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Episode 509

Sonja – shared care, syntocinon, vaginal birth, painful periods, pelvic pain, pelvic congestion syndrome, endometriosis

In today’s episode Sonja takes us through her two pregnancies and births but also talks at length about her pelvic pain. She’s been diagnosed with pelvic congestion syndrome which was exacerbated after birth and especially when her menstrual cycle returned. Her symptoms were very similar to a prolapse - a heaviness and dragging sensation in her rectum - but she also experiences sharp, debilitating pain that can last for up to an hour and significantly affects her day to day life. She is planning for a laparoscopy to investigate endometriosis and talks about the importance of specialist care and the comfort she finds in the stories of other women.

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“I went into my first pregnancy pretty relaxed; I didn’t want to overthink anything. We were in Melbourne at the time and I felt very comfortable with my GP so I did shared care with her alongside my local public hospital. From the beginning till about 22 weeks I was constantly nauseous but I only vomited a few times. It wasn’t amazing – I drank a lot of ginger ale and ate dry crackers. We did a hospital birth education class and we really like it; it was comfortable and informative.

“I made it to 40+14 with Bobby and I was really adamant that I wouldn’t be induced. The hospital was pretty good about it although there were a lot of conversations about it and we just took it step by step. I had to have a few scans at about 37 weeks to monitor the amniotic fluid levels as it looked to be a bit on the low side. The scans showed it was tracking well and everything was going okay. At about 41 weeks the head midwife suggested booking an induction date although she reassured me that baby would probably come. At 40+10 I opted for a stretch and sweep but my midwife couldn’t access my cervix which wasn’t a great sign.

“Thirteen days past my due date I stood up from the couch and my waters broke. The hospital encouraged me to come in and they did the test to confirm it was my waters. I’d tested for Group B Strep at 35 weeks and I felt very comfortable being hooked up to antibiotics and the syntocinon drip to help labour get going. In retrospect I feel like that could have been delayed because it was 2:30 in the morning and I probably should have been sleeping. I don’t have regrets but I wish I had advocated for myself at that moment.

“At about 5am the contractions started to get real. It was very hard and fast and I was grateful for the quick labour but I couldn’t get a break. I told the midwives that I didn’t want to see a doctor, I wanted their support though so they guided me through different positions. At about 9:30am I experienced that pushy feeling and I didn’t ask for pain relief, I was asking for a caesarean and that’s when the midwives knew I was in transition. The midwife asked if I felt like I needed to do a poo and I told her it felt like that. That’s wen she told me I could go ahead and start pushing, if I wanted. I moved from all fours to standing and Bobby’s heart rate started to drop and they got a bit concerned. They said they’d get one of the doctors and as soon as I heard ‘doctor’ I said: ‘no!’ and they encouraged me onto my back and I had my legs in the stirrups which is not what I thought I would do. They were very much coaching my pushing because they were concerned and I took what they were saying and did it – but it all felt so unnatural. I pushed for about thrifty minutes and Bobby was perfect and I felt so relieved.

“No one ever mentioned seeing a women’s health physiotherapist in early postpartum which is so disappointing. Covid hit about four months after Bobby’s birth and I never really questioned my symptoms but they really ramped up when my period returned; I was doing what I could to get through the days during menstruation. I’d had haemorrhoids after birth and I presumed it was that but when Bobby was one we made the move back to Western Australia. I knew things weren’t right…my symptoms were a heaviness, a dragging sensation, like the symptoms of a prolapse but I’d also get a shooting pain in my rectum and it would last for about 20 minutes until I’d used a suppository to relieve the pain. The physio did an internal and diagnosed a mild prolapse and she felt that a pessary was a good idea just to provide a supportive scaffold.

“I then fell pregnant with Indi just before Bobby was two and my symptoms really alleviated which told me it was hormone related. We were living regionally in WA and many of my early appointments were with a midwife via telehealth. I was 40+4 and I was sitting outside in the morning and I started feeling a bit crampy but those niggles had been going on for weeks. But then I noticed them getting a bit stronger and that continued throughout the afternoon. At dinner I felt like I needed to call my sister who was going to be looking after Bobby. I was having about two contractions in 10 minutes at that stage and it felt like things were heading in the right direction. I got really upset seeing Bobby go – knowing that the changes were coming – and then I went back inside and labour stalled. I wasn’t having it so I set up an obstacle course to get contractions going again. I’d heard that sex can bring labour on and I had a lot of instructions and rules but I really think it helped. I then got in the bath and had two really strong contractions and soon after we decided to go to the hospital. It was about 11pm at this stage.

“We walked through the hospital, got into the lift and as soon as I got in the birthing suite I requested the bath. I was in the water for two minutes and Indi was born – at 11:45. We stayed in hospital overnight but I was really excited to go home and we were discharged the next morning.

“When my period returned, it returned with a vengeance. It was really heavy and painful and it got worse for each cycle. I was dealing with the sharp, shooting pains which were being relieved by the steroids, but then I had heavy bleeding and debilitating pain. I went to my doctor and told her I was concerned about my blood loss and she prescribed me a medication to limit the blood loss but after doing some research I realised I didn’t feel comfortable being on that for the unforeseeable future.

“I was chatting to a friend and she suggested seed cycling which is a very alternative path but it worked for her and I thought it was worth giving it a go. I’ve been doing it for seven months now and I’ve gone from taking a prescription acid to now hardly reaching for panadol. My periods are so much lighter, they’re regular and I know exactly when I’m ovulating. It’s been a game changer. I basically ticked every box for endometriosis and now my symptoms are relieved and I’m teaching my gynaecologist about seed cycling.

“I have been diagnosed with pelvic congestion syndrome which is a heaviness, a dull ache and everything that I thought a prolapse was. For me, those symptoms are more in the rectum. My mild prolapse is part of the picture but it’s not the cause. I also have bad lower back pain and pain during intercourse. Most commonly, the syndrome stems from pregnancy because the uterus can press against the pelvic veins which prompts them to dilate and this affects the blood flow which leads to that sense of heaviness, especially when I’ve been standing for a long time or carrying the kids. I’ll be having a vein embolisation which will hopefully alleviate the pooling in my pelvis.”

Topics Discussed

Endometriosis, painful periods, pelvic congestion syndrome, pelvic pain, Shared care, syntocinon, Two Babies, Vaginal birth

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