My experience with OASI began at 8.15am on the 29th September 2015. A minute before this, the Midwife had explained that as the baby’s head was not advancing and they were concerned about his heartrate they would like to perform an episiotomy. Exhausted by back to back contractions and terrified that the consultant who had earlier warned that he would ‘come back with the forceps if this baby wasn’t born in the next ten minutes’ was going to return and carry out his threat, I gladly consented. I wasn’t particularly alarmed when the call went out for a ‘baby catcher’ to come to the delivery room urgently, I barely knew what was going on, and then seconds later my beautiful baby boy literally flew down the table, spinning like a hockey puck on the metal surface, and into the arms of the waiting nurse.
There was some concern about his breathing, his oxygen levels were low and I was hardly listening when the midwife told me they’d ‘just need to pop me down to theatre’ as I’d ‘had a bit of a tear and it’s best to get these things sorted out in theatre so we know it’s been stitched up properly’.
Nearly three hours later, having only held my baby boy briefly before being whisked off to the waiting anaesthetist, I got the idea that all may not be well. It took two colorectal surgeons, working simultaneously, an hour and 18 minutes to suture me back together.
The next four days passed in a haze, the care I received on the ward was brilliant, but at no point was my injury properly described or explained to me. I was given information about wound care and a leaflet to take home, my toilet habits were closely monitored and once I had passed a bowel movement, I was allowed home. My final appointment before being discharged was with a paediatrician, who was to check that the angry purple mass across one side of my baby’s face wasn’t a birthmark but just ‘normal’ facial congestion. It breaks my heart every time I look at the photo’s taken of his in the days following his birth, the bruising was terrible.
My husband carefully collected us both from the hospital and we drove home in the dark with our new baby. We were about five minutes from home when the tears started. I can remember saying that giving birth was the one thing I should have been able to do as a woman, but I couldn’t even do that right. That feeling stayed for years and hasn’t fully gone even now.
The midwife and health visitor came to do the usual checks. Our baby boy was doing well, and of course I was asked how I was feeling. The answer I didn’t give was dreadful. I was besotted with my new baby but felt like I had failed him on every level. At that point I was pretty much immobile, I only really left the sofa to go to the loo (which was both painful and undignified). Luckily my husband worked at home, as I never knew how long I could be in the loo for. One of the instructions I had been given on leaving the hospital was that I could no longer ‘push’ when passing a stool, as this would put pressure on the stitches (or in the longer term, the repair). It wasn’t safe for me to leave the baby alone for what could be up to half and hour, so I would phone and call my husband away from whatever he was working on to watch the baby whilst I was otherwise engaged.
I was constantly worried that the stress of the birth had affected the baby in some way that hadn’t yet become apparent, I hardly slept, barely ate, hated it when anyone wanted to hold him and didn’t even want my husband to take the baby out without me. I avoided visitors at all costs. I spent a portion of most days in tears, my husband learnt not to ask what was wrong as I’d just fly into a rage without actually giving an answer. The stress of my behaviour on our marriage in the first year was huge, there were times when he thought I was going to leave him, but we always managed to get through it. Usually due to his patience as much as anything else.
I had always intended to breastfeed however I never seemed to produce any milk at all, despite having a sizeable set of equipment for the job! I was offered absolutely no support with this in the hospital, and it felt too late by the time we arrived home, so this felt like yet another way in which I’d let our son down.
As the injury healed the pain became less intense but I was left with an urgency that was challenging to manage and had a huge impact on my confidence. I avoided any kind of social gathering as I was too embarrassed to talk about the problems I was having with friends or family and would just make excuses to stay at home, preferably with the baby.
I spent hours trawling the internet for the answers to the questions I couldn’t ask. Mumsnet was a particularly good source of information, with countless women sharing their experiences of OASI. The problem was that many of them were worst case scenarios of women who had injuries that became infected and hadn’t healed, who were still unable to have sex several years on from their injury or who were suffering from terrible PTSD and depression. This did not help my mental state and only fuelled my worries. I feel a proper, thorough debrief soon after the birth would have gone a long way towards helping me to mentally deal with what had happened, but this was never offered and I didn’t realise it was something I could ask for at the time. To this day I still have flashbacks to particular events that occurred during my labour, these can take several days to get over and can be coupled with panic attacks and a fear that something ‘bad’ is about to happen, particularly to the children.
