Share Mayflowers - Postpartum

Our Bodies, Our Cars

Do you find knowledge to be empowering or does it make you weak in the knees? Does knowledge = empowerment, or does knowledge = fear and anxiety for what may lie ahead?

Now put on your pregnancy and childbirth glasses...and answer that question, again. And be honest. When it comes to the risks of physical injury or trauma associated with pregnancy and childbirth—rare as they may be—do you want to be honestly informed? Do you want to be informed of your risks AND of the options for treatment and intervention to improve your recovery IF any of these adverse physical outcomes arise?

I’m not being rhetorical, either - please let us know via Twitter, FB, or info@sharemayflowers.org.

If you would not want to know, that’s your call. And I would suggest you stop reading.

You could potentially compare this to your car. You likely buy your car without wanting or needing to know how it works or what could go wrong with it after 2000 miles or 25,000 miles. You want it to start when you turn the key, to go faster when you press the gas, and to stop when you hit the brakes. If anything stops working, you take it to the shop to get fixed. You don’t need to know what went wrong—just get it working again.

Children in front of a pickup truck

It is tempting to take the same approach for our bodies—assuming they should work without any more intervention from us than fuel and oil changes—and when they start slowing down (or leaking under the hood!) we can go to the healthcare shop and get fixed. The big difference here, however, is that if you ignore car maintenance or something goes wrong with it either way, you can get a new car. Like it or not, there is no trade in or lease option for our bodies. One body, one lifetime—babies or not.

For this reason, as a health professional and mom, I personally choose to be on the side of wanting to know how experiences and events in my life will affect my body, what my options are to get help navigating these circumstances, and what I can do to facilitate the process. It is in that mindset, that I want to share a few stats demonstrating how rare certain childbirth injuries or traumas are and in the very same breath to share that if these happen to you (when they happen to the small percentage of women who they do affect!) that a number of resources are available for help!

Need any more convincing? Read any of our testimonials from last week and this week for stories from women who have very personal reasons for wanting this information to be more widely available.

Stats:

  • Pubic Symphysis Separation - this separation of the large joint at the front of the pelvis is rare, occurring in only 0.005% to 0.8% of women during childbirth.
  • It is believed to occur when the baby quickly and forcefully descends into the birth canal and the head wedges against the front of the pelvis with enough force to disrupt the ligaments. Many women describe hearing or feeling a “pop” and they characteristically have trouble changing positions in bed and doing anything that requires weight-bearing through the pelvis (ie. standing, walking, climbing stairs...you know, just that little stuff).
  • Treatment options include surgical fixation of the joint (never the first line or immediate option!) and conservative care (rest, wearing a belt, minimizing aggravating activities, and physical therapy). The worst treatment: no treatment at all. If treatment isn’t suggested, the care provider may simply not be aware of options, so feel free to just ask!
  • Perineal lacerations, spontaneous tearing of the tissue of the perineum and vagina, or episiotomy are said to occur in most of the approximately 3 million vaginal deliveries in the US each year. The overwhelming majority of these are 1st or 2nd degree lacerations and are considered “minor,” requiring little to no specific repair and healing on their own without incident.
  • Third and fourth degree tears by definition include damage to part or all of the ring of muscles surrounding the anal opening, and these types of traumas are linked to incontinence of urine, gas, and stool. The incidence of anal tears has been difficult to determine, with most estimates in the literature ranging from 0.5% to 18%. However, there are those who maintain that this incidence is much higher - in the neighborhood of 35% - and that outcomes are often suboptimal after operative repair, leaving over half of women with ongoing symptoms related to control of bowels and gas.
postpartum perineal care
Photo credit: www.webmd.com

Even in light of this, would I have elected a cesarean section to avoid the risk of such trauma? Heck, no.

A C-section is a life-saving procedure and a gift to modern medicine, but it is major surgery and not something to be taken lightly. My approach instead would have been to begin immediate post-delivery (after repair of the tear) rehabilitation to facilitate the best healing and recovery for my muscles. It’s the approach to post-op recovery from muscle tears/repairs elsewhere in the body. (Btw, would love to investigate this! Initial protocol is written for RCT of PT versus no PT after 3rd/4th degree tear/repair...any funders??? Smile!!!!)

For full descriptions and illustrations visit http://www.moondragon.org/obgyn/procedures/suturing.html