Episode 15

#15 Recovering from a severe (third degree) tear after homebirth The Matrescence Podcast

In this episode Bree sits down with Kel to discuss her experience sustaining a third degree (3B) tear during the homebirth of her second child, Emmy. Bree's homebirth was positive, empowering and everything she had hoped for. However despite having had an undisturbed physiological birth, Bree was surprised to realize that she wasn't experiencing the post-birth euphoria that so many had described. Infact, she seemed to be in quite a lot of pain. After some time spent bonding with her baby girl the midwives suggested that they do a routine assessment of tears. Initially they identified that Bree has sustained a second degree tear that could benefit from suturing however during the repair concerns were raised that it was infact a fourth degree tear. The decision was made to transfer to hospital for a more thorough assessment. Once in hospital it was established that Bree's tearing was of the third degree and would require surgical repair. Tune in to hear about the process of repairing tears after a homebirth, how this affected Bree's feelings about her birth and how her recovery has been so far. Themes: Third degree tear, 3B tear, severe tear, perineal tear, natural birth, homebirth, physiological birth, midwifery-led care, private midwife, doula, hypnobirthing, Hypnobirth Australia, hospital transfer after homebirth, 

Transcript

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Kelly: [00:00:00] The birth of a baby is a defining moment in a woman’s life.

[00:00:14] Bree: [00:00:14] But what about the birth of a mother?

[00:00:16] Kelly: [00:00:16] That’s right when a baby is born. So two is a mother.

[00:00:20] Bree: [00:00:20] This transition from woman to mother has a name it’s called Matrescence.

[00:00:25] Kelly: [00:00:25] This developmental stage is as powerful and irreversible as adolescents, and yet few women have ever heard of it.

[00:00:32] Bree: [00:00:32] So let’s talk about

[00:00:33] Kelly: [00:00:33] it. Let’s talk about it. Each episode, we will bring them honest and thought provoking conversations, evidence-based research and knowledgeable guests in order to help you emerge and more powerful and aligned version of yourself. So join

[00:00:47] Bree: [00:00:47] us, your hosts, Kelly and Bree. As we attempt to make sense of Al Matrescence journey and to help you make sense of yours.

So Bree, we’ve had a lot of requests since you had Emmylou about what happened with the postpartum tear. So that’s going to be the topic we’re going to discuss in this episode. And if you hear some noises in the background, that is because we do have Emmy along with us today. So this is really your story.

Bree. I’d like to start with. Asking you to address the questions and your responses around the postpartum town, how it has influenced and affected your view of your postpartum experience. Yeah. I’ll tell you a little bit about it to begin with, but the reason that I want to talk about it today is because we have had so many people contact us on social media.

After I shared about having the tear and it occurred to me that first. Tears are quite rare. So I think the statistic is less than 3% of mothers will have a severe tear. So a third or fourth degree tear. So there’s already not that many people experiencing them, but for those who do, it’s something that often carries a lot of shame and it’s not talked about.

As with most things in motherhood, I’ve been sharing openly about my experience. And a lot of people have actually messaged me to say, How refreshing that was to hear it talked about. And they’ve shared their perspective and experiences with me, which has been helpful. And so I just thought we could continue that conversation and yeah.

Share what that’s been like for me in the first week postpartum. Great. So let’s start with, when you realize that you were going to have to transfer it to hospital. So if you’d listened to other episodes Bridget did have a home birth. It was a pretty amazing experience. I was lucky enough to be there with you, but there was a point.

Where there was a realization that you would need to transfer for care? Yeah, I was there at the time. But I’d really love to hear your perspective because I think that’s really where the story starts because there’s a number of forks in the road that occur when you have a baby. And that was one of them where you realize that you were going to need to transfer to home.

Yeah. So I think it was pretty clear to me immediately that I’d had a tear. People have asked me on social media, if I felt myself tearing. And if you’ve had a physiological birth without drugs, you don’t, it’s also intense that it’s not a sensation that you can single out. So there was no feeling of I’m ripping or I’m tearing, which.

A lot of people are scared of, but in the intensity of the experience, I don’t believe it’s something that anyone really notices and can isolate us. That is the pain that I’m feeling. But immediately postpartum. I think I was in a bit of a state of shock, which tends to happen with precipitous birth.

