Briefly – my story:
- Prolonged labour following induction
- My son was stuck and I had an episiotomy and ventouse
- Ended up with an undiagnosed 3c tear – diagnosed over a year later
- Stitched as if it was 2nd degree, so obviously didn’t work
- As a result – anal sphincter injury, which has had a devastating and profound effect on my physical and mental health and wellbeing.
I had heard about tearing, I had heard about birth intervention such as forceps, but no one had spoken with me about those things. I had not been told or heard anything about the risk of ASI and getting anal incontinence from childbirth. I simply didn’t know it could happen. This seems ridiculous to me now – as it affects me every day and my involvement with MASIC means I often speak about and discuss it, so it is hard to remember when it wasn’t on my radar. But at the time I had no idea. No one sat down with me – either pre-birth (at antenatal or midwife appointments) or at the hospital during the two days I was there waiting for the induction drugs to work. No one told me about the possible complications of birth – such as ventouse, forceps, c sections – and the risks related to those procedures. Probably the most important event of my life and yet I was, I now know, woefully underprepared for it. And I feel such guilt about that. I feel like I was someone the birth just happened to. I wasn’t involved. Nothing was discussed with me.
My birth plan, such as it was, was that I would have a baby and take any drugs on offer. I wasn’t someone who was desperate for a natural birth. I just wanted to have my baby, as safely as possible. At the time I was happy to place my faith in the medical professionals dealing with me. I had no reason not to. Whilst birth is normal, natural and inevitable, and women’s bodies are designed to do it, unfortunately as we all know it isn’t always that simple. It doesn’t help anyone to act as if it is. As so many of us know, the picture can change very quickly, and very dramatically. Theoretical risks can suddenly become the reality, and natural and easy becomes an extreme emergency situation. At that point, any detailed discussion and informed decision making is, in my view, impossible. These major issues only came into my world when I was too tired and out of it to really be involved or understand. I was in massive amounts of pain (no epidural, despite requests) and had had no sleep for 48 hours. Surely it made no sense for me not to have been informed about the potential emergency situations which may arise and the potential consequences if things went wrong, and to understand that, in advance.
In my view mothers should be informed about potential emergency situations and the risks of childbirth and interventions before the labour. Instead, all I got was advice on breathing and breastfeeding. I now know the risk of me tearing was high. I was a relatively old first time mother at 34; scans showed I had a large baby with a big head. I was induced, so once it started things were intense and moved fast and my son got stuck. Had I known then that a c section was an option that I could have considered, in light of my particular circumstances, then I believe a planned section, even with all the attendant risks, would have been preferable to the risk of a ‘natural’ delivery, which ended up with a ventouse and anal sphincter injury. I know c sections are major surgery not without risk but surely, as I fell squarely within a risk category, I should have been warned of the risks of a natural birth and c section and been able to make an informed decision.
The argument that explaining risks in advance will lead to an increase in c sections is, in my view, misconceived. The value attached by society to natural birth means many women wouldn’t want a section. But they deserve to be given the knowledge to make an informed decision to understand the risks as they relate to them. Every woman is different and every birth is different. Costs are often stated as a reason to keep a lid on c section numbers. But what about the cost of dealing with a woman with ASI for a lifetime, treating birth injuries and incontinence?
I believe I had the right to know about the risks pertinent to my case and the potential emergency situations which may arise and to decide for myself whether those risks were material and what sort of potential emergency treatment I was willing to sign up to. Elective c sections were never mentioned and I had no idea that with the indicators in my case it may have been a good idea. Instead I had no choice and a feeling of a complete lack of control over my experience.
I don’t agree that we shouldn’t tell mums about potential risks as it may scare them. That is a patronising approach which infantilises women and treats them as objects that labour happens to. Sweeping discussions about emergency situations under the carpet and crossing our fingers is not good enough. Tears such as mine may be rare but that is not a reason not to warn people about what may happen.
My life today looks like this: – I rarely leave the house before 8.30 due to my toileting needs – I won’t go anywhere without knowing where the loos are – Long drives and travel generally are riven with anxiety – I left a job I loved as it was heart breaking the impact my condition had on my career and ability to do my job – I struggle to be around friends with babies. Every year on my son’s birthday I have difficulty dealing with the psychological impact. I carry pads, wipes, Imodium, pants everywhere I go – I have been shouted at when using disabled loos as I don’t ‘look disabled’.My confidence, my ‘me-ness’, the essence of who I am, has been destroyed. My relationship with my partner has suffered – I live in a constant state of anxiety.
Now imagine how different my life might look if I had had a discussion about the risks and been afforded the time and respect to think about my situation and what might have been the right thing for me. If I had been able to attend, for example, an ante natal class about consent and birth complications, or if I could have attended a consent clinic, or if in one of those many wasted hours waiting or the induction drugs to kick in, someone had come to talk to me about it. I came across a quote the other day – that birth and death “are like holes in this ordinary life, through which something higher showed”. The hole of childbirth is not fully discussed, explored, prepared for. I have heard so many women say to me since I had my son: “I cannot believe I never knew this could happen to me”. And that needs to stop.