C-section or natural after 3rd degree tear?

[Anonymous]

NP two posts above - it is the work of Sharon Dekel at Harvard Medical School https://www.theatlantic.com/health/archive/2015/10/the-mothers-who-cant-escape-the-trauma-of-childbirth/408589/

I'm delighted that you and your friends had positive birth experiences. Many women do.

Please respect those of us who did not, wish we had known more and are trying to get the word out so that other women can make their own informed choices.

For myself, I don't want to shock or terrify people, and I wince when people write that they feel "so sorry" for me. My main goal in sharing is to help make sure other women don't suffer the same fate, and if somehow they do, they went into the situation fully understanding the risks and impact.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:God, who is this person who also knows about Handa and Dietz!!! Wonderful!!! When I had my child in 2014, I was so badly mangled and I felt like the only person, in the subsequent months of trying to put myself back together, who knew who they were. Thank you for highlighting their work. To the adamant vaginal birth person who has posted previously: You can sing your song after you have walked in my shoes. I cannot hold gas, or soft stools. Constipation pushes my rectum into my vagina. Evacuation has to happen edigitally because all the hard stool goes to where my levator ani used to be, and guess what, there is no anus there. My sexual enjoyment - what's that? I am a giant hole with three prolapsed organs (uterus, bladder and rectum) hanging in it, and no levator on my right side to contract for any sort of pleasure. Did I forget to tell you about my intussception? I really notice that when I am constipated, because when I can finally evacuate the stool, part of my colon emerges from my body. Thankfully it goes back in. But I dont know if it will when I have menopause someday. And did I mention my nerve damage (again, sexual enjoyment), enterocele and general daily pelvic pain? Or what it was like to not be able to life anything over ten pounds after my son, or how it feels inside when I have to tell him i cant carry him or pick him up? FWIW, arguably the most prominent midwife practicing in the district was in the room when I delivered. So, fuck your sanctimony. You try being me first. For the rest of your fucking life.

Holy shit. What a nightmare for you pp! What happened during your vaginal birth? I've never heard anyone have any of those problems you mentioned. I'm so sorry for you.

I'm not PP, but I'm not surprised you haven't heard. Women are shamed into not talking about their problems with vaginal birth. By contrast, C-sections are expected to be hard so it's easy to talk about C-section complications.

PP isn't alone or unusual, unfortunately.

PP is not alone, but she is unusual, actually. Just as the horror stories and death from c-section are unusual. The majority of women, regardless of birthing method, give birth without incident. I am very sorry for PP and her experience, but you have to recognize that her case is extreme and unusual.

I have heard you make this statement before on other threads, PP, and frankly I find you to be callous, rude, and insensitive. First of all, please cite evidence stating that most women give birth without incident. You can't just make blanket statements based on dogma and ideology from the natural birth movement and not back them up with facts. So if you're going to make a gross, blanket statement about "most women" and their experiences, back it up with something. Where's the research? Show some citations.

Frankly, I find your lack of compassion to be unusual and extreme. Did you know that an estimated 25 percent of women have one or more symptoms of postpartum PTSD and around 9 percent of women have full blown postpartum PTSD. This is just emotional trauma, not even talking about physical. Would you deny that these women exist? Would you tell them that they are "unusual?"

Also, how dare you dismiss someone's suffering and traumatic experience? Are those really appropriate words to use for someone whose quality of life has been destroyed? How dare you try to invalidate someone's experience by marginalizing them as an outsider, when the reality is that millions of untold women around the world deal with these issues? There is so much stigma around them that most women are loathe to speak out, and when they do get the courage they must face trolls like you who are going around promoting natural birth agendas and ostracizing anyone whose story does not fit the narrative you are promoting.

I find you to be extremely anti-woman, and I hope that you are not in any position to be around, caring for, or supporting pregnant or post-partum women. You have no right to invalidate someone else's experience.

NP. If you're going to ask other posters to provide cites for their statements, you should do the same for yours. Obviously this is anecdotal, but I have 19 friends who had babies in the past two years, and zero of them had PTSD or any ongoing physical issues (probably around 2/3 were vaginal and 1/3 c-section). All were in their 30s. I find your 25% figure difficult to believe. And pointing out that someone's experience was not the norm does not invalidate it in any way.

