Bad advice / things you wish you’d known

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I wish people were more honest about pelvic floor damage from birth. I don’t remember them mentioning it in any pre-birth classes.

This is mostly due to the way women give birth (on their back with legs pushed back) and purple pushing. There is also no pelvic PT prior to birth that would alleviate some of the tightness and teach women how to properly engage the TVA to assist with childbirth. Pushing a poo out is not the same and to be frank, pushing a poo out is one of the worst things for your PF when pooping so when an 8lb baby is coming down vs a 1lb shit, the damage is greater than 8x the poo.

PF damage can happen from c-sections too because it can start just by being pregnant. A c-section does not absolve PF damage. We need better healthcare for WOMEN pre, post, and during childbirth.

I am distressed that women continue to think that vaginal vs section is the equalizer. Nope.

You are wrong.

spontaneous vaginal delivery is significantly associated with stress incontinence and prolapse, and the most dramatic risk is associated with operative vaginal birth.

A scheduled (not emergency!) c section can be protective. No woman with a scheduled C section who did not go into labor will have levator ani avulsion.

NP and no - it’s really only the use of forceps/vacuum during vaginal deliveries that increase risk of pelvic floor issues. Can scheduled C-sections reduce the risk of them, sure, but they’re not without their own risks. Ideally, more awareness of how to push during vaginal deliveries would be helpful, e.g., on the side, on all fours (which can be done with an epidural).

This is a great thread, OP. My kids are older now - 11, 9, and 7, but there are still things I wish I’d known:

-Many, many women *hang onto* weight while they breastfeed and lose when the wean
-It’s okay to supplement (truly! It’s okay!)
-Having low supply doesn’t mean there’s something wrong with you or that you’re doing something wrong. It doesn’t mean you need to go to great lengths to get your supply up. Bodies are different and that’s okay
-Stress urinary incontinence is common, but not “normal” or healthy. *talk to someone* if you have it - there are ways to help

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I wish people were more honest about pelvic floor damage from birth. I don’t remember them mentioning it in any pre-birth classes.

This is mostly due to the way women give birth (on their back with legs pushed back) and purple pushing. There is also no pelvic PT prior to birth that would alleviate some of the tightness and teach women how to properly engage the TVA to assist with childbirth. Pushing a poo out is not the same and to be frank, pushing a poo out is one of the worst things for your PF when pooping so when an 8lb baby is coming down vs a 1lb shit, the damage is greater than 8x the poo.

PF damage can happen from c-sections too because it can start just by being pregnant. A c-section does not absolve PF damage. We need better healthcare for WOMEN pre, post, and during childbirth.

I am distressed that women continue to think that vaginal vs section is the equalizer. Nope.

You are wrong.

spontaneous vaginal delivery is significantly associated with stress incontinence and prolapse, and the most dramatic risk is associated with operative vaginal birth.

A scheduled (not emergency!) c section can be protective. No woman with a scheduled C section who did not go into labor will have levator ani avulsion.

NP and no - it’s really only the use of forceps/vacuum during vaginal deliveries that increase risk of pelvic floor issues. Can scheduled C-sections reduce the risk of them, sure, but they’re not without their own risks. Ideally, more awareness of how to push during vaginal deliveries would be helpful, e.g., on the side, on all fours (which can be done with an epidural).

This is a great thread, OP. My kids are older now - 11, 9, and 7, but there are still things I wish I’d known:

-Many, many women *hang onto* weight while they breastfeed and lose when the wean
-It’s okay to supplement (truly! It’s okay!)
-Having low supply doesn’t mean there’s something wrong with you or that you’re doing something wrong. It doesn’t mean you need to go to great lengths to get your supply up. Bodies are different and that’s okay
-Stress urinary incontinence is common, but not “normal” or healthy. *talk to someone* if you have it - there are ways to help

This is a good reply generally, PP, but the bolded is not exactly true. I had hypertonic pelvic floor (overly clenched muscles) because of pushing for a long time and basically being "stuck" while in the pushing phase. I pushed on all fours and in various positions as well, and that's a valid point, but vaginal deliveries present a lot of different pelvic floor risks in addition to forceps/vacuum which are the big ones.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I wish people were more honest about pelvic floor damage from birth. I don’t remember them mentioning it in any pre-birth classes.

This is mostly due to the way women give birth (on their back with legs pushed back) and purple pushing. There is also no pelvic PT prior to birth that would alleviate some of the tightness and teach women how to properly engage the TVA to assist with childbirth. Pushing a poo out is not the same and to be frank, pushing a poo out is one of the worst things for your PF when pooping so when an 8lb baby is coming down vs a 1lb shit, the damage is greater than 8x the poo.

PF damage can happen from c-sections too because it can start just by being pregnant. A c-section does not absolve PF damage. We need better healthcare for WOMEN pre, post, and during childbirth.

I am distressed that women continue to think that vaginal vs section is the equalizer. Nope.

You are wrong.

spontaneous vaginal delivery is significantly associated with stress incontinence and prolapse, and the most dramatic risk is associated with operative vaginal birth.

A scheduled (not emergency!) c section can be protective. No woman with a scheduled C section who did not go into labor will have levator ani avulsion.

