We shouldn’t have to live with 'broken vaginas'

For such a sweet and gentle boy, my second son, Frank, came into this world with remarkable violence. He was wrenched out of me via forceps—essentially an enormous pair of stainless steel tongs. To this day, I can’t mix my salad with anything but a wooden spoon.

Forceps are not an unusual birth intervention, but in my particular case, they proved to be an unfortunately traumatic one. Frank was knocked cold and emerged unconscious, barely breathing, with an Apgar score of two. For 45 minutes, the doctors resuscitated him, placing a tiny gas mask over his heavily bruised little face.

“You should see the other guy,” the midwife in the neonatal intensive care unit joked after taking me in a wheelchair to meet him for the first time, a full 24 hours after his birth. “You have,” I said grimly. “The other guy is me.”

The idea that Frank’s birth “broke my vagina” became a bit of a joke around my house until I began to realize that it was probably true. “It’s like a truck drove through your pelvic floor,” I recall the OB/GYN saying to me, rather regretfully, as I lay in my hospital bed receiving a blood transfusion in the days after the birth. What nobody told me in explicit terms until much later on was that I’d been seriously injured in the birth process, and the road to recovery would be a long and circuitous one.

Several months later, after I’d finished breastfeeding and emerged from the postnatal fog, I still didn’t feel quite right. I like to run, but even a short jog around the block made me feel desperate for the bathroom. There was a dragging sensation and a strange pressure in my nether regions. “It feels as if my bottom has been turned inside out,” I kept telling my husband, who looked understandably alarmed and packed me off to visit my GP. When I did, she examined me, told me that my stitches had healed and pronounced me fit. When I protested that I was sure something was off, she explained—as if I didn’t already know this—that I’d had two babies. “You’re a mother now,” she said. “You can’t expect to feel the same as you did before.”

Those words echoed in my mind for months as I embarked on what would prove to be a year-long journey toward recovery from birth injury. Like many aspects of maternal health, birth injury and trauma—both of body and mind—are woefully underdiagnosed. In 2015, the British Journal of Obstetrics and Gynaecology found that 24 percent of women still experience pain during sex 18 months after giving birth. The same year, researchers from the University of Michigan conducted magnetic resonance imaging on 68 women seven weeks after they had delivered babies. Of the admittedly small sample, they found that 29 percent had fractures in their pubic bones—which all of them were unaware of—and 41 percent had tearing and severe damage to their pelvic floor muscles that had remained undiagnosed. Another recent US study, published in the journal PLOS One, found that 77 percent of mothers still suffered from back pain and 49 percent experienced urinary incontinence a year after having their babies. An astonishing number of women live markedly diminished physical lives as a result of trauma from childbirth, and far fewer of us take it as seriously as we should.

Eventually, after many appointments with different doctors, midwives and gynaecological physiotherapists, I was diagnosed with a condition called cystocele (prolapse of the bladder). Crudely put, my vaginal walls had been so damaged by Frank’s birth that my bladder was now pushing through them. A gynaecological consultant put me on the waiting list for surgery to repair the damage. Almost two years after Frank’s birthday, I was admitted to hospital and had an operation affectionately known as the “hitch and stitch.” That was six weeks ago and, while the recovery has been slow, I’ve been pleased with the results.

Despite what my doctor said, I can feel the same after becoming a mother—and I do. It just required that my condition be recognized and treated.

Britain’s National Health Service estimates that one in 10 women who have had children will eventually require surgery for vaginal prolapse, but most will live with the condition far longer than I did. In many cases, birth injuries are misdiagnosed or dismissed altogether, as mine initially was. Many women choose to live with the discomfort because they are embarrassed or ashamed to seek treatment. But many treatments options are available, and they can make a huge difference in your quality of life.

There is a collective gallows humour that gets many women through the darker aspects of new motherhood. We often joke about stress incontinence (urinating when laughing, sneezing or coughing) as if it’s an inevitable fact of postpartum life. Similarly, the inability to exercise vigorously, experience sex without pain and use tampons after birth are often laughed off as natural, unchangeable consequences of reproduction. While it can feel great to bond with other women over the brutality of birth, we shouldn’t act as though these injuries are just our burden to bear.

Almost all birth-related injuries are treatable and should be taken seriously. If you tore your knee skiing, you’d get the surgery, right? Why not extend the same courtesy to your vagina?

This article was originally published online in May 2018.