How do you know if any of your friends have PTSD or not? It's not exactly something most people go around discussing. Not everyone shares their mental health struggles with their 20 closest friends.

Approximately 9% of women experience postpartum post-traumatic stress disorder (PTSD) following childbirth.
http://www.postpartum.net/learn-more/postpartum-post-traumatic-stress-disorder/

No one knows for sure how common the condition actually is: According to Dekel, an estimated 1-3 percent of new mothers suffer from full-blown postpartum PTSD, but around 25 percent have one or more symptoms of it. Other researchers estimate that postpartum PTSD may affect up to 17 percent of new mothers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3745743/
https://www.theatlantic.com/health/archive/2015/10/the-mothers-who-cant-escape-the-trauma-of-childbirth/408589/

Also, all of these studies.

http://www.birthtrauma.org.au/about/research

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:God, who is this person who also knows about Handa and Dietz!!! Wonderful!!! When I had my child in 2014, I was so badly mangled and I felt like the only person, in the subsequent months of trying to put myself back together, who knew who they were. Thank you for highlighting their work. To the adamant vaginal birth person who has posted previously: You can sing your song after you have walked in my shoes. I cannot hold gas, or soft stools. Constipation pushes my rectum into my vagina. Evacuation has to happen edigitally because all the hard stool goes to where my levator ani used to be, and guess what, there is no anus there. My sexual enjoyment - what's that? I am a giant hole with three prolapsed organs (uterus, bladder and rectum) hanging in it, and no levator on my right side to contract for any sort of pleasure. Did I forget to tell you about my intussception? I really notice that when I am constipated, because when I can finally evacuate the stool, part of my colon emerges from my body. Thankfully it goes back in. But I dont know if it will when I have menopause someday. And did I mention my nerve damage (again, sexual enjoyment), enterocele and general daily pelvic pain? Or what it was like to not be able to life anything over ten pounds after my son, or how it feels inside when I have to tell him i cant carry him or pick him up? FWIW, arguably the most prominent midwife practicing in the district was in the room when I delivered. So, fuck your sanctimony. You try being me first. For the rest of your fucking life.

Holy shit. What a nightmare for you pp! What happened during your vaginal birth? I've never heard anyone have any of those problems you mentioned. I'm so sorry for you.

I'm not PP, but I'm not surprised you haven't heard. Women are shamed into not talking about their problems with vaginal birth. By contrast, C-sections are expected to be hard so it's easy to talk about C-section complications.

PP isn't alone or unusual, unfortunately.

PP is not alone, but she is unusual, actually. Just as the horror stories and death from c-section are unusual. The majority of women, regardless of birthing method, give birth without incident. I am very sorry for PP and her experience, but you have to recognize that her case is extreme and unusual.

I have heard you make this statement before on other threads, PP, and frankly I find you to be callous, rude, and insensitive. First of all, please cite evidence stating that most women give birth without incident. You can't just make blanket statements based on dogma and ideology from the natural birth movement and not back them up with facts. So if you're going to make a gross, blanket statement about "most women" and their experiences, back it up with something. Where's the research? Show some citations.

Frankly, I find your lack of compassion to be unusual and extreme. Did you know that an estimated 25 percent of women have one or more symptoms of postpartum PTSD and around 9 percent of women have full blown postpartum PTSD. This is just emotional trauma, not even talking about physical. Would you deny that these women exist? Would you tell them that they are "unusual?"

Also, how dare you dismiss someone's suffering and traumatic experience? Are those really appropriate words to use for someone whose quality of life has been destroyed? How dare you try to invalidate someone's experience by marginalizing them as an outsider, when the reality is that millions of untold women around the world deal with these issues? There is so much stigma around them that most women are loathe to speak out, and when they do get the courage they must face trolls like you who are going around promoting natural birth agendas and ostracizing anyone whose story does not fit the narrative you are promoting.

I find you to be extremely anti-woman, and I hope that you are not in any position to be around, caring for, or supporting pregnant or post-partum women. You have no right to invalidate someone else's experience.