NP and no - it’s really only the use of forceps/vacuum during vaginal deliveries that increase risk of pelvic floor issues. Can scheduled C-sections reduce the risk of them, sure, but they’re not without their own risks. Ideally, more awareness of how to push during vaginal deliveries would be helpful, e.g., on the side, on all fours (which can be done with an epidural).

This is a great thread, OP. My kids are older now - 11, 9, and 7, but there are still things I wish I’d known:

-Many, many women *hang onto* weight while they breastfeed and lose when the wean
-It’s okay to supplement (truly! It’s okay!)
-Having low supply doesn’t mean there’s something wrong with you or that you’re doing something wrong. It doesn’t mean you need to go to great lengths to get your supply up. Bodies are different and that’s okay
-Stress urinary incontinence is common, but not “normal” or healthy. *talk to someone* if you have it - there are ways to help

This is a good reply generally, PP, but the bolded is not exactly true. I had hypertonic pelvic floor (overly clenched muscles) because of pushing for a long time and basically being "stuck" while in the pushing phase. I pushed on all fours and in various positions as well, and that's a valid point, but vaginal deliveries present a lot of different pelvic floor risks in addition to forceps/vacuum which are the big ones.

Agreed. I did not need forceps or vacuum but have had incontinence just from the pushing. My sister had a major tear from pushing.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I wish people were more honest about pelvic floor damage from birth. I don’t remember them mentioning it in any pre-birth classes.

This is mostly due to the way women give birth (on their back with legs pushed back) and purple pushing. There is also no pelvic PT prior to birth that would alleviate some of the tightness and teach women how to properly engage the TVA to assist with childbirth. Pushing a poo out is not the same and to be frank, pushing a poo out is one of the worst things for your PF when pooping so when an 8lb baby is coming down vs a 1lb shit, the damage is greater than 8x the poo.

PF damage can happen from c-sections too because it can start just by being pregnant. A c-section does not absolve PF damage. We need better healthcare for WOMEN pre, post, and during childbirth.

I am distressed that women continue to think that vaginal vs section is the equalizer. Nope.

You are wrong.

spontaneous vaginal delivery is significantly associated with stress incontinence and prolapse, and the most dramatic risk is associated with operative vaginal birth.

A scheduled (not emergency!) c section can be protective. No woman with a scheduled C section who did not go into labor will have levator ani avulsion.

NP and no - it’s really only the use of forceps/vacuum during vaginal deliveries that increase risk of pelvic floor issues. Can scheduled C-sections reduce the risk of them, sure, but they’re not without their own risks. Ideally, more awareness of how to push during vaginal deliveries would be helpful, e.g., on the side, on all fours (which can be done with an epidural).

This is a great thread, OP. My kids are older now - 11, 9, and 7, but there are still things I wish I’d known:

-Many, many women *hang onto* weight while they breastfeed and lose when the wean
-It’s okay to supplement (truly! It’s okay!)
-Having low supply doesn’t mean there’s something wrong with you or that you’re doing something wrong. It doesn’t mean you need to go to great lengths to get your supply up. Bodies are different and that’s okay
-Stress urinary incontinence is common, but not “normal” or healthy. *talk to someone* if you have it - there are ways to help

This is a good reply generally, PP, but the bolded is not exactly true. I had hypertonic pelvic floor (overly clenched muscles) because of pushing for a long time and basically being "stuck" while in the pushing phase. I pushed on all fours and in various positions as well, and that's a valid point, but vaginal deliveries present a lot of different pelvic floor risks in addition to forceps/vacuum which are the big ones.

Agreed. I did not need forceps or vacuum but have had incontinence just from the pushing. My sister had a major tear from pushing.

I’m the PP you’re both referring to - I’m sorry about the damage from pushing you both experienced. I didn’t mean to minimize that risk, because it is there, certainly, even without instrumental assistance.

More, I think it’s important to consider the *trade-off* of risk, because those exist with C-sections. I know people who had severe infections after Cesarean. Who needed revision surgery because the healing led to secondary infertility. Who experience permanent nerve damage as a result. I think the ultimate take-away is that birth is inherently risky and pregnancy and delivery carry risks to the mother, which aren’t discussed enough. I’d never presume to tell an individual woman how to account for those risks because I’m not her.

Broadly, though, the “have a C-section, save your vagina” isn’t helpful, for multiple reasons.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I wish people were more honest about pelvic floor damage from birth. I don’t remember them mentioning it in any pre-birth classes.

This is mostly due to the way women give birth (on their back with legs pushed back) and purple pushing. There is also no pelvic PT prior to birth that would alleviate some of the tightness and teach women how to properly engage the TVA to assist with childbirth. Pushing a poo out is not the same and to be frank, pushing a poo out is one of the worst things for your PF when pooping so when an 8lb baby is coming down vs a 1lb shit, the damage is greater than 8x the poo.

PF damage can happen from c-sections too because it can start just by being pregnant. A c-section does not absolve PF damage. We need better healthcare for WOMEN pre, post, and during childbirth.

I am distressed that women continue to think that vaginal vs section is the equalizer. Nope.

You are wrong.

spontaneous vaginal delivery is significantly associated with stress incontinence and prolapse, and the most dramatic risk is associated with operative vaginal birth.

