Life after Labour: Post-Birth Injuries and Birth Trauma
We have featured many a birth and breastfeeding story on these pages, but one area we haven’t covered in much detail is postpartum recovery. Today reader Steph shares her story.
Often, when you think of birth or labour, you think about just that particular process – giving birth; about the little person who has been widening your waistbands and using your bladder as a trampoline for the past nine months entering the world and finally being able to meet them. It’s an exciting time but for some women, it’s not the end. The Birth Trauma Association estimates that in the UK alone, 20,000 women a year develop Post Traumatic Stress Disorder from their experience with a birth, followed by “as many as 200,000 women feeling traumatised by childbirth.” Included in that are women who have suffered physical and emotional injuries that have had a significant impact on their lives – from incontinence, to chronic pain, to crippling anxiety. Yet there seems so little accessible knowledge in regards to post-birth injuries and discussion on this, with many women continuing to suffer silently or remaining undiagnosed. I wanted to share my experience with the lovely readers of Rock My Family, in the hope to open up that discussion even more.
In May 2017, I gave birth to my first child – a beautiful little girl who we named Alice. I was 27, relatively fit and healthy (although I would rather sit indoors binge-watching The Crown with Ben and Jerry’s than going out for a jog), and apart from a few hiccups along the way, it was a relatively straightforward pregnancy. My husband and I had undertaken a hypnobirthing course in preparation for giving birth and one of the key mantras was ‘your body is designed to do this’. Now physiologically, the female body is designed to give birth. What it did not include was that although the body was designed to give birth, it did not necessarily have to like it or agree to come out the other side of it intact. In my case, after a gruelling 46 hours of back-to-back labour with 16 of those deemed ‘active labour,’ and all manners of pain relief failing me by the end; I left the hospital with a bundle of joy in my arms, but a body and mind wrecked by the process.
Physically, I first knew something was wrong when we moved from the delivery suite to my side room. I had a numbness radiating from my right knee up through to the top of my thigh that when touched felt as if I was being pricked by hundreds of needles, alongside a constant pain across my lower back and sides. I mentioned it to the midwives, but it was deemed not to be of concern post-labour. With that, I was discharged that evening with no follow-up plan or advice on who to go to if it didn’t improve. The psychological fallout of Alice’s birth came later when I returned back to our house. I found myself unusually anxious about going back to the place where my last experience had been early labour, but once inside and back in our bedroom, this anxiety exploded into a fully-fledged panic attack. Rather than excited to bring my daughter home to the place I had been painstakingly perfecting for her, I found myself unable to move past it as where labour started.
So the first couple of weeks passed and the emotional rawness that surrounded what the midwives deemed a difficult birth began to ease. Replaced, to an extent, by an all-encompassing love for my daughter. However, the physical pain remained, steadily getting worse as it spread from my lower back into my ribs, across my sides and into my stomach. I was continuing to have labour contractions, more frequently triggered when I was breastfeeding but also sporadically throughout the day, lasting anything from 30 minutes to three hours. At each check up, I brought up my concerns but again they were brushed off as being normal, post-birth recovery. No one examined me or looked into it further, so I managed the best I could at home whilst looking after my newborn.
Then, when Alice was three weeks old, it became more serious. I was rushed by ambulance back to hospital with a sudden onset of crippling pain that had left me curled up, heaving on our living room floor, unable to talk or move. It was as if I had gone back into the most intense back-to-back contractions of my labour, with no breaks between each contraction. With the paramedics advising that Alice be kept at home with her grandparents (a blessing that they live in the road opposite to us and that I had been expressing like Daisy the Cow for days beforehand) until further notice, I was re-admitted back onto the postnatal ward, attached to IV antibiotics, pain relief and told I would be there for a minimum of 24hrs. I was inconsolable – exhausted from the pain and drowsy from the morphine and gas & air, I sobbed at being away from Alice, who I had not spent more than ten minutes away from since she was born. After five long hours, my parents brought her in and the two of us spent a sleepless night, entangled in drips and surrounded by the relentless beeps of medical monitors. By the next evening, after undergoing ultrasound scans on my abdomen/pelvis, I was discharged by the on-call consultant with what he suspected was a severe muscle spasm and urine infection, but wasn’t completely convinced. Grasping a bag of painkillers and muscle relaxants in my hand, I was waved off with the promise that it would be better within a few days.
It wasn’t. The cocktail of pain relief made me confused, drowsy and sluggish – not how you need to be when looking after a baby. Luckily, I had a fantastic support network of my husband and family who stepped in and helped look after Alice, but the pain was becoming increasingly worse and the attacks of the contraction-like spasms more frequent, with no explanation as to why. Weeks went by and not only was I physically suffering, but mentally I began to struggle more. The constant pain had begun to take its toll, and with the contractions, my anxiety from the birth came back with a vengeance. With each attack, I was forced to re-live the more difficult aspects of Alice’s labour that I had buried away in my mind. Coupled with a baby who viewed sleep as her mortal enemy and was only satisfied being bounced around the house like a kangaroo, I found myself in tears daily, continuously snapping at my husband, and becoming more withdrawn as I spiralled further downwards. I saw my body and self as a failure – unable to come through birth unscathed or able to look after my daughter wholly independently like my mummy friends. I resented myself for relying so heavily on others for help; viewing myself as a burden to those I loved and a disappointment to my daughter. As someone who has always been extremely independent and headstrong, having to accept so much help was in direct contradiction with my instinctual behaviour. The guilt and disillusionment ate away at me. I started becoming more and more of a recluse, opting to remain in the house to avoid an attack out in public and kept friends at a distance, in fear that witnessing an attack without explanation would be upsetting.