NP. If you're going to ask other posters to provide cites for their statements, you should do the same for yours. Obviously this is anecdotal, but I have 19 friends who had babies in the past two years, and zero of them had PTSD or any ongoing physical issues (probably around 2/3 were vaginal and 1/3 c-section). All were in their 30s. I find your 25% figure difficult to believe. And pointing out that someone's experience was not the norm does not invalidate it in any way.

How do you know if any of your friends have PTSD or not? It's not exactly something most people go around discussing. Not everyone shares their mental health struggles with their 20 closest friends.

Approximately 9% of women experience postpartum post-traumatic stress disorder (PTSD) following childbirth.
http://www.postpartum.net/learn-more/postpartum-post-traumatic-stress-disorder/

No one knows for sure how common the condition actually is: According to Dekel, an estimated 1-3 percent of new mothers suffer from full-blown postpartum PTSD, but around 25 percent have one or more symptoms of it. Other researchers estimate that postpartum PTSD may affect up to 17 percent of new mothers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3745743/
https://www.theatlantic.com/health/archive/2015/10/the-mothers-who-cant-escape-the-trauma-of-childbirth/408589/

Also, all of these studies.

http://www.birthtrauma.org.au/about/research

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:[...]

[...]

[...]

[...]

[...]
Frankly, I find your lack of compassion to be unusual and extreme. Did you know that an estimated 25 percent of women have one or more symptoms of postpartum PTSD and around 9 percent of women have full blown postpartum PTSD. This is just emotional trauma, not even talking about physical. Would you deny that these women exist? Would you tell them that they are "unusual?"
[...]

NP. If you're going to ask other posters to provide cites for their statements, you should do the same for yours. Obviously this is anecdotal, but I have 19 friends who had babies in the past two years, and zero of them had PTSD or any ongoing physical issues (probably around 2/3 were vaginal and 1/3 c-section). All were in their 30s. I find your 25% figure difficult to believe. And pointing out that someone's experience was not the norm does not invalidate it in any way.

DP here. I don't find it hard to believe at all. I had nightmares/flashbacks (I'm not sure which, they were intense) for a couple weeks after my DD's birth. When I've told anyone about the birth I always leave out the part about the nightmares. I never even discussed it much with my DH, who was also pretty traumatized at the time. It just feels very private. Luckily I didn't develop full-blown PTSD and I was able to move on.

[Anonymous]

Anonymous wrote:I am pp. Don't you dare dismiss me as some sort of marginal instance. Who do you think you are? Look st the research. Levator avulsion affects between 10 and 33 percent of women. Calling me a one off isn't an srguement. 50% of postmenopausal women have prolapse - most due to vaginsl birth complications that catch up to them when muscle tone starts to go and hormone levels change

OP Has the right to

Be fully informed if the risks to her body of both options

In a perfect world, as a pp said, to be screened thoughtfully for vaginal delivery complications and have this discussion with her provider so as to factor it into her birth plan.

Yeah my mother is dealing with prolapse issues. She had two natural births with minimal complications in the 80's but fastforward 30 years and her uturus is prolasping.

Friendly reminder to everyone to do your kegels!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:God, who is this person who also knows about Handa and Dietz!!! Wonderful!!! When I had my child in 2014, I was so badly mangled and I felt like the only person, in the subsequent months of trying to put myself back together, who knew who they were. Thank you for highlighting their work. To the adamant vaginal birth person who has posted previously: You can sing your song after you have walked in my shoes. I cannot hold gas, or soft stools. Constipation pushes my rectum into my vagina. Evacuation has to happen edigitally because all the hard stool goes to where my levator ani used to be, and guess what, there is no anus there. My sexual enjoyment - what's that? I am a giant hole with three prolapsed organs (uterus, bladder and rectum) hanging in it, and no levator on my right side to contract for any sort of pleasure. Did I forget to tell you about my intussception? I really notice that when I am constipated, because when I can finally evacuate the stool, part of my colon emerges from my body. Thankfully it goes back in. But I dont know if it will when I have menopause someday. And did I mention my nerve damage (again, sexual enjoyment), enterocele and general daily pelvic pain? Or what it was like to not be able to life anything over ten pounds after my son, or how it feels inside when I have to tell him i cant carry him or pick him up? FWIW, arguably the most prominent midwife practicing in the district was in the room when I delivered. So, fuck your sanctimony. You try being me first. For the rest of your fucking life.