A scheduled (not emergency!) c section can be protective. No woman with a scheduled C section who did not go into labor will have levator ani avulsion.

NP and no - it’s really only the use of forceps/vacuum during vaginal deliveries that increase risk of pelvic floor issues. Can scheduled C-sections reduce the risk of them, sure, but they’re not without their own risks. Ideally, more awareness of how to push during vaginal deliveries would be helpful, e.g., on the side, on all fours (which can be done with an epidural).

This is a great thread, OP. My kids are older now - 11, 9, and 7, but there are still things I wish I’d known:

-Many, many women *hang onto* weight while they breastfeed and lose when the wean
-It’s okay to supplement (truly! It’s okay!)
-Having low supply doesn’t mean there’s something wrong with you or that you’re doing something wrong. It doesn’t mean you need to go to great lengths to get your supply up. Bodies are different and that’s okay
-Stress urinary incontinence is common, but not “normal” or healthy. *talk to someone* if you have it - there are ways to help

This is a good reply generally, PP, but the bolded is not exactly true. I had hypertonic pelvic floor (overly clenched muscles) because of pushing for a long time and basically being "stuck" while in the pushing phase. I pushed on all fours and in various positions as well, and that's a valid point, but vaginal deliveries present a lot of different pelvic floor risks in addition to forceps/vacuum which are the big ones.

Agreed. I did not need forceps or vacuum but have had incontinence just from the pushing. My sister had a major tear from pushing.

I’m the PP you’re both referring to - I’m sorry about the damage from pushing you both experienced. I didn’t mean to minimize that risk, because it is there, certainly, even without instrumental assistance.

More, I think it’s important to consider the *trade-off* of risk, because those exist with C-sections. I know people who had severe infections after Cesarean. Who needed revision surgery because the healing led to secondary infertility. Who experience permanent nerve damage as a result. I think the ultimate take-away is that birth is inherently risky and pregnancy and delivery carry risks to the mother, which aren’t discussed enough. I’d never presume to tell an individual woman how to account for those risks because I’m not her.

Broadly, though, the “have a C-section, save your vagina” isn’t helpful, for multiple reasons.

NP. Agree. WHO statistic is that c section rated above 10% are not associated with an improvement in maternal or fetal health. I’m not advocating for vaginal or c or c over vaginal, but both have risks and it’s not really possible to know what delivery will be like because there are so many factors playing in - maternal health, fetal health, baby size and position, pelvic size etc…

Anecdotally I have a smooth c section but I horrible recovery involving a splitting incision and severe constipation that resulted in muscle tears. I ended up developing ptsd from my c section post partum recovery. Obviously this is not representative of c sections as a whole but I had a horrible experience. No guarantee that vaginal would have been any better. Could have also been a horrible recovery or even worse.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I wish people were more honest about pelvic floor damage from birth. I don’t remember them mentioning it in any pre-birth classes.

This is mostly due to the way women give birth (on their back with legs pushed back) and purple pushing. There is also no pelvic PT prior to birth that would alleviate some of the tightness and teach women how to properly engage the TVA to assist with childbirth. Pushing a poo out is not the same and to be frank, pushing a poo out is one of the worst things for your PF when pooping so when an 8lb baby is coming down vs a 1lb shit, the damage is greater than 8x the poo.

PF damage can happen from c-sections too because it can start just by being pregnant. A c-section does not absolve PF damage. We need better healthcare for WOMEN pre, post, and during childbirth.

I am distressed that women continue to think that vaginal vs section is the equalizer. Nope.

You are wrong.

spontaneous vaginal delivery is significantly associated with stress incontinence and prolapse, and the most dramatic risk is associated with operative vaginal birth.

A scheduled (not emergency!) c section can be protective. No woman with a scheduled C section who did not go into labor will have levator ani avulsion.

NP and no - it’s really only the use of forceps/vacuum during vaginal deliveries that increase risk of pelvic floor issues. Can scheduled C-sections reduce the risk of them, sure, but they’re not without their own risks. Ideally, more awareness of how to push during vaginal deliveries would be helpful, e.g., on the side, on all fours (which can be done with an epidural).

This is a great thread, OP. My kids are older now - 11, 9, and 7, but there are still things I wish I’d known:

-Many, many women *hang onto* weight while they breastfeed and lose when the wean
-It’s okay to supplement (truly! It’s okay!)
-Having low supply doesn’t mean there’s something wrong with you or that you’re doing something wrong. It doesn’t mean you need to go to great lengths to get your supply up. Bodies are different and that’s okay
-Stress urinary incontinence is common, but not “normal” or healthy. *talk to someone* if you have it - there are ways to help

Omg stop, this is completely untrue. Dr. Handa at JHU did a whole story on this. The Vaginal birth is strongly associated with stress urinary incontinence and prolapse and operative deliver worsens the risk.

“Compared with cesarean birth without labor, undergoing vaginal birth increased the risk of stress incontinence and prolapse in women who were examined 5–10 years after childbirth, Dr. Victoria L. Handa reported.

The risk of all pelvic disorders, including prolapse, was elevated even further in women who had undergone operative vaginal delivery, she said.“

Don’t act like an authority on something if you are going to spread false information.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681820/

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I wish people were more honest about pelvic floor damage from birth. I don’t remember them mentioning it in any pre-birth classes.