So if you’ve listened to her birth story, you’ll know that it was very quick. And what tends to happen is your brain takes some time to catch up with what has just happened. But alongside that, I was just in a lot of pain and I’ve heard so many times people talk about the euphoria and the intense high that comes after a physiological.

And I was thinking I’m not feeling that what is going on. I’m really just not. That’s not what I’m feeling here. And I was so distracted by the pain. I really wanted to soak up that, that little bubble and look at her and enjoy her, but I was in quite a lot of pain and I just couldn’t focus and I didn’t want to And I’ve been gentle with myself because I know a lot of people beat themselves up about that, but I just, I’d said multiple times to my husband.

Like I know, I think I know I should breastfeed her, but I just don’t want to. Right now I need some time. And immediately after I had her eight. Posture over. And I said, I need to go for a shower. I just need a second to warm up. Firstly, it was quite cold. And secondly, to just be by myself. So that was when it was occurring to me hang on, actually, I’m really quite uncomfortable.

I am in a lot of pain. But not unbearable. I was up, I was walking around as having a shower. So then at some point the midwives told me that we need, it would be helpful to assess for tears. And they identified that they thought I had a second degree tear. Which made sense to me sounded pretty reasonable.

That’s what I’d had with my first little boy. I lied down. They can perform. Stitches sutures for a second degree tear at home. So we decided that we’d do that. And we just did it in my bed. So I had my little girl on my chest and My husband holding my hand and they did a local anesthetic. So the injection itself is a little bit painful, but it’s, they don’t suit you without pain relief, which I think is a concern if you’re having a home birth.

But they were able to numb it and start suturing. They did give me the option not to repair it. That is an option with secondary green tears and going into my birth. I had thought that I would leave it to heal naturally. That is an option and it sounded like a really good option to me, but my midwives assessed it and they said that they would really recommend repairing it.

And I trusted them implicitly. I know that they are actually really quite for leaving it to repair by itself. So when they came back and said, actually we do think this needs stitches. I agreed with them and we went ahead with it. My second midwife started repairing the tear. And she asked to do a rectal examination, which is optional.

It is kind of part of standard care at all for it. And I agreed to it. And in hindsight, it’s really lucky I did, because that was how she identified that it was more extensive than we initially believed. So can I ask a question? Yeah, because I was in the room when this was occurring and I do distinctly remember, because this is not.

NX, this is the first birth that I’ve been to. That was not my own. And I do remember my own stitches. So I was really curious to see, and I was watching very closely to the midwives faces. And I do remember looking at their faces and hearing you describe your pain. And I had that moment where I thought this is probably quite serious, but the point, the question that I wanted to ask is I wasn’t expecting when she asked to do a record.

Rectal examination. But when she asked, I thought, oh, that makes sense. But I actually didn’t know it was coming. Did you know that she was going to ask and did you know it was standard care? Because I wonder if anyone didn’t know that if they would be shocked by that question. I don’t know enough about the way we manage tares in hospitals to answer it properly.

There is some controversy about whether they should offer them or not, because obviously it’s not a nice thing. No one wants a finger up their bum. It is how we identify the more severe tears. And if they’re not identified, that’s when they become really problematic. So I’m not sure what her experience was, but I think it was maybe the fact that I was consistently saying I’m still in pain, I’m still in pain.

And they’d given me multiple rounds of the local and it was still really quite painful. So again, I trusted her so much. That recommendation made sense to me. I’m like, if you’re asking to do it, it is probably important. Yeah. And she seemed to immediately know from that, it was very clear to her, the muscle tone.

I could hear them talking and saying the muscle tone, et cetera. So it was a moment where she obviously had this thought of, oh, this doesn’t seem quite right. And that confirmed that suspicion from what I understand, she’s feeling for certain things. And then there’s also, she asked me to essentially perform a key goal too.

Engage my pelvic floor. And it was identified that I really couldn’t. I had very little ability to contract. So that was when she mentioned that she feared, it might be a fourth degree tear, which is like worst case scenario. It was the last thing I wanted to hear. And it was one of those situations where I was like, oh, I know, thought too much about this.

