealth of knowledge and I can’t quite believe how much we covered in this episode.

She has suffered from incontinence since she was 19 and puts it down to a childhood with constipation and incorrect exercise (lots of dancing and sucking her tummy in). She would wet herself while she sneezed which, as a hayfever sufferer, was often. However, she never spoke about it despite working as a midwife and encouraging her patients to work on their pelvic floor exercises.

“I ignored it for 11 years. Prior to wanting to conceive, I knew that the pregnancy would be an issue and the weight of the baby would make my incontinence worse so I saw a women’s health physio. She did an internal and told me that my pelvic floor was weak and I needed to do my kegels, which I did. I waited six months to start trying for a baby and then three months later, I found out I was pregnant with Banjo.”

The novelty of morning sickness only lasted for about 48 hours and then Bernadette was in the depths of all day and night vomiting which only made her incontinence worse. She was working as a homebirth midwife in Melbourne at the time and had to take a change of clothes and wet wipes wherever she went.

“I was traumatised by my first pregnancy as there were many times when I would be covered in vomit and urine and it was just awful. I vomited all day and night from six weeks pregnant. As a homebirth midwife I was in homes and my incontinence pad would fill and leak and I would have urine dripping down my leg. I look at that situation and wonder how on earth I dealt with that without telling anyone. I continued to vomit to 24 weeks and I wasn’t in a great headspace by then, I actually wanted a termination. I remember thinking: if I can’t even sneeze without wetting myself how on earth am I going to give birth? As a midwife the incontinence challenged my belief in giving birth. I wanted a physiological birth and I wanted it at home.”

She opted for private midwifery care and while she had all the routine checks, she actively declined the Group B Strep (GBS) test. “It’s a really challenging one because it has a lifespan of 5 weeks and i can be there when you have the test but perhaps not when you’re giving birth or vice versa, so that’s the tricky thing. If it’s present at birth 1 in 200 babies will become sick with an infection post-birth. If you are positive you’ll be given IV antibiotics every 4 hours. The research now is looking into the effects of the baby receiving antibiotics before birth. Also, if you do test positive and your waters break, many hospitals will induce you immediately without giving you the chance to go into spontaneous labour. There are a lot of grey areas and as always, it’s about looking at the information and making an informed choice that’s right for you.”

Bernadette and her husband went camping together when she was 34weeks as a little babymoon and she noticed a few pains in her belly. She woke the next day having lost her mucous plug. She carried on without telling anyone and worked up until 36weeks.

“On the monday I had a massive rush of love and I couldn’t get enough of Mick, on the wednesday I saw my midwife and asked her if we were ok to stay at home if I did go into labour as if I was in the public system I could only labour at home if I was over 37weeks. On the Thursday morning I woke up with loose bowels and I had two thoughts: I’m going to have this baby and also, don’t be stupid. Mick came home early from work, we had sex and had a nap and I went to prenatal yoga and I got this pain and my waters broke, so I went home and started labouring.”

She laboured all night by herself with Mick encouraging her all the way. She hadn’t called her midwives and while she was in the shower she started doubting herself and her ability to birth. At 4am she decided to lay down on the camping mattress in the loungeroom.

“I lay there and went into a subconscious state, I zoned in on my Nanna, she had 4 homebirths in Malta and my Nan, who was in Scotland when she gave birth, i focused on them and their births, I flicked my fingers open and imagined my cervix opening, i was just in the zone and I think I dilated there.

It was 6:30 when she felt she called her midwife. She got in the shower and felt the head descend, her midwives were stuck in traffic and she began doubting herself again.

“I doubted myself so much, as you do when you birth and parent your first baby, I told Mick to warm the towels, I was trying not to push and so here I was in the shower, and I think I was saying no because I didn’t want to birth without a midwife there. Jan Ireland was off work at that stage and so my midwives had called her and she got there and caught him. And then I went into complete shock because here I was thinking I was 1cm. Babies born at 36weeks don’t have a great sucking reflex so the first two weeks were a hard slog and very painful but then I couldn’t get him off the boob at 3 so there you go.”

She describes her first birth as epic and she honestly felt like she could do anything so she threw herself into research and looked at everything written on the pelvic floor so she could start to heal her own.

“The pelvic floor is a muscle, it can strengthen and heal. I’m a published author and I love research but women’s pelvic floor is an under researched and underfunded area. I always say that if mens testicles were falling out at the rate at which women’s pelvic floors, uterus, bladders and rectums are falling out, this would be an issue that was well managed and well addressed but it’s not. Did you know that 50% of women have prolapse post-birth, 1 in 3 leak urine and 1 in 5 leak faeces?! But that’s not what we talk about with friends when we’ve had our babies, is it?

What I did find was encouraging; the only side effect of doing your pelvic floor exercises is better sex and better orgasms but then I wanted to know what other people around the world were doing. I became a personal trainer after trialling what other people were doing, I created programs based on research and what I thought would work and then six months after birth I realised that I could sneeze and not leak. I started sharing my story and the more I shared the more women opened up about their experience. It’s about moving and breathing right….there’s so much more to it that squeezing your pelvic floor exercises at the traffic lights.”

When she fell pregnant for the second time she was determined to embrace her own journey and really honour her own self throughout. At 34weeks when out walking with a friend she started to experience the same pains as she did with Banjo so she went on bed rest till 36 weeks. She loved this pregnancy and constantly reminded herself that it was going to be her last so she soaked it all in with an immense amount of gratitude. On the night before she started labouring she woke full of anxiety about who was going to be at her birth and the inevitable pain of labour. After working her way through it she went back to sleep  and woke up at 3am with the same pain she had in the yoga class with Banjo. Soon after her waters broke.

“I went back to bed and Banjo was laying next to me, I had a few niggles so I tried to go back to sleep, I got up to go to the toilet and did those early labour poos that really clear you out and I went back to bed and Banjo woke up and kissed me and my belly and I could feel things starting to happen.”

By 5:15am she was regularly contracting so she called her best friend to look after Banjo and organised for her photographer to be there, too. She admits that it felt like her labour was steadily and quickly climbing; there wasn’t any reprieve.

“I was thinking just go with it, just enjoy it, this is amazing, my body is incredible! It just felt like it was happening really fast and then I realised that I was about to have my baby, I was in the shower and noticed I was on my tippy toes and I knew I was in transition. I got out of the shower, my friend and the photographer there, and I asked Mick to call the ambulance, it was 6:15 and the midwives ETA was 6:30 so I knew they were going to miss it. I hd a contraction and I tried not to push, I was half in and half out of the shower, I breathed through it and walked out onto the carpet, and I said it was coming, I said: that’s the chin, that’s the shoulders, I could feel every single movement and Suze told me the head was out and he was born in one contraction and Mick missed it. I had a homebirth and he missed it!”

Bernadette opted for a physiological third stage and ended up birthing the placenta on the toilet as her midwives looked on. “It was quick, I was only in labour for an hour!”

Topics Discussed

Prolapse, GBS, Pelvic floor, Midwife, Incontinence, Two births, Home birth

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