This is mostly due to the way women give birth (on their back with legs pushed back) and purple pushing. There is also no pelvic PT prior to birth that would alleviate some of the tightness and teach women how to properly engage the TVA to assist with childbirth. Pushing a poo out is not the same and to be frank, pushing a poo out is one of the worst things for your PF when pooping so when an 8lb baby is coming down vs a 1lb shit, the damage is greater than 8x the poo.

PF damage can happen from c-sections too because it can start just by being pregnant. A c-section does not absolve PF damage. We need better healthcare for WOMEN pre, post, and during childbirth.

I am distressed that women continue to think that vaginal vs section is the equalizer. Nope.

You are wrong.

spontaneous vaginal delivery is significantly associated with stress incontinence and prolapse, and the most dramatic risk is associated with operative vaginal birth.

A scheduled (not emergency!) c section can be protective. No woman with a scheduled C section who did not go into labor will have levator ani avulsion.

NP and no - it’s really only the use of forceps/vacuum during vaginal deliveries that increase risk of pelvic floor issues. Can scheduled C-sections reduce the risk of them, sure, but they’re not without their own risks. Ideally, more awareness of how to push during vaginal deliveries would be helpful, e.g., on the side, on all fours (which can be done with an epidural).

This is a great thread, OP. My kids are older now - 11, 9, and 7, but there are still things I wish I’d known:

-Many, many women *hang onto* weight while they breastfeed and lose when the wean
-It’s okay to supplement (truly! It’s okay!)
-Having low supply doesn’t mean there’s something wrong with you or that you’re doing something wrong. It doesn’t mean you need to go to great lengths to get your supply up. Bodies are different and that’s okay
-Stress urinary incontinence is common, but not “normal” or healthy. *talk to someone* if you have it - there are ways to help

This is a good reply generally, PP, but the bolded is not exactly true. I had hypertonic pelvic floor (overly clenched muscles) because of pushing for a long time and basically being "stuck" while in the pushing phase. I pushed on all fours and in various positions as well, and that's a valid point, but vaginal deliveries present a lot of different pelvic floor risks in addition to forceps/vacuum which are the big ones.

Agreed. I did not need forceps or vacuum but have had incontinence just from the pushing. My sister had a major tear from pushing.

I’m the PP you’re both referring to - I’m sorry about the damage from pushing you both experienced. I didn’t mean to minimize that risk, because it is there, certainly, even without instrumental assistance.

More, I think it’s important to consider the *trade-off* of risk, because those exist with C-sections. I know people who had severe infections after Cesarean. Who needed revision surgery because the healing led to secondary infertility. Who experience permanent nerve damage as a result. I think the ultimate take-away is that birth is inherently risky and pregnancy and delivery carry risks to the mother, which aren’t discussed enough. I’d never presume to tell an individual woman how to account for those risks because I’m not her.

Broadly, though, the “have a C-section, save your vagina” isn’t helpful, for multiple reasons.

NP. Agree. WHO statistic is that c section rated above 10% are not associated with an improvement in maternal or fetal health. I’m not advocating for vaginal or c or c over vaginal, but both have risks and it’s not really possible to know what delivery will be like because there are so many factors playing in - maternal health, fetal health, baby size and position, pelvic size etc…

Anecdotally I have a smooth c section but I horrible recovery involving a splitting incision and severe constipation that resulted in muscle tears. I ended up developing ptsd from my c section post partum recovery. Obviously this is not representative of c sections as a whole but I had a horrible experience. No guarantee that vaginal would have been any better. Could have also been a horrible recovery or even worse.

Nerve damage can happen regardless of the delivery mode. My vaginal birth resulted in nerve damage in my pelvic floor that caused anal incontinence for over a year! I could hardly leave the house and wore diapers for over a year.

And please, for the love of god, do not cite the WHO. That stat is wrong, and it’s outdated, and it has been debunked thoroughly. You also got it wrong - they initially set a target of 15 percent back in the 80s and then further evidence have shown outcomes at that rate are horrible!

There was a huge JAMA study done by Gawande and others that showed that a minimum of 19 percent C section rate is necessary and target rates could even be higher!

“Conclusions and relevance: National cesarean delivery rates of up to approximately 19 per 100 live births were associated with lower maternal or neonatal mortality among WHO member states. Previously recommended national target rates for cesarean deliveries may be too low.”

https://pubmed.ncbi.nlm.nih.gov/26624825/

https://pubmed.ncbi.nlm.nih.gov/28253469/

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I wish people were more honest about pelvic floor damage from birth. I don’t remember them mentioning it in any pre-birth classes.

This is mostly due to the way women give birth (on their back with legs pushed back) and purple pushing. There is also no pelvic PT prior to birth that would alleviate some of the tightness and teach women how to properly engage the TVA to assist with childbirth. Pushing a poo out is not the same and to be frank, pushing a poo out is one of the worst things for your PF when pooping so when an 8lb baby is coming down vs a 1lb shit, the damage is greater than 8x the poo.

PF damage can happen from c-sections too because it can start just by being pregnant. A c-section does not absolve PF damage. We need better healthcare for WOMEN pre, post, and during childbirth.

