Cosmo on birth injuries and postpartum pain
July 20, 2016 7:47 AM   Subscribe

"Millions of women are injured during childbirth. Why aren't doctors diagnosing them?"

"Childbirth is a well-studied traumatic experience for women's bodies, yet modern medicine still leaves far too many mothers debilitated, sometimes for the rest of their lives. ... Obstetric training is understandably focused on life-threatening childbirth complications, like hemorrhage or infection. Non-life-threatening (but still painful and incapacitating) problems get less attention."
posted by liet (44 comments total) 48 users marked this as a favorite
 
I know a lot of massage therapists who specialize in post partum care because of this lack. They are all very busy with pelvic floor problems and abdominal work (mostly for the women who get csections). This is the reason why they are busy - they are in many cases the only person who can help.
posted by thebotanyofsouls at 8:09 AM on July 20, 2016 [7 favorites]


If anyone needs this kind of care, find a local massage therapist and email them. Most don't do this because pelvic floor work is so intimate, but many know someone - either chiro or LMT - who can help.
posted by thebotanyofsouls at 8:11 AM on July 20, 2016 [2 favorites]


That's such a great article.

"If a woman has a problem like urinary incontinence or prolapse, they'll talk to their mom or their sisters, and their mom and sisters may have experienced a similar thing and that may normalize it," says Dr. Fox, of Brown University.

So true. My mum has been incontinent for at least three decades now (I don't know which kid did it). It's completely normalised and just what happens when you have a kid. I've pointed out to her that there are clinics available but the embarrassment factor is huge and its just not something she would ever, ever do.

I had to have proper surgery for my tear. Unlike the other surgery I've had, the follow-up clinic wasn't for six months. The tests took another two, and i finally got the all-clear the month after that. It's just not treated as a major problem.

There's a tremendous amount of pressure on women to act normal straight away both from the media and medical professionals. After the surgery following birth, I was "encouraged" to make my own way around the hospital straightaway (not so after my other surgery, where they insisted on wheeling me everywhere).
posted by threetwentytwo at 8:26 AM on July 20, 2016 [7 favorites]


Ugh. My pelvic floor was in bad shape for a few weeks after my most recent kid... and I had a bunch of relatives visiting, and stairs between the main floor of the house and the bathroom where I kept all my postpartum supplies. I had a few close calls. Things seem more or less normal up in there now, thank god.
posted by town of cats at 9:18 AM on July 20, 2016


I was incredibly fortunate to have an OB that said the safest way to birth my large, huge-headed son was to have a scheduled c-section, and my only postpartum 'issue' was numbness in my abdomen that disappeared by the time my son was ten months old. I have no doubt that my son's 14.5 inch circumference head would have absolutely wrecked my pelvic floor muscles, especially with the weakened state of my pelvis from SPD.
posted by The Juche Idea at 9:23 AM on July 20, 2016


That "29% have pelvic fractured they are unaware of" is fucking infuriating. The big bad that everyone always talked about was tearing/major episiotomy. Nobody mentioned the possibility of bruised/broken pubic or tailbone, not my prenatal classes, not my doc, nada.

So when I bruised/broke my tailbone pushing with my first and couldn't sit straight for more than 6 weeks, it was "eh, not much to do, suck it up buttercup." When it happened again with my second at least I was prepared (viva the industrial rubber donut we blew up at the gas station).

Now reading this, NOW I discover that because of that I might be at a greater risk for pelvic weakness and prolapse in the future?!?

Rage. Pure motherfucking rage. For myself and for everyone else not properly educated or listened to by the medical establishment wherever.
posted by romakimmy at 9:40 AM on July 20, 2016 [21 favorites]


I don't think this is a problem because of women talking to each other and normalizing it. If doctors talked to women about these things during pregnancy and after childbirth, and made it clear that incontinence and other issues are NOT things that they just have to live with, then women probably wouldn't seek solace in the communal misery of their female friends and relatives who also didn't get treatment.
posted by a strong female character at 9:43 AM on July 20, 2016 [18 favorites]


I also feel like a lot of women only discover the true horrors of childbirth when they're already pregnant.
posted by a strong female character at 9:46 AM on July 20, 2016 [34 favorites]


I'm sitting here with the blood gone from my face.