Immediately I knew what that meant, what it entailed in terms of surgery and recovery. And I don’t know. I feel like it would almost have been better, not know to be a little bit blissfully unaware. So I had that stomach drop moment of great, we’re going to have to transfer which is not what anyone wants.

You’re in this beautiful bubble in our room and we were warm and we were snugly and we were bonding and it was like, yeah. Knowing that we were immediately going to have a huge dynamic shift ahead of us. But as I said, I do know enough to know that it wasn’t an option. There were many opportunities throughout my birth and throughout the tear situation where I got to make choices.

But in terms of having a surgical repair, it really isn’t much of a choice. There are some people that choose not to re repair them. But at that point we thought we were dealing with a fourth degree and that absolutely needs surgical repair. It wasn’t what I wanted, but it, I had this moment of acceptance where I was like, okay, this is what needs to happen.

Let’s do it. Yeah. Then we went about organizing a transfer and one of the things that I really loved about being. In a home birth situation then was we got to do that on your terms, on your timing. It wasn’t an emergency situation. Whilst we did call an ambulance to ensure that you were stabilized because traveling in pain is an issue in a car in an upright manner, which so getting the ambulance to come.

A great choice, but we were able to pack an ice bag, make sure you were ready, make sure you’re warm and cozy. Make sure Emmy had some clothes on because at this point she, you’re doing a lot of skin to skin with her. Yeah. And I’ve been that it wasn’t imagined wasn’t an emergency situation.

We were able to still make choices. And the midwives did ask me, do you want, do you mind if we organize an ambulance And that was a great choice because it allowed me to lie down for what was a relatively long transfer, but it took over half an hour. So I wouldn’t have wanted to be sitting in a car.

But as you said, it allowed me to get dressed and packed, pack a bag. And we took a moment to give my little boy his gift from his little sister, which had been waiting for all morning. And. I think that had we been in a hospital, there would have been a rush to get that done, but it really isn’t an emergency situation.

An hour difference does make a huge difference. It allowed us to still have that time in our bubble bonding, doing those rituals that felt important to us like cutting the cord, having skin to skin, the first breastfeed. And I think in hindsight, that was so important to. Closing off my birth experience and separating this as I had my beautiful blissful homebirth and closing that chapter.

And then we had this next chapter, they didn’t just encroach upon one another and really detract from what was a beautiful birth. So we organized. Ambulance transfer. And the ambulance offices were beautiful. They were really respectful and positive and it was all calm and lovely. And we just chatted the way there.

And can I just ask one quick thing? Because I do think that’s a really important, there’s a number of people in my life that knew. You were expecting a baby and having a home birth. And when they heard that you had a tear, what are the immediate reactions is? Oh, no, I’m so sorry for her. You know what a shame she had this idea.

And I think being really clear that the birth experience you had in its own right, was a contained and beautiful experience. And that does come out in the booth story. But that. Medical situation that occurred afterwards, having that as a separation and not letting it affect your view of your birth is a really important part of your own healing around that process.

Absolutely. It was so important to me. And I think also while I didn’t feel a need to defend my choices or my birth experience when I was sharing it on social media specifically I wrote a blog on our website about my birth experience, which I separated into birth. And what came after. And part of that was for the people that were reading it.

I understand that reading about a severe tear can be quite confrontational and some people will feel that knowledge is power and other people just want to go into their birth being blissfully unaware. And while I’m a huge advocate for being informed and educated, I think there is a point. Yeah. You know too much, and it’s not actually helpful.

It just creates fear, which is gonna hinder your birth experience. So part of that was for the person reading the blog. And part of it was for me to say, Hey, in my mind, these are two separate experiences and I had an incredible birth. And not only was that separate to the tearing experience, I think that being at home really prepared me to deal with what came after.

Having seen what my body was capable of and this incredible thing that it just did. Having relied on my husband for such intense support and him coming through and delivering that during my birth, all of these things really prepared me for what came next. So I think as you said, it was really important to have that separation of experiences and to.

Realized that it wasn’t a failed home birth. I think there’s that fear of I failed, I ended up with a negative experience or home birth is dangerous. Look what happened, but that was not what the experience felt like to me at all. Okay. Excellent. Thanks for clarifying that. So what happens when you arrive at the hospital?