I am distressed that women continue to think that vaginal vs section is the equalizer. Nope.

You are wrong.

spontaneous vaginal delivery is significantly associated with stress incontinence and prolapse, and the most dramatic risk is associated with operative vaginal birth.

A scheduled (not emergency!) c section can be protective. No woman with a scheduled C section who did not go into labor will have levator ani avulsion.

NP and no - it’s really only the use of forceps/vacuum during vaginal deliveries that increase risk of pelvic floor issues. Can scheduled C-sections reduce the risk of them, sure, but they’re not without their own risks. Ideally, more awareness of how to push during vaginal deliveries would be helpful, e.g., on the side, on all fours (which can be done with an epidural).

This is a great thread, OP. My kids are older now - 11, 9, and 7, but there are still things I wish I’d known:

-Many, many women *hang onto* weight while they breastfeed and lose when the wean
-It’s okay to supplement (truly! It’s okay!)
-Having low supply doesn’t mean there’s something wrong with you or that you’re doing something wrong. It doesn’t mean you need to go to great lengths to get your supply up. Bodies are different and that’s okay
-Stress urinary incontinence is common, but not “normal” or healthy. *talk to someone* if you have it - there are ways to help

It is a myth that pushing the correct way can prevent pelvic floor trauma. It is nice to believe that we can control this, but the reality is that the tone of your muscles, how stretchy they are, what your collagen type is, your bone structure, genetics, baby size, etc. all play a role in this. There’s just so little we can control. But midwives LOVE to tell us that if we push the correct way that somehow bad things won’t happen to our bodies and it’s just a lie. My good friend had a water birth with midwives, pushed on her side in the correct way, and ended up with all 3 prolapses and levator avulsion.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I wish people were more honest about pelvic floor damage from birth. I don’t remember them mentioning it in any pre-birth classes.

This is mostly due to the way women give birth (on their back with legs pushed back) and purple pushing. There is also no pelvic PT prior to birth that would alleviate some of the tightness and teach women how to properly engage the TVA to assist with childbirth. Pushing a poo out is not the same and to be frank, pushing a poo out is one of the worst things for your PF when pooping so when an 8lb baby is coming down vs a 1lb shit, the damage is greater than 8x the poo.

PF damage can happen from c-sections too because it can start just by being pregnant. A c-section does not absolve PF damage. We need better healthcare for WOMEN pre, post, and during childbirth.

I am distressed that women continue to think that vaginal vs section is the equalizer. Nope.

You are wrong.

spontaneous vaginal delivery is significantly associated with stress incontinence and prolapse, and the most dramatic risk is associated with operative vaginal birth.

A scheduled (not emergency!) c section can be protective. No woman with a scheduled C section who did not go into labor will have levator ani avulsion.

NP and no - it’s really only the use of forceps/vacuum during vaginal deliveries that increase risk of pelvic floor issues. Can scheduled C-sections reduce the risk of them, sure, but they’re not without their own risks. Ideally, more awareness of how to push during vaginal deliveries would be helpful, e.g., on the side, on all fours (which can be done with an epidural).

This is a great thread, OP. My kids are older now - 11, 9, and 7, but there are still things I wish I’d known:

-Many, many women *hang onto* weight while they breastfeed and lose when the wean
-It’s okay to supplement (truly! It’s okay!)
-Having low supply doesn’t mean there’s something wrong with you or that you’re doing something wrong. It doesn’t mean you need to go to great lengths to get your supply up. Bodies are different and that’s okay
-Stress urinary incontinence is common, but not “normal” or healthy. *talk to someone* if you have it - there are ways to help

It is a myth that pushing the correct way can prevent pelvic floor trauma. It is nice to believe that we can control this, but the reality is that the tone of your muscles, how stretchy they are, what your collagen type is, your bone structure, genetics, baby size, etc. all play a role in this. There’s just so little we can control. But midwives LOVE to tell us that if we push the correct way that somehow bad things won’t happen to our bodies and it’s just a lie. My good friend had a water birth with midwives, pushed on her side in the correct way, and ended up with all 3 prolapses and levator avulsion.

I didn’t say prevent anywhere in my post. I said, “helpful,” and I stand by that, using helpful to mean “reduce risk for.” Hell, surgeons (which is what OBs are) LOVE to tell us that C-sections are the best thing for women and if we all had them, nothing bad would happen to our bodies and that’s also a lie.

That’s all this comes down to, really: being clear that EVERY method of delivery carries risks, considering YOUR specific situation, talking to trusted providers, and deciding the best option for YOU. That’s what I wish I’d known.

[Anonymous]

Anonymous wrote:I wish I hadn’t continued to breastfeed despite it definitely not being the right choice for me. My breasts hurt, I was constantly touched out, I felt resentful, and I hated it. I made myself bf for a year with my first and was miserable. I was much happier weaning with my second at 6 months and will do the same with my third (due in March!).

There’s not nearly enough support or information on the absolute necessity on resting hard for at least a full month after birth. I take all the time I need and set strong boundaries about not having visitors for the first six weeks. I will not be pressured and I do not care if anyone judges me for it.

You don’t need a good 75% of baby crap that is marketed. You just don’t.