What on earth. Look, I've never given birth (I'm likely unable to conceive) and yet I still know – because it's publicized every-freaking-where here – that women get several medical follow-up exams and abdominal reeducation after birth because pushing or having a small human otherwise delivered from yourself tends to put your health at risk in several ways. On top of it being common knowledge here, it's all reimbursed!! Reeducation and all! Because it's what can happen when you have a baby!!!

That the different potential risks are not commonly-shared medical knowledge in the States absolutely horrifies me. It's bad enough there's no generalized paid parental leave. Gaahhhh.
posted by fraula at 9:53 AM on July 20, 2016 [8 favorites]


Hah!! Oh boy!! Where to even start! 4 months after my last kid i was still bleeding. NON STOP and was leaking like i forgot how to be potty trained! They kept telling me that as long as i wasn't soaking through a pad an hour, i was ok an that the incontinence was normal and would pass. Just keep doing Kegels, they told me! I couldn't get anyone to listen to me! I eventually called my childhood friend in AFRICA of all places (who's a gynecologist) and begged for advice. She did some research and came back to me with the name of a gyne-urologist based in my home city, and emailed her on my behalf. She called me and told me to come in. 2 weeks later, guess who had to have a hysterectomy and bladder repair surgery? Basically my uterus was shot and never healed after childbirth and my pelvic wall had collapsed.
So pardon me if i sound bitter...
posted by ramix at 9:55 AM on July 20, 2016 [18 favorites]


I often wonder...is it possible that the societal pressure to

1) glorify women who "bounce back" almost overnight
2) downplay the potential risks and lasting injuries that may result from childbirth

might in some way be connected to the fact that we are living in a time when women (theoretically) have full control over their reproductive choices, and therefore could opt out of childbirth altogether, if they so chose?

I don't think it's a direct connection by any means, of course. But if you go back and look at old diaries and letters from the nineteenth-century, childbirth was acknowledged to be an extremely dangerous thing. Yes, yes, antibiotics etc. have drastically reduced that danger. But we, as a society, behave as though "modern medicine" has made childbirth a totally safe experience, when in fact, in comparison to other developed countries, the U.S. has a pretty shockingly poor maternal mortality rate, and it's getting worse.
posted by mylittlepoppet at 11:07 AM on July 20, 2016 [20 favorites]


I think that the greater reason childbirth is no longer considered wildly dangerous is the availability of modern hospital care and the knowledge of germ theory, which keeps women from dying of "childbed fever" (sepsis). Also, we don't like to acknowledge the effects racism has on medical care. This data from the 1990s shows an enormous disparity between outcomes for white and black women.
posted by epj at 11:19 AM on July 20, 2016 [7 favorites]


Pertinent article. Two nine and a half pound kids later annnd I peed myself a little at the mall today. Goddamn sneezing.

At my follow up appointment my doctor said "Give it time. If it doesn't get better, call me". Get better when? How? Never peeing myself? Only peeing myself when I have a full bladder? Only during allergy season? Because all the moms I know have incontinence to some degree.
posted by lydhre at 11:54 AM on July 20, 2016 [4 favorites]


In a landmark report from the Institute of Medicine in 2011, a team of experts noted that women "have faced not only severe pain, but also misdiagnoses, delays in correct diagnosis, improper and unproven treatments, gender bias, stigma, and 'neglect, dismissal and discrimination' from the health care system."

Yup. Sigh.

I don't have kids. Never had the interest. But hearing stories like this are just mortifying. And it's not so much that birth can be painful or cause injuries but that women are again shit on by the medical system.

I wonder if there might be some truth to women not being told the problems and risk of pregnancy until they're already in it. I'm a hairs breadth away from 40, and I've only heard many of these things via friends who've had kids and something didn't go well or a smattering of articles and discussions as above. Had I decided to have kids, I certainly would have been in a learn as I go situation as most of my peers have been.
posted by [insert clever name here] at 12:07 PM on July 20, 2016 [2 favorites]


I had a surgical delivery after hours of labor, and a post-surgical infection. I lost sensation in my vagina for 6+ months. It's quite possible that my auto-immune issues are related to pregnancy. Being female is not for the weak.
posted by theora55 at 1:41 PM on July 20, 2016 [2 favorites]


Well, yes, I think there's an understandable phenomenon where women don't really research pregnancy and birth outcomes until they're invested in it somehow--intent, conception. That's understandable because most people don't develop deep interests in stuff that's not relevant to them.