Because I was curious as to how. This may play out, given that you’re arriving, having just birth to baby with the baby, with you and your husband there as your support. Okay. Awesome. Yeah. So if you missed this bit, you were at home drinking champagne w I need to just toasting your health and I was using a beautiful.

I was nesting and stripping the beds at cleaning the sheets. But to clarify, Kel had feed me champagne, which I was then glad I refused because I had about seven doctors asked me what have you eaten today? And by this point it was only 8:00 AM. So I was glad to not have to say, oh, I’ve had a glass of champagne.

But you guys didn’t stay behind to put my house back together, which I was super grateful for it to come home to. We wouldn’t have been aware out in any way. And the reality is we talk about the COVID restrictions. I don’t think these are changing anytime soon. So even being, having, Matt being allowed to go with you in the ambulance, I thought it was a positive thing, was something I would have fought for anyway, but we didn’t need to, they were incredibly supportive and inclusive.

Yeah. So we just, I pumped in me on my chest. I did ask them, I said, can I bring, my husband and my baby with me? And they were like, of course, no problem. So she went on my chest and he wrote in the ambulance next to me. And they just took us straight up to birth suite. I believe once we got to the hospital And the ambulance officers helped me do a week.

I was so busting and it’s funny. And the enormity of the situation and the pain, I was like, I’ve just got to go find a toilet. I’ve got to do a week. So they helped me do that and get settled in bed. And then we waited to be seen by an OB to come and assess the tears and to, A little bit better because that is their area of specialty compared to the midwives.

So he came in and chatted to me. So OB being obstacles. Yeah, great. And they offered me the gas, which I accepted. And I was really grateful in hindsight, as I alluded to in the blog, I wasn’t looking to be a hero. It’s a different kind of pain. So birth, I think, is a very physiological, productive pain.

Whereas the pain of having my tans assessed, it was not productive. It just hurt. And that was. Honestly the worst part of the experience, it was really incredibly painful. So I had the gas and my husband holding my hand and he assessed it and he said that he thought it might be a threesy, which is great because it was not as bad as a fourth degree tear.

Obviously the less severe tearing the better. Great knowing that it wasn’t as severe. But he did determine that it definitely needed to be repaired surgically. So from there they said that they would, prep, everyone for surgery prepped me for surgery. Emmy would be able to stay with Matt throughout it.

And we would. Lucky and grateful that we had, I had expressed some classroom and that you’d had the presence of mind to pack that for us. So Matt knew that should he need to hit, could feed her. So just very quickly what I put in your hospital bag, and we’ve actually not had a chance to discuss, even if I miss something, but when I was packing the bag for Bri to go, I had a effectively an ice box with ice bricks.

Syringes of claustrum. I put some snacks. Yeah. In case you woke up from surgery, hungry a number of pairs of clean underpants, nappies clothes for the baby, a spare set of clothes for you. The other baby accoutrements, et cetera, a toothbrush and toothpaste. So very small amount of gear. We just had one small bag, but I think that the most important package was the claustrum on ice.

And I think that some people, if you’re having a home birth, they will pack a hospital birth. Some people choose not to. And I think that’s a perspective of, I don’t want to jinx it. I didn’t need that. Honestly. I just figured that should we need to transfer? I had enough people there that they could support me and help pack a bag.

And that was exactly what happened. It turned out to be fine that we weren’t super prepared. But we did have most of what we needed. I can’t remember anything that we really, yeah. I do remember him saying she’s all right, but I’m starving and I felt really bad. I was like, whoa, I forgot to lower it.

Worry about dad. So that’s my learning for next time. Make sure dad’s got a snack pack. Yes. So that was probably the only thing, but yeah, so we ended up, they prepped me for surgery. In the room. So they just put a cannular in and things like that, and everyone was really respectful. And that was something that I had worried about was that we’d have this kind of attitude of.

Yeah. What did you expect? You had a home birth, things go wrong at home births. You know that, and I didn’t want to have to defend myself or defend our choices. And I was really glad that especially from the midwives, we didn’t feel that at all. In fact, a lot of people. Oh, you had a home birth.

That’s incredible, good for you. And it’s really disappointing that you ended up here. I know this is not what you hoped for, but you know how incredible that you got that experience. And that was so lovely to hear honestly. So yeah, I had a moment in the room where I really just felt like poor me and I had a little cry to my husband because this is not what we hoped.