What baby crap don’t you need, and what is actually necessary?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I wish people were more honest about pelvic floor damage from birth. I don’t remember them mentioning it in any pre-birth classes.

This is mostly due to the way women give birth (on their back with legs pushed back) and purple pushing. There is also no pelvic PT prior to birth that would alleviate some of the tightness and teach women how to properly engage the TVA to assist with childbirth. Pushing a poo out is not the same and to be frank, pushing a poo out is one of the worst things for your PF when pooping so when an 8lb baby is coming down vs a 1lb shit, the damage is greater than 8x the poo.

PF damage can happen from c-sections too because it can start just by being pregnant. A c-section does not absolve PF damage. We need better healthcare for WOMEN pre, post, and during childbirth.

I am distressed that women continue to think that vaginal vs section is the equalizer. Nope.

You are wrong.

spontaneous vaginal delivery is significantly associated with stress incontinence and prolapse, and the most dramatic risk is associated with operative vaginal birth.

A scheduled (not emergency!) c section can be protective. No woman with a scheduled C section who did not go into labor will have levator ani avulsion.

NP and no - it’s really only the use of forceps/vacuum during vaginal deliveries that increase risk of pelvic floor issues. Can scheduled C-sections reduce the risk of them, sure, but they’re not without their own risks. Ideally, more awareness of how to push during vaginal deliveries would be helpful, e.g., on the side, on all fours (which can be done with an epidural).

This is a great thread, OP. My kids are older now - 11, 9, and 7, but there are still things I wish I’d known:

-Many, many women *hang onto* weight while they breastfeed and lose when the wean
-It’s okay to supplement (truly! It’s okay!)
-Having low supply doesn’t mean there’s something wrong with you or that you’re doing something wrong. It doesn’t mean you need to go to great lengths to get your supply up. Bodies are different and that’s okay
-Stress urinary incontinence is common, but not “normal” or healthy. *talk to someone* if you have it - there are ways to help

It is a myth that pushing the correct way can prevent pelvic floor trauma. It is nice to believe that we can control this, but the reality is that the tone of your muscles, how stretchy they are, what your collagen type is, your bone structure, genetics, baby size, etc. all play a role in this. There’s just so little we can control. But midwives LOVE to tell us that if we push the correct way that somehow bad things won’t happen to our bodies and it’s just a lie. My good friend had a water birth with midwives, pushed on her side in the correct way, and ended up with all 3 prolapses and levator avulsion.

I didn’t say prevent anywhere in my post. I said, “helpful,” and I stand by that, using helpful to mean “reduce risk for.” Hell, surgeons (which is what OBs are) LOVE to tell us that C-sections are the best thing for women and if we all had them, nothing bad would happen to our bodies and that’s also a lie.

That’s all this comes down to, really: being clear that EVERY method of delivery carries risks, considering YOUR specific situation, talking to trusted providers, and deciding the best option for YOU. That’s what I wish I’d known.

Show me any study that shows that correct pushing minimizes tearing. Waiting.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I wish people were more honest about pelvic floor damage from birth. I don’t remember them mentioning it in any pre-birth classes.

This is mostly due to the way women give birth (on their back with legs pushed back) and purple pushing. There is also no pelvic PT prior to birth that would alleviate some of the tightness and teach women how to properly engage the TVA to assist with childbirth. Pushing a poo out is not the same and to be frank, pushing a poo out is one of the worst things for your PF when pooping so when an 8lb baby is coming down vs a 1lb shit, the damage is greater than 8x the poo.

PF damage can happen from c-sections too because it can start just by being pregnant. A c-section does not absolve PF damage. We need better healthcare for WOMEN pre, post, and during childbirth.

I am distressed that women continue to think that vaginal vs section is the equalizer. Nope.

You are wrong.

spontaneous vaginal delivery is significantly associated with stress incontinence and prolapse, and the most dramatic risk is associated with operative vaginal birth.

A scheduled (not emergency!) c section can be protective. No woman with a scheduled C section who did not go into labor will have levator ani avulsion.

NP and no - it’s really only the use of forceps/vacuum during vaginal deliveries that increase risk of pelvic floor issues. Can scheduled C-sections reduce the risk of them, sure, but they’re not without their own risks. Ideally, more awareness of how to push during vaginal deliveries would be helpful, e.g., on the side, on all fours (which can be done with an epidural).

This is a great thread, OP. My kids are older now - 11, 9, and 7, but there are still things I wish I’d known:

-Many, many women *hang onto* weight while they breastfeed and lose when the wean
-It’s okay to supplement (truly! It’s okay!)
-Having low supply doesn’t mean there’s something wrong with you or that you’re doing something wrong. It doesn’t mean you need to go to great lengths to get your supply up. Bodies are different and that’s okay
-Stress urinary incontinence is common, but not “normal” or healthy. *talk to someone* if you have it - there are ways to help

It is a myth that pushing the correct way can prevent pelvic floor trauma. It is nice to believe that we can control this, but the reality is that the tone of your muscles, how stretchy they are, what your collagen type is, your bone structure, genetics, baby size, etc. all play a role in this. There’s just so little we can control. But midwives LOVE to tell us that if we push the correct way that somehow bad things won’t happen to our bodies and it’s just a lie. My good friend had a water birth with midwives, pushed on her side in the correct way, and ended up with all 3 prolapses and levator avulsion.