What I noticed when I was in the pregnancy/neonate phase of life is that we well-educated and diligent women expected that we would learn everything, or at least everything enough, from Doing Our Homework. Then real life hits and a lot of us learn really fast that there are a wide variety of experiences and outcomes, and even the best-prepared dilettante doesn't begin to understand the breadth of possibilities that might happen.

The people who do this work day in and day out for years as their professions gain this understanding, but their ability to predict is still pretty imperfect. It's a fine line: does a responsible medical professional disclose absolutely every possible outcome, including the horrific ones, to each patient that comes along? Of course not, and we'd rightly fault them if they did.

Pregnancy and childbirth are major life event, major stressors to a woman's health. Some people get lucky and are dealt a hand that lets them breeze through, and a lot of us are not. I think the reference to urogynecology upthread is invaluable. Most women don't realize that OB-GYNs are not the only gynecologist specialty. They know a lot about women's pelvic and reproductive systems as a result of being specialists in reproduction--but urogynecology focuses on pelvic anatomy and function exclusively they know things that OBs just don't. Kinda makes me wonder why OBs don't refer to urogyns more often for postpartum recovery. Professional rivalry?
posted by Sublimity at 1:45 PM on July 20, 2016 [6 favorites]


I also feel like a lot of women only discover the true horrors of childbirth when they're already pregnant.

YES YES FUCKING YES. This was my experience. And although it is very much frowned-upon in my social circle to feel that pregnancy/childbirth/motherhood are anything other than the best thing that has ever happened to you, I feel like it is my duty to crow from the rooftops " IT FUCKING SUCKS!!" whenever the subject arises. So that maybe I will save some other poor woman from the horror and disillusionment that I went through.

I even tell men- just the other day a friend in his early twenties said something about "when you have another kid" and I was like "ok, pull up a seat and hold on to your hat because I am never having another kid AND I AM GOING TO TELL YOU WHY".
posted by lollymccatburglar at 2:07 PM on July 20, 2016 [23 favorites]


I have actually said to a man once (who pooh-poohed epidurals ) "Ok, so imagine that you were trying to pee out a bowling ball, but then it got stuck, so they used forceps to pull it out, but they also had to cut the tip of your penis with a knife to make the hole bigger, but it didn't help and you still tore all the way down the shaft to your testicles, and then you got a few dozen stitches and then they wouldn't give you anything but paracetamol for the pain."

I should have added, "and then the stitches get infected and hurt like an 11 out of 10 on the pain scale to have cleaned ( still no good painkillers) and then afterwards it doesn't heal right and sex hurts and will never ever feel the same way again, and also you piss yourself every time you sneeze."
posted by lollymccatburglar at 2:15 PM on July 20, 2016 [37 favorites]


It is an ongoing irritation for me that people act like the only important statistic about childbirth is the C-section rate, and no one ever seems to talk about postpartum injury from vaginal birth.
posted by purpleclover at 2:52 PM on July 20, 2016 [11 favorites]


I feel like we've just finished discussing how menstrual problems aren't taken seriously by doctors. Now we're talking about how injuries of pregnancy and childbird aren't taken seriously by doctors.

Take home message: medicine in the US treats female-specific illness/injury/life like crap.
posted by sciencegeek at 3:03 PM on July 20, 2016 [14 favorites]


Well, yes, I think there's an understandable phenomenon where women don't really research pregnancy and birth outcomes until they're invested in it somehow--intent, conception. That's understandable because most people don't develop deep interests in stuff that's not relevant to them.

