Prolapse, muscle tears and trauma: Why women need better support post birth

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Former Sydney Swifts netballer, Kimmy Smith, recalls losing her identity when she suffered birth related trauma. A new campaign wants to see women given subsidized access to treat these types of injuries.

“At two weeks postpartum I felt like my insides were falling out and I was really upset and I went back to the hospital where I had her and they said everything looks normal.”

It was 2012 when former Sydney Swifts professional netballer, Kimmy Smith, had her first daughter via a vaginal delivery.

At six weeks postpartum, her general practitioner diagnosed her with prolapse – a condition she knew nothing about.

Prolapse occurs when the ligaments that hold the pelvic organs - bladder, uterus, cervix, vagina, and rectum - in place are stretched or weakened. Without the support, the uterus can drop forward all the way into the vaginal passage.

Smith, who had her own fitness business, says the condition had a huge effect on her mental health.

“It really affected my self-worth to be honest, it completely destroyed any form of identity that I had then.”

“I was an elite athlete and quite a high achiever and that was so intrinsic to how I viewed myself so to have that taken away from me it really affected my mental health and my confidence in my body, it stripped a lot of that away.”

Kimmy Smith
Kimmy Smith says guidance and information about prolapse was lacking when she was diagnosed.
Supplied

She admits she probably returned to exercise too soon after the birth of her first child, but says information and guidance about how to help heal her body was lacking.

It was her third pregnancy that Smith says “really shook me to my core” and made her realize she needed serious help.

“When I was pregnant with my third baby, my daughter’s school is 500 meters from our home and I would wet my pants the whole way there and back, just the pressure of the pregnancy on my body,” she explains.

“Even just pushing the pram and feeling like every step that my insides are bulging down, it’s just really demoralizing …. it just takes all your power away from you, you feel like you can’t trust in your own body anymore.”

Smith was fortunately referred to a women’s physio who has helped her manage her condition. But her symptoms are something she says are constantly in the back of her mind.

“…..things that should be a fun, relaxing experience just have an added layer to them now.”

Birth related trauma

Smith isn’t alone. Research suggests that each year around 10 to 20 per cent of first-time mothers suffer major irreversible physical birth trauma in the form of pelvic floor muscle and/or anal sphincter tears.

It’s for this reason that mum-of-two, Amy Dawes, founded the Australasian Birth Trauma Association – a not-for-profit trying to reduce birth-related trauma as well as support affected women, families and health professionals.

Amy
Amy Dawes believes making women aware of all the risks and options before labor will empower them to make the right decision.
Supplied

When Dawes suffered damage during the birth of her first daughter, she says information was scarce and she felt alone.

“I ended up having a forceps delivery, at the time I was diagnosed with a third degree tear … but when I was 16 months postpartum I actually ended up prolapsing.”

“At the time I just felt completely broken and when I was diagnosed I suddenly needed to use a pessary to hold my organs inside my body, I thought I must be the only one because I’d never heard of it.

“I absolutely fell apart, I needed to see a psychiatrist because I had this constant fear of things getting worse.”

Over the years, both Smith and Dawes have spent thousands of dollars trying to heal their bodies, and minds. But this is a luxury many women can’t afford, and why Dawes wants to see women given Medicare-subsidised access to a women’s physio and specialist.

The Australasian Birth Trauma Association has launched a change.org petition which they hope will get 100,000 signatures. They then want to put forward their requests to Health Minister Greg Hunt. Some of these requests include;

  • To provide Medicare-subsidised access to quality physiotherapy assessment and management via GPs to specialists, for women during pregnancy and up to one year postpartum.
  • To provide Medicare-subsidised access via GPs to pelvic physiotherapy for up to one year postpartum, in particular for women who are most at risk of future health problems such as urinary and faecal incontinence and/or pelvic organ prolapse.
  • To provide women with access in hospitals to imaging services capable of diagnosing physical birth trauma, that is, anal sphincter tears (third or fourth degree tears) and pelvic floor muscle tears (‘avulsion’), with a referral pathway to tertiary urogynaecological and/or colorectal services.
  • To implement systems and processes that facilitate collaboration between a woman’s healthcare providers (mental health clinician, obstetrician, midwife, physiotherapist, GP etc) during the perinatal period.

Both Smith and Dawes feel strongly that women can have better outcomes post birth if they are given access to the right people at the right time.

“These injuries, they don’t just impact you, they impact how you are as a mother, how are as a partner, relationships break down ….” Dawes explains.

“There’s so many facets to it that if we can better support women going into birth, and also afterwards, we’re not just going to protect that individual, we’re going to have a much broader reach within the community as well.”

Have you experienced birth related trauma? Insight would like to hear your story. Please contact rebecca.baillie@sbs.com.au - all conversations confidential

Source SBS Insight

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