I didn’t say prevent anywhere in my post. I said, “helpful,” and I stand by that, using helpful to mean “reduce risk for.” Hell, surgeons (which is what OBs are) LOVE to tell us that C-sections are the best thing for women and if we all had them, nothing bad would happen to our bodies and that’s also a lie.

That’s all this comes down to, really: being clear that EVERY method of delivery carries risks, considering YOUR specific situation, talking to trusted providers, and deciding the best option for YOU. That’s what I wish I’d known.

Show me any study that shows that correct pushing minimizes tearing. Waiting.

Impact of position during pushing:
https://www.tandfonline.com/doi/full/10.1080/01443610802665090?casa_token=YKWgAB919BoAAAAA%3AsyGirGP4eqGzw6dE_XC_375h7LLB5naLIOUEPEskxS1Zw9FEdQ8Yl1Deq-O0QOlEpJu0r0PWb-Ga

Peer-reviewed research out there showing increased risk of pelvic floor damage due to instrumental delivery:
https://www.sciencedirect.com/science/article/pii/S0002937803005726?casa_token=k7sk2AoxejIAAAAA:ONy3OHpMsdriqDxoQD8qt-w6DV_JWbLEvpNALaFsVF7FjeTqusMu-etEySUdU0R47BXCJFg

https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-13-59

https://www.sciencedirect.com/science/article/pii/S0020729214000022?casa_token=AfctyWxsPbQAAAAA:OBLNFJXbpLJEmgPHOD3YTMBcMKqC1ywfIyPVuXV7JoaeD19ZZB5JOfP-5mrViodr8dC9hU4

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I wish people were more honest about pelvic floor damage from birth. I don’t remember them mentioning it in any pre-birth classes.

This is mostly due to the way women give birth (on their back with legs pushed back) and purple pushing. There is also no pelvic PT prior to birth that would alleviate some of the tightness and teach women how to properly engage the TVA to assist with childbirth. Pushing a poo out is not the same and to be frank, pushing a poo out is one of the worst things for your PF when pooping so when an 8lb baby is coming down vs a 1lb shit, the damage is greater than 8x the poo.

PF damage can happen from c-sections too because it can start just by being pregnant. A c-section does not absolve PF damage. We need better healthcare for WOMEN pre, post, and during childbirth.

I am distressed that women continue to think that vaginal vs section is the equalizer. Nope.

You are wrong.

spontaneous vaginal delivery is significantly associated with stress incontinence and prolapse, and the most dramatic risk is associated with operative vaginal birth.

A scheduled (not emergency!) c section can be protective. No woman with a scheduled C section who did not go into labor will have levator ani avulsion.

NP and no - it’s really only the use of forceps/vacuum during vaginal deliveries that increase risk of pelvic floor issues. Can scheduled C-sections reduce the risk of them, sure, but they’re not without their own risks. Ideally, more awareness of how to push during vaginal deliveries would be helpful, e.g., on the side, on all fours (which can be done with an epidural).

This is a great thread, OP. My kids are older now - 11, 9, and 7, but there are still things I wish I’d known:

-Many, many women *hang onto* weight while they breastfeed and lose when the wean
-It’s okay to supplement (truly! It’s okay!)
-Having low supply doesn’t mean there’s something wrong with you or that you’re doing something wrong. It doesn’t mean you need to go to great lengths to get your supply up. Bodies are different and that’s okay
-Stress urinary incontinence is common, but not “normal” or healthy. *talk to someone* if you have it - there are ways to help

It is a myth that pushing the correct way can prevent pelvic floor trauma. It is nice to believe that we can control this, but the reality is that the tone of your muscles, how stretchy they are, what your collagen type is, your bone structure, genetics, baby size, etc. all play a role in this. There’s just so little we can control. But midwives LOVE to tell us that if we push the correct way that somehow bad things won’t happen to our bodies and it’s just a lie. My good friend had a water birth with midwives, pushed on her side in the correct way, and ended up with all 3 prolapses and levator avulsion.

I didn’t say prevent anywhere in my post. I said, “helpful,” and I stand by that, using helpful to mean “reduce risk for.” Hell, surgeons (which is what OBs are) LOVE to tell us that C-sections are the best thing for women and if we all had them, nothing bad would happen to our bodies and that’s also a lie.

That’s all this comes down to, really: being clear that EVERY method of delivery carries risks, considering YOUR specific situation, talking to trusted providers, and deciding the best option for YOU. That’s what I wish I’d known.

Show me any study that shows that correct pushing minimizes tearing. Waiting.

Also - I consulted 4 OBs before I had a scheduled C section. Literally not one of them told me nothing bad would happen to my body. They instead discussed risks and benefits of the surgery. I don’t know what agenda you are pushing but literally the only providers I have met who were liars were the midwives who made me believe that if I did the right things (diet, exercise, Spinning Babies, have a doula and midwife, forego pain relief, don’t have an epidural) I would have an easy, natural delivery that would leave me and my baby healthy and feeling empowered. Such a crock of bull. Like kale and salmon could prevent birth injuries or a badly positioned baby.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I wish people were more honest about pelvic floor damage from birth. I don’t remember them mentioning it in any pre-birth classes.

