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Episode 432

Claire | Postpartum – pelvic floor recovery, faecal incontinence

Faecal incontinence affects one in 25 women in postpartum and today, Claire shares her experience. She takes us briefly through her labour and birth and details the confronting realisation that she had no control of her anal sphincter. Thanks to a women’s health physiotherapist who demanded horizontal rest - essential for all new mothers! - pelvic floor exercises and dietary changes, Claire recovered by six weeks. She emphasises how important it is to share her story because she had never heard of it happening before and wondered if it was her new reality; a challenging prospect at a very vulnerable time.

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“I birthed my baby at the Angliss Hospital with standard midwifery care. I saw the same midwife for most of my appointments and I also had a wonderful student midwife throughout my pregnancy and birth. On the Thursday, I went to my 38 week appointment and the midwife noticed that the baby hadn’t engaged so she suggested doing spinning babies and staying active. The next day I was on my feet all day and I had slight cramping which felt just like gas. I was a bit concerned because I hadn’t felt many movements. That night I got more cramps and some spotting. I called the hospital and the midwives encouraged me to come in for monitoring, so we went in at about 5am. Thankfully everything was fine and I was told that baby could still be a few days or weeks away. We headed home, I did some spinning babies exercises that morning, and in the afternoon we
celebrated my baby shower while my contractions ramped up.

“By that night I was in labour and we headed into the hospital about 1am; I was using the TENS machine, the hot shower and gas. Around 11:30am I had a vaginal examination that was particularly painful and traumatic. The midwife was gentle but for some reason it was painful. She stopped immediately, but it played on my mind for days. That was the only part of my labour that I felt sad about. A few days after birth I called the hospital and spoke to another midwife about my experience. She just listened and helped me understand why it might have hurt, said she was sorry about what happened and encouraged me to send in feedback so that they can learn from it and improve.

“The rest of the labour and birth went smoothly, although when bub came out he didn’t turn as they usually do and that could have been why I ended up having some tears. He cried straight away, and we had lovely uninterrupted cuddles for hours after he was born. I was on cloud 9 and felt like I could achieve anything! There were a few tears and grazes which a surgeon repaired later in the afternoon. The local anaesthetics were very painful!

“I’d remembered hearing that the first time you have bowel movements after birth, it can be really painful, but for me it wasn’t. In hindsight, I wonder if it might have been because I had some nerve damage. Once I got home from the hospital, I started to notice some issues with bowel incontinence. I’d be going about my day, and all of a sudden without warning, it would come out. I remember telling the midwives during the home visits after the birth that I was having issues and they told me it wasn’t unheard of, but it’s also not common. They encouraged me to see my doctor and get a referral to a women’s health physiotherapist.

“It continued for around six weeks, which was really challenging. At the beginning it would happen every couple of days, but over the weeks it got less. Pelvic floor exercises and time helped me heal, but it was definitely my biggest challenge after birth. It would just occur without warning, so I was concerned that this was my new normal. I googled, but there wasn’t much information. I recently read that it affects one in 25 women in postpartum, but I had never heard anyone talk about it on podcasts or social media which is what I was getting a lot of information about pregnancy and birth. I was worried that something was wrong with me, or that I had done something wrong.

“A nurse at my GP clinic provided me with two contacts for local Women’s Health Physiotherapists. I called one of them, Lise, who couldn’t fit me in for ap little while, but gave me some really helpful advice over the phone regarding exercises I could start, and prescription for a prebiotic/probiotic fibre supplement which would help support healthy bowel function. I saw another great physio while I waited, who emphasised the importance
of horizontal rest – lying completely flat (not just sitting on the couch!) – and pelvic floor exercises. I went on to work with my wonderful physio Lise who is very holistic and helped me with all aspects of my pelvic and gut health and beyond. As the weeks passed, I received treatment from the physios, did my exercises, took care with my diet, and my symptoms eased in severity. Thankfully by around 6 weeks, it had stopped happening. My physiotherapists were really reassuring and emphasised that it would be possible to heal and strengthen.

“Those early postpartum days were very hard, I had a rollercoaster of emotions, the baby blues and was feeling very vulnerable. I shared my feelings with my husband and family and messaged with my other friends who were new mothers. It was a lot. But I also felt empowered from the birth and had this beautiful baby keeping me busy!

“I want to share my experience so that others going through similar issues such as incontinence don’t feel so alone and know that in most cases it can be resolved and there is a light at the end of the tunnel.”

Topics Discussed

faecal incontinence, Midwifery care, One baby, Vaginal birth, women’s health physiotherapy

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