What I'm referring to specifically is the common injuries like vaginal tears and incontinence. Things which can be debilitating but are still not considered serious by health practitioners. There are of course a million rare complications that can happen, but I am a 30-year-old (happily childless) woman and I only found out within the past couple of years that it's "normal" for women to bleed for several weeks straight after childbirth. I've just gotten the impression from my many many conversations with women on this subject that the majority of women really do not understand fully what they've signed up for until after it's too late to opt out.
posted by a strong female character at 3:06 PM on July 20, 2016 [6 favorites]


t is an ongoing irritation for me that people act like the only important statistic about childbirth is the C-section rate, and no one ever seems to talk about postpartum injury from vaginal birth.


YES. I have a friend in Western MA, where "natural" birth is considered the top priority who lamented that yeah, she avoided a csection after a difficult labor - but ended up with a fistula that had to be surgically repaired. Twice.

The natural birth NEVER C SECTION squad that's prevalent among women of a certain class and education status *never* mentions injury from vaginal birth. And the second worst thing that could happen is an episiotomy - because if you rub oil on your perineum, it won't tear! If you get a second degree tear, clearly it's your fault for not using enough oil!

Add this to the reasons women don't talk about birth injury: well, clearly they just didn't give birth the right way.
posted by sonika at 3:11 PM on July 20, 2016 [20 favorites]


I don't know how it is in other families, but in my family, you get the story of your birth. It's part of your life story and they tell it to you so that you know how it was you arrived in the world. Here's mine...

I was my mother's second birth. She had delivered twins (Brother-the-elder and his fraternal twin, who died at six months of a heart valve defect) vaginally the year previously with no difficulties or tearing, so this was not her first rodeo.

My mother was two weeks overdue with me. It was early April, 1970, cold enough to flurry. When she showed up at the hospital in labor (yet again -- there'd been a couple of instances of false labor or whatever) the head of obstetrics was "Let's get that baby born! I have a bridge game!" (exact quote) And he got overly happy with the pitocin. The attending nurse was "Are you sure that's wise?" but he ignored her. Following the pitocin, I got born in very short order and Dr. Gordon got to his bridge game on time because that was, after all, what was really important.

To this day, when my mom goes in for a pelvic exam, the ob-gyn is like 'Omg, what the hell happened here?'. Apparently, it's clear even forty-six years later that the landscape was violently torn to pieces and half-ass cobbled back together. (I was an 8 1/2 lb baby, not excessively huge or anything.) All my mom's subsequent ob-gyns since Dr. Gordon have apologized to her on behalf of the profession for what he did when she was in labor with me.

Sorry, mom. He Had A Bridge Game.

Anyway, that's why I grew up aware that "woman being torn to shreds" was totally a possible outcome for pregnancy.
posted by which_chick at 3:38 PM on July 20, 2016 [17 favorites]


I've just gotten the impression from my many many conversations with women on this subject that the majority of women really do not understand fully what they've signed up for until after it's too late to opt out.

Well, c'mon. That's not fair. And if everyone "opts out" then there goes the end of civilization. It kind of, almost, makes you feel like if you don't "opt out" then you get what's coming to you. Here's the deal, though, every pregnancy is different. Every body is different. Every baby is different. I did not "bleed for weeks" but that could be due to the fact that I had a c-section and much of the stuff that your body must expel naturally was cleared out during the C.

What needs to happen is better post-partum care for women. Better and more pro-active referrals to specialized care. Less foisting the horribleness on women...just because. This idea that people use up "too much healthcare" is such a load of American baloney. I'm with Kaiser right now and they are so good at sending you on your way without having done anything for you. Take the $20 copay, suggest it's "stress" and come back if it doesn't go away. Nobody got time for that shit. Not between the childcare juggle, two-income hustle, retirement savings freakouts, skyrocketing housing prices, etc., etc.. I digress.

I was super worried (about all the scary stories) throughout my pregnancy and my care providers didn't seem concerned about anything. I had as near as I can tell, a healthy and very uneventful pregnancy that ended in a C-section. A birth that was long, tough and beautiful. One problem I see, though, is that healthcare is reactive not proactive. And it's squeaky wheel reactive not "care for the least among us" active. I had a specific issue that I brought up frequently before I had my baby and was continually put off. And it did indeed become an issue post-partum but because I was told, continuously, "You'll be fine, you'll get medicine" I felt sort of adrift when I wasn't fine. And 1 week after having my baby, recovering from labor and c-section and trying to breastfeed and no sleep and etc., I should have gone to the E.R. because I could not poop. I ended up being able to take care of myself but it was horrible. So I tell all new moms, don't leave the hospital until you poop. Also: Hi, Internet!

