Mon 29, Mar 2021
Amy Dawes is the CEO and Co-Founder of the Australasian Birth Trauma Association. She shares the emotions and challenges of her birth experience, diagnosis and how far she has come since her diagnosis six years ago.
Warning: This story discusses birth trauma. For more support, you can reach out to birthtrauma.org.au.
This year will mark six years since my diagnosis. After the birth of my first daughter, I was diagnosed with a bilateral levator avulsion (the medical term for when the pelvic muscle is off the bone) and subsequent prolapses.
I’ll spare you the gory details of that December day. Let’s just say it involved forceps, a 3rd degree tear and hemorrhage thrown in for good measure. Although the perineal tear was quickly picked up, the true trauma wouldn’t reveal itself until months later.
My first week postpartum involved lots of liquid: champagne (finally!), urine and blood. I thought I was okay; everyone told me I did well. I got the birth I wanted, but I clearly remember how I felt then: broken, bewildered, vulnerable and empty.
Leading up to birth
I’d truly drunk the kool-aid. I was very fit when I found out I was pregnant and could lift my bodyweight easily. They say birth is like running a marathon – and I could do that. I was strong and empowered after participating in a private birth course, expecting to breathe my baby out in a meditative way. What I didn’t expect to happen was for the birth to steal my identity and replace it with this broken shell of a woman, old before her time.
Feelings of failure
A week after we welcomed our baby into the world, we made it home. I was incontinent, bleeding heavily and unable to sit comfortably without rolling up two parallel towels and making sure I wasn’t sitting on my bum! My time was spent mostly crying, feeling like a failure. I felt I hadn’t been good enough to birth and I wasn’t good enough to breastfeed. I now know how common it is to experience breastfeeding difficulties, let alone after birth trauma.
At that time, without anything to compare it to, I had no idea I’d experienced trauma. I guess I assumed feeling like I’d gone 40 rounds with a boxer was a normal part of postpartum recovery. I now hear that if you feel like that, it is quite likely you’ve experienced some physical trauma.
I was optimistic that life would resume as normal, even after hearing one woman's health physio liken my injuries to that of being in a car crash. I’d soon be the ‘yummy mummy’ in the park doing bootcamp while my baby slept soundly. It was a solid no on all accounts.
At 15 months postpartum I did a mindful triathlon: 5km run, 90 mins yoga, concluding with a 15 minute meditation. It was my first and last run post baby.
It was that day that I felt this unfamiliar, heavy, dragging feeling in my vagina. I didn’t know what it was, but I knew it wasn’t good. A month later, I received my prolapse diagnosis after an appointment with a new women’s health physiotherapist. That appointment was a pivotal moment in my life. I was LOVING my motherhood journey. I didn’t really have any symptoms: I had managed to improve my faecal incontinence and didn’t have urinary incontinence. I had no idea that my pelvic floor muscles were literally hanging on by a thread.
Why didn’t I know anything about forceps? The only time I’d heard of prolapse was when I asked the registrar who delivered my baby whether I could train like I used to. His response was, “just live the life you want. If you prolapse, you can just get surgery when you finish having kids”. Just an FYI – this is NOT good advice.
When I got home from my physio appointment I frantically googled ‘physical birth trauma’. Nothing came up. From that moment on, I decided that I was a freak and self-loathing reared its ugly head once again. At a later appointment, I discovered how common it is to experience birth injuries, prolapse and incontinence. It is still hard to understand why something so common and grim is met with silence. Who are we protecting by not sharing our post-birth experiences?
For a while there, I plummeted into a deep well of despair. No longer the woman I thought I’d be, my body had limitations that I never thought possible. I was even advised to avoid lifting my toddler, which I dutifully did. It’s a time that I’ll never get back.
My physio became my saving grace when she introduced me to other women with similar interests who were also navigating motherhood and life with birth injuries. I had my professional guidance and trusty pessary, but I also had a way to connect with someone who ‘got it’. There really is power in sharing our experiences with someone who won’t try and make it better but will listen, understand and not pass judgement.
I also got comfortable with getting uncomfortable, as silly as it sounds. I preferred a trained stranger to use their fingers to determine the integrity of my pelvic floor muscles rather than risk surgery at this stage. Conservative management doesn’t work for everyone but it’s worth giving it a shot.
I never thought that at the grand old age of 35 I would need to learn how to poop correctly. I also required a splint to hold my organs inside my body and couldn’t help but revisit that question: why didn’t anyone tell me? But you learn to cope and you will be okay.
Fortunately, I learned to make my vulnerability my superpower. I started sharing my story. I was compelled to break the stigma attached to birth injuries and I wanted to help others along the way if I could. That’s how the Australasian Birth Trauma Association was founded in 2016: on the power of peer support which was so crucial in my own recovery.
Where I’m at now
Flash forward, another child delivered by elective caesarean. A lot more stress incontinence… I’m still a work in progress and thankful for my period pants! However, I’m happy with where I’m at now. My prolapse doesn’t dominate every waking thought.
I lift heavy (ish). I love exercise and will try anything to see how it feels. I am an active person and the good far outweighs the bad. My symptoms can get a bit worse leading up to my period but I know I will be alright.
You have to find what works for you. For me, meditation continues to be a huge part of my life. So does my psychologist – after a few failed attempts at finding the right one for me. One of the first things she said to me when I explained why I’m so anxious was, “yes, you’re anxious but it’s completely understandable”. She has been supporting me ever since.
Do I still get angry about it? Heck yes, but I channel that anger for good. What happened to me has fueled a sense of resilience that I had no idea I possessed. My dream is for more women who have experienced birth injuries to know that they aren’t alone and that they don’t need to suffer in silence. If we don’t start talking about common issues that occur from childbirth, then how will we ever fix our overall quality of life? If you’re reading this and any of it resonates with you, please seek support because this doesn’t have to be your new normal.
If you would like to support the Australasian Birth Trauma Association’s campaign asking for Medicare support to access pelvic physiotherapy go to: https://www.change.org/p/the-hon-greg-hunt-mp-pelvic-health-physiotherapists-to-support-birthing-women
You aren’t alone. The National Continence Helpline 1800 33 00 66 is a free service providing information and advice on bladder, bowel and pelvic health. The experienced nurse continence specialists can help you find the right services and specialists in your area.