Holy shit. What a nightmare for you pp! What happened during your vaginal birth? I've never heard anyone have any of those problems you mentioned. I'm so sorry for you.

I'm not PP, but I'm not surprised you haven't heard. Women are shamed into not talking about their problems with vaginal birth. By contrast, C-sections are expected to be hard so it's easy to talk about C-section complications.

PP isn't alone or unusual, unfortunately.

PP is not alone, but she is unusual, actually. Just as the horror stories and death from c-section are unusual. The majority of women, regardless of birthing method, give birth without incident. I am very sorry for PP and her experience, but you have to recognize that her case is extreme and unusual.

I have heard you make this statement before on other threads, PP, and frankly I find you to be callous, rude, and insensitive. First of all, please cite evidence stating that most women give birth without incident. You can't just make blanket statements based on dogma and ideology from the natural birth movement and not back them up with facts. So if you're going to make a gross, blanket statement about "most women" and their experiences, back it up with something. Where's the research? Show some citations.

Frankly, I find your lack of compassion to be unusual and extreme. Did you know that an estimated 25 percent of women have one or more symptoms of postpartum PTSD and around 9 percent of women have full blown postpartum PTSD. This is just emotional trauma, not even talking about physical. Would you deny that these women exist? Would you tell them that they are "unusual?"

Also, how dare you dismiss someone's suffering and traumatic experience? Are those really appropriate words to use for someone whose quality of life has been destroyed? How dare you try to invalidate someone's experience by marginalizing them as an outsider, when the reality is that millions of untold women around the world deal with these issues? There is so much stigma around them that most women are loathe to speak out, and when they do get the courage they must face trolls like you who are going around promoting natural birth agendas and ostracizing anyone whose story does not fit the narrative you are promoting.

I find you to be extremely anti-woman, and I hope that you are not in any position to be around, caring for, or supporting pregnant or post-partum women. You have no right to invalidate someone else's experience.

Lack of compassion? How is it dismissive of someone's experience to point out that the experience is unusual? And yes, the extent of PP's injuries is unusual. Acknowledging that does not diminish her suffering or her experience. My best friend nearly died in childbirth from an amniotic fluid embolism. Her experience was horrifying, and she suffered from PTSD (not sure what your rant about PTSD was about - I never mentioned it?). I love her like a sister and I hate what she had to go through and continues to go through. I support her efforts to spread awareness of AFE and donate money. All that said, her experience was unusual. Saying that does not dismiss the gravity of it. She says the same thing.

I am not a part of some "natural birth community" like you seem to think. I did not birth my own children "naturally." You seem to have a lot of anger, and I believe it is misplaced.

[Anonymous]

I'm not the pp you refer to. Your friend's story sounds terrible.

I note that in the posts above there are many examples of trauma. There is a link to a book on traumatic birth. There are many support groups on line with thousands of women who have experienced traumatic births. Please understand that we who have experienced them are trying to warn women that they are more common than we would all like to think so that they can make informed birth choices, and do thigns to prepare, like see a pelvic floor PT and have frank talks with doctors, get a late-term u/s, etc.

Misplaced anger on the part of the PP? I would not say so. Again, people with injuries in this string have made it very clear how this has affected them. It's hard. You need to respect that. It sounds as if you did for your friend.

We are tired of being marginalized. And would like to see a little more sisterhood, frankly. Because this is something that affects many more people than any of us would like to think.

All of the deep sexism in our society that the #metoo movement rises up against plays into these problems. Why is it that in 2017, we can't figure out how the nerves and muscles of the pelvic floor work, and how to protect them? Why is it shrouded in mystery? Why can I get a hamstring avulsion fixed, but not a levator avulsion? A muscle is a muscle, a tendon is a tendon. Why is it that when I went for my follow up visit and told my provider that I had no labia on my right side anymore (the least of my worries, but one more example of being mutilated), I just got a shrug back. Like this part of my body did not matter at all. Why is it that when I suspected I had levator avulsion, three urogynecologists told me they would not do diagnostics unless I was ready to sign up for surgery? Why did I not desrve to know and see the damage in an MRI, like if I had torn my roataor cuff or something? Why was this part of my body less important? Why is it that when I contacted three lawyers I never heard back? Why is it that when I reached out to my seven sister alumnae network about this, every women told me they had also been unsuccessful at retaining a lawyer? I never found anyone - including a woman I met who had fistula - who manged to sue. If something happens to your baby, yes, you can sue. But if something happens to a woman, a mother - forget it.