And it was that feeling of how did we get here? An hour ago we were in this beautiful, home birth setting, everything was lovely and went perfectly. And now we’re here. But there wasn’t a lot of time to dwell on it, honestly, because we were prepped and ready for surgery within an hour, which I was super grateful for because I just wanted to get it over and done with and get back to being with her and being in our little bubble as much as we could.

Excellent. So when, before you went into surgery, you, did they explain to you what they were going to do to repair it? Yes, really well. I was actually really impressed with how. Seriously, they took informed consent because we know that is an issue in birth, but everyone really took the time to walk me through what had happened, what needed to happen, what the repair would look like, what I could expect after, and to really answer any questions I had.

Which I didn’t have a lot of questions. I really felt thoroughly informed by what they’d shared with me. So that was really positive. And they took us me through the surgery. I had to say goodbye to Emmy and to my husband. And they stayed in my room. And again, it was really positive. Everyone was really friendly.

The anesthetist did say to me, at one point I was obviously looking a little solar mini. Oh, what’s wrong. And I thought that was such a bizarre question. Cause it seemed incredibly obvious to me. Like I had a severe tear. It was painful. This is not what I hoped for. I was separated from my baby. I was about to have surgery.

I I couldn’t even answer it. I just went. Oh, nothing. I’m fine. I was like, how does he want me to answer that? So anyway, apart from that, it was fine. They took me through to surgery which is, I cannot contrast how different that experiences to my birth. Firstly, I was fully clothed almost my entire life and it was dark and it was warm and it was intimate.

And then suddenly you’re in a surgery room and butt-naked fetal position trying to get the spinal and Which took four attempts. Which was one of my least favorite beds because obviously it’s very uncomfortable. Yeah. So that’s a point of clarity. So to have it repaired, there was option of a general or a spinal block.

Yes. It wasn’t really an option in the end anyway, being that I had eaten, but so therefore they couldn’t do the general they wouldn’t have advise doing it. You meant to be fostered. But regardless it’s probably not the option I would have chosen anyway, because it’s more likely to affect.

Bonding and breastfeeding and you’re out of it for longer. It takes longer to wake up and be coherent after a general than a spinal. We opted for the spinal, which I, as I said, I think I would have chosen anyway, but I did have this feeling of honestly, I do not want to be awake for this, I would probably, if I wasn’t a new mom, if I was just going in for a procedure, I probably would have opted to have it under general. But as fate would have it, we went with the spinal, which meant that I was awake and they gave me other drugs. A long list of them. I later found out, but it meant that I was very relaxed, very calm throughout the procedure.

So they did four attempts at the spinal. I believe it was a student or someone relatively inexperienced doing it. She had the Nathan talking her through it. And at some point I was like, oh, can we just get someone who knows what we’re doing, what they’re doing in here, but they did get it eventually.

And it worked really effectively. And then they just covered me up, kept me warm. And there was a lovely midwife in there called Jan. And she had such warm hands and she just kept coming over to me and, putting her hands on me and saying, how are you going? You’re all right, do you need anything?

And then. Gestures during those moments are so important. Just moments of human connection. Us so lovely and they make such a big difference. So I really appreciated that. And I think I was in surgery for about 45 minutes. And as I said, I was really calm. I could actually see the repair in the light above me, which I thought was probably not ideal.

I think it would make some people really queasy, but I was actually quite curious. So I was watching them, stitch it and listening to them. And then if it started to make me feel a bit queasy, I’d just go back to. Dosing, but, apart from the fact that it was not what I would’ve chosen, I felt very exposed.

It was very clinical. It wasn’t a bad experience. It wasn’t painful. Everyone was very respectful. And I think it went as well as it could. And when I was wheeled out, the surgeon took some time to talk to me and he said that he was incredibly happy with the repair. That’s really reassuring because we know that with severe tearing.

How they’ve repaired makes such a big difference. And if it’s not repaired well, that’s when you’re going to encounter long-term problems. So super relieved to hear that had gone really well in his opinion. And then I went through to recovery and I only spent maybe 20 minutes there just being monitored, having my vitals monitored.