So you can add that to the "Why did no one tell me this?" canon. Except, I did hear about this and I raised this issue leading up to baby's arrival and nobody cared. It wasn't an issue until it was an issue and at that point, I was too exhausted to advocate. My stay in the hospital was punctuated with around-the-clock interruptions on my sleep to check my temperature, though, so there's that. I think they do that so that you'll leave.
posted by amanda at 4:05 PM on July 20, 2016 [5 favorites]


There's a huge culture of silence around negative outcomes around childbirth. I think it kind of comes down to modesty + don't freak out the pregnant lady + hormone fog and the way we humans seem to reproduce beyond the first delivery which I personally think is one of the evolutionary bases of dissociation - not remembering childbirth being essential to the species' continued existence. On the part of women.

On the part of doctors, I have no idea.

My baby died at 4 days old due to a dramatically bad labour. Not only did no one -- not. one. -- nurse or OB in the hospital where I delivered ever talk to me about that, no one, including my actual OB who had been on vacation, talked to me about my partially dislocated hip, which had popped back in, but which bothers me to this day because I didn't know it was dislocated until I pulled my own records almost a year later as a part of deciding about a lawsuit. Which is when I learned I shouldn't have chosen walking/running as my way to deal with grief. To reiterate: my daughter's delivery was so bad that she died, I dislocated my hip, and had a massive episiotomy and abnormal bleeding, and not one medical professional talked to me about any of it until my /next/ OB for my next pregnancy at an (obviously) entirely different hospital.

And I don't talk about it to pregnant women. Because, I tell myself, what are the risks really? But I will say I spent 5 months working with a pregnant coworker and she knew I had lost my baby but never asked. And I didn't offer any information. And her baby was stillborn after going past her due date by quite a bit, guided in part by the same natural childbirth zeitgeist that kept me from screaming for a c-section early in my labour. But I still don't offer pregnant friends my experience unless they ask, because it is a horrible story at a vulnerable time.

So...I don't know.
posted by warriorqueen at 4:23 PM on July 20, 2016 [39 favorites]


To be clear, I'm not at all blaming the women for whatever experience ends up happening during childbirth. I did not mean to imply that women just need to do more research, or anything in that vein. And I know that many women do know what they've signed up for and are ok with that. But, I have met women who would rather not have had a baby if they'd known what the risks are. I think in addition to the culture of silence, women are expected to just be happy with whatever the end result is because they've been rewarded with a baby.
posted by a strong female character at 5:01 PM on July 20, 2016 [5 favorites]


I shared this article on Facebook just now and within five minutes I got (a lot for me) three "holy shit, thank you!"-type reactions from female friends who've given birth and/or are pregnant.
posted by nicebookrack at 5:02 PM on July 20, 2016 [3 favorites]


I had my daughter under the Australian healthcare system (I'm American) and the messaging here is very much that "pregnancy and childbirth are very normal routine things and there's no reason to make a big deal out of them." You only ever see a midwife (board certified, basically an OB-nurse practitioner) unless things are really going wrong. The antenatal classes focus on telling you how normal everything is. You can leave within 4 hours of a vaginal birth if everything has gone well. Routine. Routine. Nothing to freak out about.

And on one hand that's great, and I sort of understand why nurses and midwives and OBs are kind of over having to deal with the fact that this is probably the most painful thing 99% of their patients will experience in their lifetimes and so they're, on average, likely better judges of what's normal than the individual patient is.

But it *encourages* them to normalize everything and to downplay what women are complaining about. My daughter ended up being posterior, which made for painful back labor, and a strong urge to push when I was 100% not even close to being at push time, but they didn't know she was posterior, took my screaming and saying "I feel like I need to push!" (which I KNEW WAS NOT RIGHT but was not really in a position to clearly and calmly communicate) as me freaking out unreasonably (I think they even made comments to my husband about how they could hear me in the waiting room) rather than as a sign of something actually being wrong. It was when it *was* finally time to push that they suddenly realized things weren't going as planned, my daughter's heart rate was dropping with each contraction, and suddenly in a "this is routine and you only see midwives" hospital I had like 6 OBs in the room in under five minutes trying to figure out what to do. lol, first time pregnant lady saying labor hurts, boohoo, OH WAIT maybe there was something to it.

