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Episode 321

Amy

In today’s episode I interview Amy, the founder of the Australiasian Birth Trauma Association. In honour of her experience and Birth Trauma Awareness Week, Amy talks about the physical trauma that resulted from an instrumental (forceps) birth. She goes into detail about her pelvic floor injury and prolapse and because her story shares so many parallels with mine, I also talk about my experience with prolapse and the way I’ve managed for the past nine years. 

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This is an intimate and honest conversation about birth trauma, birth injuries, mental health, managing severe physical symptoms, the impact on sex life and the value in connecting with other women who have similar experiences.

One in three Australian women describe their birth as traumatic; if you haven’t experienced it, chances are you know someone who has. Amy started the Australiasian Birth Trauma Association in 2017 (birthtrauma.org.au) and this week launched a report featuring the experiences of over 800 Australian women.

“When I fell pregnant I was the fittest I’ve been in my life. I did two negative pregnancy tests but I just had a feeling I was pregnant so I went to the GP and the test I did there was positive. I was stoked to be accepted into the MGP program in my local public hospital in Sydney.

“I felt that if I did all the right things I would get the birth that I wanted. That said, I was a massive stress head so I took up meditation, pregnancy yoga, I maintained my fitness and I read The Gentle Birth Method. The only thing I knew about the pelvic floor was what was mentioned in yoga classes; it was never mentioned in my fitness training. There’s a gap in fitness education about the pelvic floor and the focus on strengthening it; a strong pelvic floor is not always going to be the best for your birth experience.

“My pregnancy was amazing; I only started to feel a bit of tiredness and breathlessness late in my third trimester. I was 39 weeks and 4 days and by 9pm that evening I was getting quite significant pain. Within a matter of hours I was vomiting, I was switching from shower to bath…all I can say is that I was in a lot of pain very quickly. I went to the hospital at 6am the next morning and I remember begging for the epidural and it taking quite some time before I got it. I was 6cm dilated when I arrived at hospital and within a couple of hours of having the epidural I was 10cm. I started pushing – I was on my back because of the epidural – and she just wasn’t coming. The registrar told me I would need forceps or a caesarean and I begged for more time. Nothing was working and the registrar came back and was taking me through both interventions and I just remember crying. We opted for the forceps and I was in the operating theatre. I was completely numb, no feeling at all. I remember him getting Elia out and it was quiet; my immediate thought was is she ok? They gave Elia to Ron and he took her and I was in surgery for another few hours after that. I was shaking, the theatre was cold, but I was wondering if my life was ebbing away from me. At the time I was told that I sustained a third degree tear but there was also significant bleeding that required padding internally. It was two hours till I saw my baby again.

“It’s a really difficult experience being in a room with three other women trying to manage their newborns. My midwife came to see me and she admitted that I’d been through a rough experience and she got me a private room. I was in hospital for seven days because I needed a catheter for five days because of the padding. I was a first time mum – I didn’t realise that it wasn’t normal. I was struggling, I was trying to establish breastfeeding, I couldn’t get out of bed to go to my baby and I was just desperate to go home.

“I couldn’t really walk for the first four weeks. Eli didn’t sleep and that was probably because I had a low milk supply. I got support through Tresillian and going there was the first time that someone had asked me about my work. The registrar suggested I see a women’s health physio and she was amazing and kind and aware of my struggles. I was fecally incontinent for the first six months but I always had faith that I would get better and I think that warded off postnatal depression and trauma. The physio was the first one to acknowledge my birth injury. She said what you’ve been through is like a car accident. It was really validating because it put into perspective what I’d been through. My symptoms improved, I loved being a mum but at a year postpartum it was really painful for me to have sex. I spoke to my mum and she told me that what I went through wasn’t right and I should make a complaint. I saw the registrar and he removed some scar tissue but it didn’t change the fact that I didn’t want to have sex. That’s a whole different element of my recovery.

“I was diagnosed with major pelvic floor damage and prolapse at 16months postpartum and everytime I had sex I just cried; I felt broken and like my womanhood was taking away. I have no feeling at all. It wasn’t until a year later that I saw a urologist for a 4D ultrasound; I wanted to know what my options were and I wanted the opinion of another specialist. I walked in feeling like a 35-year-old and I walked out feeling like an 80-year old. I was told don’t lift up your daughter, don’t bend, don’t squat, avoid basic functional movements. It severely affected my mental health, I just fell apart.

“I used a pessary to manage my involution and oh my goodness, I used to cry putting it in and cry pulling it out. It’s really confronting initially because it feeds that thinking that you’re broken and old…but you get used to it and it helps. With the right support and learning to feel into your body, there’s so much you can do.

“When I fell pregnant with my second daughter, I had an internal conflict about what was best for my child and what was best for me. I knew without doubt that a caesarean birth felt best for me. I didn’t want to risk further damage and it was cathartic to link with a care provider who would be at the birth. I was terrified though; there were so many forms to fill out, but even knowing the doctor and meeting the staff and it not being an emergency, there was still that trauma in my body when I was in the operating theatre. The birth itself wasn’t a healing experience but it was so amazing to be up and walking one week postpartum. I recruited a lactation consultant but I was also much more accepting of mixed feeding. However, I had severe postnatal depression with my second because my symptoms were quite bad then and antidepressants worked so well for me…I’ve just come off them after four years.”

Topics Discussed

Pelvic floor injury, Women’s health physio, Postnatal depression, Prolapse, Birth trauma, Two births, Caesarean birth, Forceps

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