And again, everyone there chatted about the fact that I’d had a home birth and how lovely that was. And then I was able to go back and be with my husband and yeah. And how did they go without you? Did he have chance to feed and she was quite settled. So he didn’t end up needing to feed her.

He was hungry. He had been up for quite a while then, but they did actually admit Emmy as a patient, which my midwife had said to me going, yeah, To the hospital. They don’t need to admit her as a patient. We’ve done all her newborn checks don’t let her, it’s just going to be extra hoops for you to jump through.

But that was done without me knowing I was in surgery. And I don’t think it was made clear to my husband that was what they were doing. And it’s not that we were really against it. It was just unnecessary, but it meant that when he went to go. To the cafe to get food. They wouldn’t let him leave with her.

And he was she’s not even a patient, like why can’t I take her out of here? But she had been admitted. So that was the only reason he couldn’t go get food. But apart from that, everything was fine. She was very settled. I had fed her before going into surgery, which was really handy. So they were fine.

And I think he was really relieved once I got back and more just worried about me. I, and I think that it was. Physically traumatic for me, body was the one experiencing the trauma, but I think it was more psychologically traumatic for him because he was watching me in so much pain. And I think he was also very conscious of how I would be feeling about the whole experience and what I was going through.

So I think when I got back, he was relieved that I was okay. Physically, but also mentally. Absolutely. And so that night you stayed in the hospital and just the one night, I know you were hoping to get out on the day, in reality from the size of the operation you had that night of observation was important and making sure you were.

Stabilized. Yes. And also I had to have 24 hours of antibiotics through IVs. That meant that I couldn’t go home till about 11 or 12 the next day, which was fine. And I think that, as you said, in hindsight, I needed to be there that night anyway. Because we were trying to manage my pain and I had to see.

Healthcare professionals the next day. So I had to meet with the surgeon and pelvic floor physiotherapists. So in hindsight, I think it was great. Interestingly, I was only in hospital, 16 hours with my little boy. So my home birth, I ended up spending more time in hospital than my hospital birth. Which was amazing, but yeah, I did stay in overnight and I ended up sending my husband home at some point because he had only had two hours sleep the night before.

And he was pretty knackered and I had that perspective of I’m really gonna need your support in the coming days and weeks. So I need you to be well rested. My mom and my little boy had come up to visit us at the hospital and they’d brought us some snacks and some other essential items, which is lovely.

So when they were ready to go home, I sent my husband with. And I actually did really feel at that point, I’m okay. I can manage by myself because going into this birth, I was really concerned about my mental health. And that came from the fact that I was so anxious with my first baby. And it was immediately clear to me when I had Emmy how much calmer I was and more confident in myself and my mothering.

And so I was like, you know what, actually, I’ve got this. I can do this. By myself overnight, you go home and rest. But as soon as she started fussing, it became clear to read that I couldn’t. And that was really challenging. Trying to meet her needs as a newborn with the tear was so tough. I couldn’t roll over in bed, so I couldn’t feed her lying down.

I couldn’t sit up to feed her. I couldn’t get out of bed to get her from the bassinet, but I wasn’t allowed to co-sleep with her in hospital. Caring for a newborn when in that much pain and not even just the pain, but being aware, not to tear the stitches, I just couldn’t do it. So I ended up calling my husband and saying, I actually need someone here with me.

Can you call around and find someone? My mum also hadn’t had much sleep. So I said ask her, because I know that she’ll want to be asked first, but if not, Send someone as Cal assay mom, I don’t mind. So my mom of course jumped at the opportunity and having bad dreams. She came up and then she was able to just hand her to me.

Hold her while I adjusted the bed to feed. I eventually worked out how to feed lying down, which I had never been able to do with my little boy, but just out of necessity, I was like, we’ve got to make this work because I can not sit to feed for hours. So we got through that night, but it, I don’t want to sugar coat.

It was a challenge and I really did need support to get through that. I don’t know if but I sent your mum a text, not realizing that she was on her way back to the hospital. Just checking in, have you got, you’re doing okay, do you need anything? And she was like no, it’s fine.

I’m okay. On the way to the hospital, I was, yeah. What are you going back? Because I had miss that loop. And and again, offered to help. But I think for her, that was really an important part of her healing of, because one of she is one of the people that I had a conversation with after you transferred to hospital, when her worrying about your disappointment of the birth, not being what you wanted it to be.

