My son’s forceps delivery, and subsequent 3b OASI tear, happened eight years ago. It’s hard to remember now, several years later, how my body and my life felt before the day my baby was born.
I remember dreaming about new motherhood, and how wonderful it would be to hold my new baby for the first-time – to look forward to first walks with the pram, all the beautiful moments women are told to expect with their new arrival. My reality was being so traumatised and unwell after his delivery that I couldn’t get out of bed for weeks, couldn’t pick my tiny baby up, breast feed him, or lift the weight of his new car seat or pram.
I sustained permanent pudendal nerve damage due to being in the pushing stage for three hours, followed by two failed attempts to deliver my baby with the ventouse, which then necessitated a forceps delivery where an episiotomy tore further into the anal sphincter and caused deep vaginal tearing. I suffered a postpartum haemorrhage and lost 1.5l of blood.
Short term this delivery caused a great deal of trauma. My body went into shock, and even though I was repaired with emergency surgery following the delivery, I suffered PTSD and severe postnatal depression. I couldn’t bond with my baby, and I felt shame and a failure that giving birth had left me with these life changing injuries. If I tried to speak out about how I was feeling to the health visitor or GP, or even to my family, I felt like I was being judged on my ability to parent. I was told my injury was ‘all in my head’ on numerous occasions and another health professional suggested that maybe it was because ‘deep down I didn’t want my baby.’ The ignorance and judgement I faced only worked to compound my isolation and distress and I feared I was a bad mother because of the things I was being told every single day. I was given every single mental health diagnosis you could throw at somebody rather than anybody acknowledging that the brutal injuries I had sustained had affected me profoundly as a woman and had greatly impacted my quality of life.
Long term I have lost normal bowel function. I have daily urgency and an impaired ability to empty the bowel fully. I cannot fully control flatus and have a lot of scar tissue on the back wall of the vagina next to the bowel which causes ongoing problems. I suffered for several years with debilitating pudendal nerve pain before finally finding a specialist physio who was able to work the scar tissue internally to offer me some relief and improved function. Unsurprisingly my sexual function has been greatly affected by the injuries I sustained. My muscles are weak and damaged, and I have very little sensation. I am constantly worried that my partner will leave me because of this. Nobody ever talks about the profound affect this has on a woman psychologically.
My ability to exercise and partake in the activities that I used to love has also been badly affected by my injuries. I was a keen runner prior to giving birth and I enjoyed going to the gym three or four times a week after work and keeping fit. Since the forceps delivery I have to be extremely careful about the activities I can safely do. I have slowly got back into walking and jogging on the treadmill, but it is only ever possible by using a pessary and tampon to hold everything in place. All spontaneity and joy has been taken from exercising. It now becomes something I do to try and keep the weight off, whilst hoping I’m not making prolapses and deteriorating bowel function more likely.
When I gave birth I had no idea what had just happened to me, or what the years ahead would entail. Fighting to be heard and to get treatment. Countless visits to gynaecologists, urogynaecologists, colorectal surgeons, colorectal nurses, women’s health physiotherapists and nerve specialists. Humiliating tests and countless internal examinations. Spending thousands of pounds on private appointments. Speaking to other women this has happened to. All of this has led me to understand what a forceps delivery did to my body. And it has led me to realise that I will never get back the quality of life I once took for granted.
The question I am left with is how did I walk into an NHS hospital to have my baby delivered, and walk out the broken woman I am today? What went so wrong that I am left like this, and why wasn’t I told that that being left like this was a possibility of birth?
The answer isn’t simple. But it should be. Had I had information antenatally about the risks of vaginal birth, which could include a forceps delivery, I would have made different decisions. I could have refused an epidural because this increases the risk of instrumental delivery. I could have exercised my right to a caesarean section. I could even have made the decision not to continue with my pregnancy. Because the right for a woman to have information about what could happen to her body at birth is the same right that a woman has to bodily autonomy in all areas of her life.
My salvation has been finding MASIC, and I truly believe I wouldn’t be here today without the support and hope that the charity offers. MASIC gives women a safe space to talk openly about the impact severe birth injuries have, and in doing so allows health professionals to learn about these impacts and change and improve practice. A package like the OASI Care Bundle would have improved my experience of giving birth because I would have known about the risks of a forceps delivery, and steps would have been taken in my care to try and prevent the perineal trauma I sustained.
Looking back on my birth it is so clear to me that motherhood would have looked a very different prospect to me had I known what could be at stake. I valued my health and fitness, I valued my sexual health, and I couldn’t have imagined that my bowel continence would be at stake aged 33. If I had gone into hospital for another procedure I would have been told about the risks and benefits of the procedure and been given a consent form to sign before the procedure went ahead. Why are birthing women denied this right?