When the time came for me to return to my job teaching in a local secondary school, I found I could not bring myself to discuss my issues with HR or occupational health, so I struggled on in silence, wearing a sanitary pad in case of ‘accidents’ and making excuses to leave the room when I couldn’t control passing wind. Teenagers are quick to pick up on these things and no-one wants to be known as ‘Miss Farty’. Around this time our little boy started to suffer with recurrent bronchiolitis. I was convinced this was also in some way down to my disastrous effort at giving birth even though I was reassured by the paediatrician that there was no link. It was a relief when, after his seventh hospital admission in a single winter, my husband and I decided that I should give up work and we would take him out of nursery to be cared for fully at home.
Home happens to be a mixed enterprise farm, where I had spent most evenings and weekends helping to feed and check the livestock and generally being very active before the birth. This could no longer be the case. It was impossible for me to lift a sack of feed or wrestle a stubborn ewe, even carrying a bucket of water across the yard was too much and would exacerbate my symptoms. We are lucky to have wonderful friends and neighbours who happily step in to fill the labour gap, but I hate to watch them carrying out jobs I want to be doing and stay out of the way as much as possible. This was such an important part of my relationship with my husband, we got to know each other whilst mucking out cows and feeding sheep and I miss it, it also makes me feel pretty useless to be honest.
I have never blamed my son for my injury, I always felt it was my fault, that I had been ‘ineffective’ during the birth- this was the word used to describe my exhausted attempts to push in my medical notes. My relationship with him is wonderful, but I know I am an overprotective, anxious parent. My expectation for motherhood was that I would be an active, adventurous Mum. This hasn’t materialised. I cannot go to places without good toilet facilities, sometimes we make plans and have to cancel them as I’m having a ‘bad day’ and bowel control has gone out of the window. My OASI is coupled with mild IBS. This was not an issue before the injury, but now means that if eat something that triggers it, I won’t go out. A very awkward incident in our local supermarket taught me that it wasn’t worth the risk, although the staff are now used to me abandoning my full trolley at Customer Services, whispering urgently that I need to use the loo then heading off like a bat out of hell. They never question it, but I do wonder if I ever pop up in the staff room as an ‘amusing’ anecdote…?
I had our second child by caesarean section in 2018. I would have liked to have waited longer as in hindsight I probably wasn’t healed enough mentally or physically to go through another pregnancy at that point, but as I was approaching 40, I felt it was now or never. The pregnancy and C-section were relatively uneventful, but I noticed an increase in bowel leakage and a further reduction in bowel continence after having our daughter and so returned to my GP to see what could be done. The answer seems to currently be very little in our area. I was sent to a local ‘Bladder and Bowel’ clinic where I saw a nurse who had no experience of dealing with OASI and only wanted to focus on a bladder incontinence problem that I don’t actually suffer from. Physiotherapy was limited to checking that I am doing my pelvic floor exercises properly (I will have to do these every day for life). The only other option suggested was surgery, a path I am reluctant to go down at the moment as with two young children and a farming husband I know it would be impossible for me to rest and recover from the operation.
I find that regular yoga (to improve core muscle strength and control) and a very strict diet have improved my symptoms to a degree that allows me to live a life that I can be happy with, even though it is a compromise on what life was before I sustained an OASI. I know that I can never go back to that and fully expect that my symptoms will worsen, particularly as the menopause hits. I’m unlikely to be able to dodge the surgery forever but hopefully can hold it off until the children are older and more independent. My husband is incredibly supportive, although I never talk to him (or anyone else outside of the MASIC organisation) in specifics about my bowel problems and won’t let him read this piece. I’m hoping that a course of therapy I’m waiting to start in the next couple of weeks will help me to deal with the impact of sustaining an OASI on my mental health and ultimately enable me to be more open about my condition.