And I remember saying to her, look. From what I’d experienced in the conversation with you, you felt that you were still so grateful for the birth you had, and this was a different experience. I think for her that was actually important for her to go and be with you on that night. Yeah. Yeah.

And I think as much as part of it was I am in pain, this is hard, but another part of it was just realizing there was one point where I hopped up to get her out of there. Cradle and feed her and change her nappy and we’re going to get graphic, but I was just, I ended up gushing blood and I just thought, you know what?

This is not a time to be a hero. I know how important it is to take it slow and prioritize recovery after a severe tear. And this needs to set the tone for my postpartum experience. I’m doing myself a disservice. I’m potentially hurting myself by trying to do it by myself. A really important opportunity to say, Hey, I can’t do it by myself.

And actually I do have support available to me and I need to utilize it. So it was as much about needing the help of setting a precedence of, actually you do need help to get through. Yeah. Yeah. We are going to talk a bit more detail about the postpartum experience in a separate conversation, but specifically when you did come home and you’re still very much in repairing now, it’s what are we?

10 days postpartum, but 10 days postpartum right now. Tell me, how has the recovery been as expected? How, how have you been managing with that healing process? Honestly really good. And I think that’s important to say because. Severe tests, some really scary, and I can only speak to my own experience.

It may be better or worse for others, but what I had in mind about how it would feel and affect me to have a severe tear, it’s been far better. So the surgeon did tell me to expect incontinence for the first six weeks. And that is referring to both ways impose because. Both areas, the third degree tearing.

And that is obviously incredibly confronting to hear for anybody. But for me, I’m 25 and these are not issues that you expect to be dealing with at 25, honestly. So it was really tough to hear. He’d also mentioned that had we. If we wanted to have kids, firstly, he would recommend against it.

Secondly, if we did want to have more children, it would definitely require an elective C-section and that was discussed from the point of view of the reoccurance and tearing. Yeah. Somewhere around five to 10%. So it’s not huge. You can certainly get through birth and a subsequent birth without having another severe tear people do.

But he said from his perspective as surgeon, they can never repair these tears as well. The second time there is just not the tissue to work with. So we’d have these discussions at the hospital, which are obviously incredibly intense. We hadn’t even talked about if we wanted to have another baby after Emmy, I’d just had this one.

And. We’re talking about incontinence and future pregnancies and future births. And so that is incredibly overwhelming. When I got home, it occurred to me that I wasn’t having any issues at all with continents. I was able to wee and poo, and I knew when I needed to everything was working exactly as it should.

And that was, it’s a huge relief. Honestly, yeah we had a bit of a laugh. We were talking about how I take your bowels. So seriously, Judah, he brought me a Squatty potty to get me in the right position. That’s right. It’s pretty potty because yeah. Again, it’s something probably my triggers, but also from the conversations that I’ve had with many women, even without a severe tear, the first poop is it’s just such a big.

Thing. And sometimes it really is incredibly painful and sometimes it’s mentally painful for us to think. I think it’s almost always worse mentally even. I don’t know how many stitches I ended up with, but the certain said ballpark 50. When I asked, so that’s a lot and it obviously sounds horrific to think about, so when you.

Mentally knowing that this that’s what’s going on downstairs, and then they ask you to push a poo out. I was like, oh my God, it was bad enough. After my first baby, when I didn’t have this severe tearing. But yes, I did joke that you took my bowel movements incredibly serious, immediately postpartum.

Kel was delivering me QE foods and stewed apples and all the things. But it is, it’s one of the most important things after a severe terrorists that you’re not straining. So it was something that I had to be super mindful of. But as I said, I realized I had no issues in terms of function and that was such a huge relief.

In terms of pain. Again, it was far better than I anticipated. So people were actually quite shocked. People in my close circle that I wasn’t taking. I guess the hard drugs I was only taking Panadol immediately after and they had offered them to me, but I didn’t feel that I needed them enough to justify using them.

Personally. And I rated my pain around that three to four mark in the day after. And then by day two, day three, it was down to a one or two. So it was definitely uncomfortable rolling over and changing positions. And there was a lot of support I needed from my husband to hand the baby, to me, pick her up for me.