Finally, at eight weeks and with no sign of improvement and no follow-ups from the hospital, I began to reach out to other medical professionals myself. I found a private physiotherapist who specialised in postnatal physiotherapy where I was diagnosed with a long list of injuries caused by my drawn out, back-to-back labour. From there, she referred me onto a specialist consultant and an MRI. The diagnosis: a herniated disc in my lower back (from remaining in one position for so many hours in labour/continuous pushing), over sensitised nerves (caused by the protracted contractions and lack of pain relief), and my stomach muscles in tatters. As the disc bulged onto the nerves, my body that had remained in a semi-constant state of labour, caused spasms that were instead registered as contractions, as well as issues with my stomach and bladder. Finally I now had an idea of what was going on with my body, and we were beginning to move forward.
Treatment, however, although a step in the right direction was not as straightforward as I hoped. Breastfeeding became an area of issue. In terms of the contractions, the hormones stimulated by breastfeeding aggravated them further. With desensitising the nerves, the most commonly used medication had a list of side effects that made me extremely uncomfortable in regards to Alice. This was all combined with Alice having reached an age where she avidly despised the bottle and would scream when she even saw it in her vicinity. At this point, I was not willing to disrupt her life further by suddenly and inexplicably taking the boob away. So, alternative methods had to be found – I had weekly physiotherapy sessions that although were agonising proved effective, and used a variety of pain medications to help me manage. Post-appointments, I would spend hours googling the half-lives of the tablets I had been prescribed, reading case studies on how it interacted with breastfeeding and discussing them with the breastfeeding experts at my hospital. Often, I would go back asking for a safer, less effective alternative.
Although we were moving forward, I found my moods were beginning to drop again. Neither the physio nor consultant could provide me with a clear end date for when I would be pain-free, and it was a difficult truth to accept, having pinned all of my hopes that with a diagnosis there would be a quick fix. Compounding my feeling of failure further, I now suffered guilt from having to take pain medication that could potentially reach Alice through my milk, but knowing I was unable to look after her properly if I didn’t. I permanently felt trapped in a lose-lose situation, with no clear finish line in sight, and by this point, I crashed, utterly demoralised. Outwardly, I tried to conceal how low I was feeling and the severity of the pain, fearing that to those around me I would be viewed as miserable or unable to hack motherhood, but inside I was broken. Once again my husband, family and best friends were my saviours – at the moments when I wanted to remain silent, they were sat silently with me in solidarity or encouraged openness. When I wanted to remain hidden, they coaxed me out – even with a tearful tirade being thrown at them. My husband worked from home twice a week so that I would have assistance looking after Alice but wouldn’t feel as if I was completely handing over the responsibility of raising my child to her grandparents. The phrase ‘it takes a village to raise a child’ isn’t simply a proverb, for me, it was a lifeline.
My Alice is now almost eight months old, and my situation has significantly improved from those first eight weeks. Although I am still in pain every day, its intensity has decreased and I now have the resources to make the pain more manageable. Although it’s not ideal to be taking morphine-based pain relief, with the limited dose I take it, the side-effects are controllable. Case studies had shown it to be the safest of its kind for breastfeeding, with little to none transferring to Alice, and so the guilt was alleviated a little. I undertake physiotherapy, and although it is hard to always find the time to fit it in to an over-crammed day, it has made a significance difference to correcting some of the damage. I have undergone two rounds of spinal injections that, although, put me out of action for a week each time, has meant that my nerves have finally begun to be de-sensitised a little, although not completely. It’s not a perfect situation, and it’s a long road ahead but it’s definitely an improvement. I am beginning to have more normality in my life, and yes I still have my bad days (both physically and mentally), but there are now more good days mixed among them.
Giving birth, whether it was a positive, negative, or indifferent experience for you, undoubtedly takes its toll on your body. For those mothers who have or are struggling with post-birth trauma, do not feel you have to remain silent; and for those who are not, remember to have empathy for those who are. Do not be afraid to follow up with medical professionals, demand resolutions, or argue against them if you are not satisfied with the initial prognosis. In my debrief, the head midwife dismissed my injuries as resulting from my labour, instead blaming me for doing it elsewhere. It took the diagnosis of two specialists who confirmed the direct link between my labour and the lack of intervention by the maternity ward doctors, for her to admit that steps during my labour care had, indeed, been missed that could have resulted in a different outcome. Remember that you, as the mother, are just as important as the child. You are not just a patient number who, once has given birth, is no longer of concern. Your health and wellbeing matters just as much as the baby they have delivered, a factor that all too often seems to be forgotten. Rather than fostering an environment where new mothers feel that they have to conceal that they are struggling with their birth in one form or another, afraid of appearing negative or complaining, we should be lending a supportive ear. Rather than trivialising the experiences of mothers by saying to that they will ‘just get over it and have more children eventually’, as individuals said to me when I hesitated at the idea of more children, we should instead offer an opportunity to voice their anxieties and work through them aloud, with unconditional support and no judgment. It is ok to have found giving birth difficult, or a traumatic experience, no matter what your experience. It is ok to accept help and support when raising a baby, being a new mother is difficult enough when you are perfectly fit and healthy let alone with additional challenges, so accept all the help you can get, you are not failing at all. Most importantly, it is ok to let your voice be heard about your experience, good or bad, because by sharing your experience, you are offering others a place of comfort to know that they are not suffering alone, and giving them the critical information that could lead to more diagnosis and treatment.