Same thing with breastfeeding. "It's supposed to hurt!" It's not going to be super comfy immediately, but I'm not supposed to spend my first 48 hours at home literally crying every time I have to feed my daughter and anticipating it with utter dread. Oh wait, she has a complete tongue tie which makes her unable to feed without destroying my nipples AND it means she's not even getting the milk she needs? Maybe there was something to my complaining!

I'm lucky enough to not have much in the way of post-partum issues -- after an infected episiotomy wound for eight weeks, anyway -- but it always shocks me when I hear comments from the other women at my gym about how "Oh, god, after two kids you really think I can jump rope after drinking any water? lol!" and acting like that's totally okay. I remember a followup meeting with a midwife to check on my daughter a few days after we brought her home, and very gingerly sitting down on a chair as she checked out my kid. The midwife asked if it was painful to sit, and I said yeah, of course, and kind of laughed, and she gently said "Honey, it's not still supposed to hurt that much." (that's how we discovered that my stitches had come out and I had a good infection going) That and the saint of a lactation consultant I met with about 1.5 weeks after my daughter was born were the only people in the entire process who told me I *wasn't* supposed to be hurting as much as I was. It was like a breath of fresh air. Until they said anything I just assumed I was going through the standard post-partum pain and suffering. This is so, so dangerous, and causes women to question themselves and their physical experiences in all sorts of other ways.

Also, re: the pressure to have a "natural" vaginal birth - all of my classes/etc all emphasized how you "heal faster" with a vaginal birth and with natural tearing versus an episiotomy. They completely ignored all the other possible complications of a vaginal birth. But we heard a lot about C-section recovery and side effects!
posted by olinerd at 5:40 PM on July 20, 2016 [16 favorites]


I've just gotten the impression from my many many conversations with women on this subject that the majority of women really do not understand fully what they've signed up for until after it's too late to opt out.

I've noticed this with my friends. I don't have children and quite a lot is to do with all the pregnancy books and articles I read when I was 11 and my mum was pregnant with baby sibling. I remember horror stories in magazine articles about difficulties getting pregnant, traumatic deliveries, the works.

And then I started going to mothers group with mum and baby sibling. OMG. I went for the babies, the mothers liked to share their experiences which made for horrifically graphic discussions of things mentioned in this article and thread. I still loved the babies but at age 12 it made me look askance at the whole process of getting one (it's seriously effective birth control. Send all teenagers to mothers group!)

When I got older, I just assumed everyone knew all this stuff, along with all the other baby raising tips and techniques. Since I hadn't given birth myself, it never occured to me to go into detail with my friends. I also didn't want to be a know it all or a downer. So I can see how there's this perpetual silence surrounding these issues.
posted by kitten magic at 6:18 PM on July 20, 2016 [2 favorites]


Doctors don't take women seriously. I have a genetic disease and when I started to get symptoms I had to go to 5 doctors over 6 months to get treated. BOTH MY PARENTS have this disease. I had their records and information from their specialist, all the symptoms and copious information. No one would treat it until I specifically went to a young, female doctor who started treatment that day and now I'm fine. Months later one of the male doctors sent me a letter basically saying he'd ordered some tests related to the disease. I only saw him one time and so I called his office and inquired why. Apparently the "thought about it some more and decided he should do some tests". I told him to go fuck himself, actually I asked his nurse to tell him since he, of course, didn't bother talking to me himself.

And I'm a research scientist who is smart and pushy and had the back up of several friends and family members being doctors so I could have traveled for treatment. But no, I have to "convince" some jackass that I am really sick and not depressed or getting older or whatever bullshit they assume women are trying to fool them with.
posted by fshgrl at 9:59 PM on July 20, 2016 [9 favorites]


I am considering asking for a c section for the next one and I can't believe I ever thought that natural birth was somehow "better." Barfed up that kool-aid for sure.
posted by St. Peepsburg at 2:31 AM on July 21, 2016


Warriorqueen, you've clearly earned that name. Thank you for sharing your story.