I apologize to OP for going so far off topic. I fervently hope I live to see the day when a woman's pelvic floor, which supports her sexuality, continence and core strength is treated every bit as seriously, thoroughly and carefully as any other part of our bodies. If it were the case now, this string would not exist.

[Anonymous]

This has been such an interesting discussion and I really feel like I learned a lot from reading the pps stories. I googled levator avulsion and that brought up a lot more information on the topic as well as pelvic exercises and other research.

I had an incredibly simple vaginal birth with epidural. But I was looking for info like that while pregnant so I knew what to ask for and what to try to avoid. I'm pregnant again. I don't know how you avoid long pushing? When I dialated 10cm they told me to push. What should you do if you've been pushing for an hour and you don't know how much longer it will take?

I've worked with older women and my grandmas and great aunts were very candid. They all have pelvic floor issues. Some gave birth with forceps and most had twilight sleep. They all had multiple births. I'm an only child and my mom had me via c section- she has pelvic issues now in her 60s.

[Anonymous]

Anonymous wrote:This has been such an interesting discussion and I really feel like I learned a lot from reading the pps stories. I googled levator avulsion and that brought up a lot more information on the topic as well as pelvic exercises and other research.

I had an incredibly simple vaginal birth with epidural. But I was looking for info like that while pregnant so I knew what to ask for and what to try to avoid. I'm pregnant again. I don't know how you avoid long pushing? When I dialated 10cm they told me to push. What should you do if you've been pushing for an hour and you don't know how much longer it will take?

I've worked with older women and my grandmas and great aunts were very candid. They all have pelvic floor issues. Some gave birth with forceps and most had twilight sleep. They all had multiple births. I'm an only child and my mom had me via c section- she has pelvic issues now in her 60s.

My doctors had me on a 4 hour pushing limit. I was 15 min away from getting a c section when my baby repositioned and came out!

[Anonymous]

Anonymous wrote:This has been such an interesting discussion and I really feel like I learned a lot from reading the pps stories. I googled levator avulsion and that brought up a lot more information on the topic as well as pelvic exercises and other research.

I had an incredibly simple vaginal birth with epidural. But I was looking for info like that while pregnant so I knew what to ask for and what to try to avoid. I'm pregnant again. I don't know how you avoid long pushing? When I dialated 10cm they told me to push. What should you do if you've been pushing for an hour and you don't know how much longer it will take?

I've worked with older women and my grandmas and great aunts were very candid. They all have pelvic floor issues. Some gave birth with forceps and most had twilight sleep. They all had multiple births. I'm an only child and my mom had me via c section- she has pelvic issues now in her 60s.

Thanks for sharing, PP. I really hope that people can learn from my experience, and that they will have empathy for those of us dealing with these issues which are completely devastating to quality of life and which do not have good treatment options.

I would highly recommend you read the book, Ever Since I Had My Baby. It is a few years old but the advice is solid and there is a section for women who are pregnant about what to do in labor and delivery. I wish I had read this before I delivered. It should be required reading for all pregnant women. Also, I would watch the video I posted from YouTube from Dr. Dietz explaining levator avulsion and discussing pelvic floor issues. He is a real advocate for women and he has taken an unpopular stance to push his OB colleagues to recognize how their beliefs and actions can contribute to these disorders, and to remind them that they are first supposed to do no harm.

https://www.amazon.com/Ever-Since-Had-Baby-Understanding/dp/0609808729

Finally, I would not push for more than a few hours and would not push using directed, breath holding valsalvas as many of us are directed to do. I would instead find an OB who encourages an epidural to allow the body to relax and do the work itself until the very end. Trust me, even if your labor and delivery nurse tells you to, she's probably never heard of prolapse herself and will not have to deal with the long term consequences of your delivery. Good luck to you.