This is mostly due to the way women give birth (on their back with legs pushed back) and purple pushing. There is also no pelvic PT prior to birth that would alleviate some of the tightness and teach women how to properly engage the TVA to assist with childbirth. Pushing a poo out is not the same and to be frank, pushing a poo out is one of the worst things for your PF when pooping so when an 8lb baby is coming down vs a 1lb shit, the damage is greater than 8x the poo.

PF damage can happen from c-sections too because it can start just by being pregnant. A c-section does not absolve PF damage. We need better healthcare for WOMEN pre, post, and during childbirth.

I am distressed that women continue to think that vaginal vs section is the equalizer. Nope.

You are wrong.

spontaneous vaginal delivery is significantly associated with stress incontinence and prolapse, and the most dramatic risk is associated with operative vaginal birth.

A scheduled (not emergency!) c section can be protective. No woman with a scheduled C section who did not go into labor will have levator ani avulsion.

NP and no - it’s really only the use of forceps/vacuum during vaginal deliveries that increase risk of pelvic floor issues. Can scheduled C-sections reduce the risk of them, sure, but they’re not without their own risks. Ideally, more awareness of how to push during vaginal deliveries would be helpful, e.g., on the side, on all fours (which can be done with an epidural).

This is a great thread, OP. My kids are older now - 11, 9, and 7, but there are still things I wish I’d known:

-Many, many women *hang onto* weight while they breastfeed and lose when the wean
-It’s okay to supplement (truly! It’s okay!)
-Having low supply doesn’t mean there’s something wrong with you or that you’re doing something wrong. It doesn’t mean you need to go to great lengths to get your supply up. Bodies are different and that’s okay
-Stress urinary incontinence is common, but not “normal” or healthy. *talk to someone* if you have it - there are ways to help

It is a myth that pushing the correct way can prevent pelvic floor trauma. It is nice to believe that we can control this, but the reality is that the tone of your muscles, how stretchy they are, what your collagen type is, your bone structure, genetics, baby size, etc. all play a role in this. There’s just so little we can control. But midwives LOVE to tell us that if we push the correct way that somehow bad things won’t happen to our bodies and it’s just a lie. My good friend had a water birth with midwives, pushed on her side in the correct way, and ended up with all 3 prolapses and levator avulsion.

I didn’t say prevent anywhere in my post. I said, “helpful,” and I stand by that, using helpful to mean “reduce risk for.” Hell, surgeons (which is what OBs are) LOVE to tell us that C-sections are the best thing for women and if we all had them, nothing bad would happen to our bodies and that’s also a lie.

That’s all this comes down to, really: being clear that EVERY method of delivery carries risks, considering YOUR specific situation, talking to trusted providers, and deciding the best option for YOU. That’s what I wish I’d known.

Show me any study that shows that correct pushing minimizes tearing. Waiting.

Impact of position during pushing:
https://www.tandfonline.com/doi/full/10.1080/01443610802665090?casa_token=YKWgAB919BoAAAAA%3AsyGirGP4eqGzw6dE_XC_375h7LLB5naLIOUEPEskxS1Zw9FEdQ8Yl1Deq-O0QOlEpJu0r0PWb-Ga

Peer-reviewed research out there showing increased risk of pelvic floor damage due to instrumental delivery:
https://www.sciencedirect.com/science/article/pii/S0002937803005726?casa_token=k7sk2AoxejIAAAAA:ONy3OHpMsdriqDxoQD8qt-w6DV_JWbLEvpNALaFsVF7FjeTqusMu-etEySUdU0R47BXCJFg

https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-13-59

https://www.sciencedirect.com/science/article/pii/S0020729214000022?casa_token=AfctyWxsPbQAAAAA:OBLNFJXbpLJEmgPHOD3YTMBcMKqC1ywfIyPVuXV7JoaeD19ZZB5JOfP-5mrViodr8dC9hU4

Your first study is about the BABY’S position. It says a baby who is occiput posterior increases mother’s risk of tearing.

And yes, you’re restating what I already said - instrumental delivery worsens risk of major pelvic floor trauma. But guess what? Many women have NO choice at that point. Often delivery is about to happen and baby is stuck or needs help and going to an emergency C section at that point would delay delivery and cause more risk to the baby. So moms become collateral damage. Trust me, moms who had vacuum or forceps have literally seconds or minutes to consent and then baby is being born. Nice to think we get a choice, we often do not. Or the choice is an impossible one - destroy your pelvic floor to ensure safe delivery of your baby immediately or go to an emergency C section and increase risk of oxygen derivation/delayed delivery to the baby and add major risks of surgery to yourself. All bad choices!

[Anonymous]

Anonymous wrote:That an epidural makes it hard to feel how to push. I pushed for three freakin hours and had hemorrhoids the size of small cluster of grapes for MONTHS! They still had to vacuum DD out. Had natural the next time, no problems getting him out in minutes. I wish I had scheduled C-sections, for both. Lots of damage down there, and still am reminded 25+ years later.

Ooooh, I’m so sorry.

It would be good to see some stats. I had and loved my epidurals with both kids, and had no issues, but I remember agonizing over the decision.