The joy and hope that a newborn baby brings is intensely special. Most deliveries are highly anticipated, relatively uneventful and happily result in beautiful promising new lives. But not all. Some women struggle afterwards due to childbirth injuries that occurred during delivery. These injuries generally affect the pelvic floor structures and their function.
It isn’t popular to talk about childbirth injury and social pressure still silences women who suffer these. As urogynecologists, we work to educate and to empower women regarding their pelvic floor health and are committed to improving all related conditions for women, including injuries that occur after childbirth.
The female pelvic floor is complex and includes the:
- reproductive organs
- bladder and urethra
- rectum and anus
- pelvic floor musculature (Kegel muscles) and perineum
- nerves that supply all of these structures
What type of childbirth injuries can women experience?
A childbirth injury can affect any one of these organs, and sometimes the complications don’t show immediately after giving birth.
Skin tears of the vagina and perineum can occur after prolonged pushing and then rapid stretching that happens during childbirth. If they don’t heal well, women can develop persistent pain that makes sitting, wearing certain clothes and sex painful.
Pelvic Nerve Damage
Damage to the structural supports of the pelvic floor organs can occur and this can cause new tissue laxity, bulging of the tissues (pelvic organ prolapse), and urinary leakage. The urinary leakage can be profoundly frustrating because it generally occurs with physical activity, making it hard to return to activities like exercise or playing with older children that help us re-integrate back into our lives.
Women who suffer injury to the anal sphincter muscles can find it hard to make it in time to the bathroom to have a bowel movement. This condition, for clear reasons, can have a profoundly negative effect on a new mom’s self confidence, leaving her isolated and depressed.
Injury to the pelvic nerves can cause loss of pelvic muscle strength, poor bladder or bowel control, difficulty voiding, or pelvic pain.
All of these injuries can leave women suffering, feeling badly about themselves and less able to participate fully in their lives.
Did I do something wrong that caused the injury?
Many woman blame themselves for the pelvic dysfunction following delivery. There are many variables that go into a vaginal delivery, such as pelvic shape, baby size and position, time spent in labor, genetics and delivery method. Most of these aspects are outside of the woman’s control.
If giving birth results in an injury, you have not in any way failed. Giving birth is a demanding, physical and mental accomplishment, much like running a marathon. We all understand that athletic injuries require attention, treatment and recovery. Childbirth injury deserves the same level of attention and care.
Do I need to have a cesarean section if I get pregnant again?
This is a real consideration that many women have after a childbirth injury occurs. In cases of more advanced injury, many would not choose to go through such an ordeal a second time and in some situations a second injury may make the treatment of the initial injury less effective.
Share your concerns and discuss your options with your obstetrician. It is a very personal decision and individual situations must be considered carefully.
Who can help me with these issues?
There are many treatment options available. Talk to your obstetric provider and discuss openly any fears and concerns regarding pelvic floor function you might have. This area of a woman’s body is very personal and normal function is tied to social confidence, healthy relationships and even economic stability.
Your health care provider may refer you to a urogynecologist. We work with women on their pelvic floor function and health routinely. Depending on the type of injury, we offer education and treatments that range from physical therapy, medication, lifestyle changes, support devices and when appropriate, surgery.