[Anonymous]

Also, since your family has lots of pelvic issues you are at a higher risk, I am sorry to say. So definitely mention this to your obstetrician and see what they advise (they should take this seriously, if they dismiss it, get a new OB). In your circumstance I would also tell them under no circumstances do you want forceps, and if it appears the baby is not moving down well, is in a bad position, or labor is taking a long long time that you would prefer Cesarean delivery. An ounce of prevention is worth a million pounds of cure.

[Anonymous]

Anonymous wrote:[...]
I note that in the posts above there are many examples of trauma. There is a link to a book on traumatic birth. There are many support groups on line with thousands of women who have experienced traumatic births. Please understand that we who have experienced them are trying to warn women that they are more common than we would all like to think so that they can make informed birth choices, and do thigns to prepare, like see a pelvic floor PT and have frank talks with doctors, get a late-term u/s, etc.

Misplaced anger on the part of the PP? I would not say so. Again, people with injuries in this string have made it very clear how this has affected them. It's hard. You need to respect that. It sounds as if you did for your friend.

[...] And would like to see a little more sisterhood, frankly. Because this is something that affects many more people than any of us would like to think.

[...]

Why should we? I have posted in other threads and I think this that I found my fairly straightforward c-section traumatic and that I found the experience of being cut open while awake so traumatizing that I would never again choose that. You don't seem to think my opinion or experience matters, just yours.

[Anonymous]

Anonymous wrote:This has been such an interesting discussion and I really feel like I learned a lot from reading the pps stories. I googled levator avulsion and that brought up a lot more information on the topic as well as pelvic exercises and other research.

I had an incredibly simple vaginal birth with epidural. But I was looking for info like that while pregnant so I knew what to ask for and what to try to avoid. I'm pregnant again. I don't know how you avoid long pushing? When I dialated 10cm they told me to push. What should you do if you've been pushing for an hour and you don't know how much longer it will take?

I've worked with older women and my grandmas and great aunts were very candid. They all have pelvic floor issues. Some gave birth with forceps and most had twilight sleep. They all had multiple births. I'm an only child and my mom had me via c section- she has pelvic issues now in her 60s.

This is interesting because my mother also had two children, both via c-section but now in her sixties has uterine prolapse and pretty significant incontinence issues. This is a big discussion amongst her friends of the same age, and their experiences run the gamut, with most having given birth vaginally, and about half with some mild incontinence issues and/or the need for pelvic OT. Interestingly, my mom's closest friend gave birth to six children naturally, and now has zero issues in her seventies. Most experiences are more middle of the road, but she does have a friend who never even experienced pregnancy but has significant incontinence issues in her sixties. I wish there were a better way to predict and protect women's health in this area, regardless of childbearing status or birthing history, and more attention and better treatments available as a whole.

[Anonymous]

Always natural if there is a choice. Seriously.

[Anonymous]

Anonymous wrote:

Anonymous wrote:[...]
I note that in the posts above there are many examples of trauma. There is a link to a book on traumatic birth. There are many support groups on line with thousands of women who have experienced traumatic births. Please understand that we who have experienced them are trying to warn women that they are more common than we would all like to think so that they can make informed birth choices, and do thigns to prepare, like see a pelvic floor PT and have frank talks with doctors, get a late-term u/s, etc.

Misplaced anger on the part of the PP? I would not say so. Again, people with injuries in this string have made it very clear how this has affected them. It's hard. You need to respect that. It sounds as if you did for your friend.

[...] And would like to see a little more sisterhood, frankly. Because this is something that affects many more people than any of us would like to think.

[...]

Why should we? I have posted in other threads and I think this that I found my fairly straightforward c-section traumatic and that I found the experience of being cut open while awake so traumatizing that I would never again choose that. You don't seem to think my opinion or experience matters, just yours.

I'm sorry for your experience, PP. I also found my c-section extraordinarily traumatic, and have found no one wants to hear about it. Instead, I am constantly told it is a simple surgery and no big deal. I am sorry for your pain.