I've just gotten the impression from my many many conversations with women on this subject that the majority of women really do not understand fully what they've signed up for until after it's too late to opt out.

I am feeling like the codgeriest codger on Crone Island this morning, reading this statement inspired by the realization that women bleed for several weeks postpartum....

From where I sit in my late 40s I feel like that statement sums up all of adulthood--pregnancy, parenthood, marriage, career, health maintenance and illness, dealing with aging parents, grief and loss, you name it. For women and men alike. You deal and you get through.
posted by Sublimity at 5:38 AM on July 21, 2016


So, because suffering exists, people should just deal with childbirth and get over it?
posted by a strong female character at 6:22 AM on July 21, 2016 [3 favorites]


My former next door neighbour suffered chronic pain, and during the 7 years I lived beside her she took frequent trips to Toronto to see specialists and had multiple (mostly unsuccessful) surgeries. She walked very slowly and painfully, with a cane. She renovated her house to have a bedroom and bathroom on the ground floor because she couldn't handle the stairs anymore. I don't know her full story, because as others have noted above One Does Not Ask About These Things, but my mother told me that the origin of our neighbour's pain was a birthing injury. Which horrified me, because this woman was recently retired with adult children. She had been in gradually increasing pain for decades.

Happy Ending: Eventually the surgeries worked. She regained her mobility, and bought herself a standard poodle puppy that she enthusiastically takes on long energetic walks around the neighbourhood.
posted by Secret Sparrow at 6:23 AM on July 21, 2016 [7 favorites]


I went to a birthing class 29 years ago when I was pregnant. It was all about natural/ vaginal birth. Surgical delivery got a brief mention - yeah you might have a c-section, like 25% of all deliveries. No education about the dangers of childbirth, infection, recovery, danger signs. All that crap about breathing? not much help. Nobody tells you that when you go back to the hospital with your post-surgical infection, you'll be on a general surgical floor, not the wonderful birth unit. There's a whole industry around birth being magical; your reality may vary.
posted by theora55 at 8:40 AM on July 21, 2016 [1 favorite]


You deal and you get through.


Yes, and "dealing" should include receiving proper medical care.
posted by sonika at 9:16 AM on July 21, 2016 [12 favorites]


Agree completely on that.

I think the thing that sticks in my craw is that there is a false belief that a woman could ever really know "what they're getting into" regarding pregnancy, childbirth, parenthood. Yes, for sure, get informed, by all means. I just wish there were a better way to inoculate against that somehow hardening into a belief that a woman has the responsibility to have all the contingencies covered--that the birth injuries and postpartum pain somehow are her responsibility, because *you should have known*. That just ain't true.
posted by Sublimity at 12:48 PM on July 21, 2016


I don't think anyone in this thread is saying that women just should have known?
posted by a strong female character at 1:18 PM on July 21, 2016 [2 favorites]


I think I hear Sublimity. Two false beliefs – you can know "what you are getting into" and then make decisions based on this knowledge and on the other hand, birth is a magical thing and women's bodies are "made to do it!" so therefore, carry on. If we can circle back around and make sure that women have access to good prenatal care and good aftercare, and that women are part of ongoing medical research studies then maybe there is somewhere in the middle where it all makes sense. But there is a certain level of, people get a different hand dealt and you have to find a way through and that's sort of life. However, it's clear that in many cases not even the bare minimum is being done. That's a travesty.

I just got through Padma Lakshmi's memoir and her stuff about endometriosis is so harrowing. A "textbook" case of the medical community failing women and allowing severe pain and abnormal menstruation to get swept away as typical "women's issues" with nothing to be done. She had been to see numerous gynecologists and professionals over the years before getting a diagnosis in her late 30s. In a few cases, it appears that doctors had "seen" the issue but neglected to tell her about it. I mean, WTAF? This shit will not stand on Crone Island!
posted by amanda at 2:25 PM on July 21, 2016 [3 favorites]


I mean, I know enough about pregnancy and childbirth that it's one of the main reasons I've decided to not get pregnant ever. That's a choice I made based on what I've learned. Other women decide to go ahead with it no matter the risks, which is totally fine (and they obviously can't know for certain what will happen to them, but they CAN know what some of the common risks and outcomes are). The medical establishment absolutely can and does still fail those women.

My point is more like..... I sent the article to my mom, who has had 2 kids, and she had NO CLUE that problems like incontinence and persistent pain were so common. Those weren't problems she experienced herself or heard women talk about often. Would she still have chosen to have kids if she'd known that there was a high risk of those injuries? Who knows.
posted by a strong female character at 2:47 PM on July 21, 2016 [5 favorites]


I definitely don't think that it's something a woman 'should have known'. But there's this aura of mystery around childbirth that doesn't help - everyone should know more about how it works and what it can do to you and not have it be such a secret shameful hush hush thing or all couched in euphemism.

When I told friends I was buying a house I got practical advice, things to watch out for. If you tell someone you're planning on having a baby you get 'oh how wonderful, how exciting'. Or that patronising nonsense from older female family members who are all 'ah, you'll understand when you're a mother'.
posted by kitten magic at 5:01 PM on July 21, 2016


Would she still have chosen to have kids if she'd known that there was a high risk of those injuries? Who knows.

And there's the rub. One thing that would be great for us to know, as women, as a society, is how often these complications arise. I bet we don't have reliable statistics. And when we treat issues that may have had their source at birth but then so many years after the fact, it's hard to say definitively what the reason for the issue is. I bet it's not counted as a birth injury if you finally get necessary surgery 20 years after the fact.

We are wired to have babies. We are very lucky that there are more options to avoid pregnancy if we don't want children but wanting children and raising them is fundamental on a few levels. What we really need is more research into these issues, more follow-through from the medical community and also a just greater awareness that being female is not suffering.
posted by amanda at 5:14 PM on July 21, 2016 [4 favorites]


This is one reason why I think the rise of the online/Facebook mom's group is so important. I'm in a few different groups, but spend most of my online time in one, and there is a lot of talk about postpartum issues, what is normal, what is not normal, who to see for help, and that sort of thing. Physical issues as well as mental ones. In my group there are a variety of perspectives, and no shame about epidurals or formula use or anything like that. It demystifies and normalizes, but more importantly can point out when things aren't normal.

I'm lucky. I gave birth in a hospital with midwives, had a hospital birthing class that went over all the different pain remedies available and what would happen if I had a caesarean, and had supportive and helpful nurses. I gave birth without medication like I wanted both times, and didn't tear. (Well, I wanted to use nitrous the second time but he came too fast!)

But I still pee when I sneeze. My first baby made my pelvis wonky and I had to get physical therapy to tip it back the right way. My second came so fast and was facing the wrong way so his head bruised the inside of my pelvis as he rocketed out of me and I couldn't get out of bed without help for a day and a half. 14 months later I get tired when I stand too long because my abs are still separated. Still I think I'm lucky.
posted by apricot at 6:51 PM on July 21, 2016 [3 favorites]


Oh hey, I had the same scar tissue as Krysten in this article! Granulation tissue. My midwives were generally great but I had to go back like four times before they took me seriously about it, because I hardly teared and only had one stitch and it was the sort of thing they said usually went away on its own but just didn't. It was a dangly little visible piece of pink skin right over my vaginal opening. Urine would drip over it every single time I peed, which was good fun. Sex was impossible. I had it cut out at a doctor's office and then burned with silver nitrate at 7 months postpartum but sex remained scary for awhile after. I think I still have a bit of scar tissue in back, but it only bothers me during sex in certain positions, so we avoid those.

(My midwives also told me that having lots of sex would help break up any remaining scar stuff but I don't know if that's true and anyway having your partner rub up against bright pink raw sensitive scar tissue is sort of fundamentally unsexy.)

The out-patient removal was more painful and traumatic than the birth was, honestly, and I pushed for a really long time. Good birth, but that part was crappy. The lingering hemorrhoids have been pretty crappy, too.
posted by PhoBWanKenobi at 10:12 PM on July 21, 2016


« Older »Mr. Klein wants to keep control over bad stories...   |   Was Diane Arbus the Most Radical Photographer of... Newer »


This thread has been archived and is closed to new comments