And the biggest challenge was again, feeding her especially overnight, but the pain really manageable. And for me personally, I didn’t feel that the pain was any worse than it had been with my second degree tear. So with my first baby, I had a second degree tear, which required five sutures to repair.

And I don’t know, but I suspect that it’s just a case of it was repaired so well that I didn’t find the pain bad at all, honestly. So I think day three or four, we went to get a coffee at the shops which I know is a big no-no in some people’s minds. Taking the baby out so early, but we had her in the sling and I felt really comfortable with that decision.

So we just minimized walking and when I started to get sore, I said to my husband, all right, I’m ready to go home now. And then I spent the rest of the day lying down. So just listening to my body and following, my own pain and lead to make sure I’m healing. And then by about a week postpartum, I felt really good.

In the papers. Barely anything. And the challenge then was slow continuing to take it slow because. My stitches are still healing. I think the internal stitches take about three months to fully dissolve. So it’s a long recovery. And it’s so easy, especially with a toddler running around to think I feel well, I can, pick him up and things like that.

My husband’s been really good in reminding me go sit down, go lay down. Don’t pick that up. I can do it for you because without that constant reminder that I do have this injury and I have had major surgery, I just felt like I could get back to normal life because I am feeling so well. So that was became the challenges I went on.

And you did have one situation where you did start to experience some pain. Yeah. Worry about that and get it checked. And I think that was a really, again, the mental load of have I done something was almost worse than finding out, but do you know what triggered it? It was just rolling over in bed. I started to get a really sharp pain.

So until then my pain had been dull. And as I sit around that one to two out of 10, and then it increased to more of a 3 0 4 and it was a really sharp tugging all my feelings. Quite deep and internal. And as I said, consistently, that’s been the harder thing for me, the pain totally manageable. It’s the fear that has been really challenging.

And I started to think, oh my God, what if I’ve been taught? I’ve torn some internal student sutures, which is what it felt like to me. What are the consequences for that? Long-term if it’s not identified, if it’s not picked up. So I did end up messaging my private midwife. Yeah. In the time that I was waiting to hear back from her, I was like to my husband, I think I’m just going to call the hospital.

Cause I want to know what the process looks like. If something is wrong, being that I was going through the public hospital. Am I just going to fall through the cracks where they’ll go? Yeah. It’s not really bad enough to justify immediate surgery. We’ll put you on a waiting list. And that was my worst fear.

So we called them and she said, yeah, it does sound like that’s what’s happened. Let us assess them and then we’ll know what we need to do. So I organized for my family to watch Taj, my eldest, and we went in to have them assessed, and that was a really positive experience because last time I’d had my tears assessed, it was so incredibly painful.

And I don’t know I’m going to stereotype here, but the nurse, the OB that did it this time was a female and she was just far more. Sensitive both in her assessment and her approach is very gentle. Took the time to inform me, I’m going, is it okay if I do this, I’m going to do this now. Is that okay?

And I don’t know. I just think maybe you just have a bit more of an awareness of how sensitive those bits are and yeah, so it was really positive. And she said that she thought some had Some had pulled in externally. But they weren’t going to affect structure or function. She was really happy with how the repair had gone.

So part of me had that feeling of, oh, w am I being a hypochondriac? Was I overreacting? But again, I know how important it is to get this initial here, healing period. And I’m a big advocate for, if you think something is wrong, trust your gut, go follow it up. And that’s what I did. And I was really proud of myself for doing that because.

Then it allowed me to come home with peace of mind and to know this pain is normal. Keep doing what you’re doing and yeah. To not have to worry that maybe something was wrong. Great. We asked her quite very much inside of your healing process. And I’m sure we’ll pick this up down the track as you reflect on your overall process further down, because the postpartum period goes for much longer than what society tells you certainly longer than 10 days

would be lost it. I’m sorry. I just had a funny connection in my headset. So what. I’ll pro I’ll cut this out. Sorry. So in terms of the wrapping up. The tear one, one of the important things to talk about is with particularly first-time mothers, but often second time mothers, also the fear associated with what if I get a tear.

So I really appreciate that you sharing a lot of detail about that and taking some of that anxiety away to know that there are care providers who know that there’s great opportunities. Them repaired well heal well, but as we, the rest of the birth experience, how you rest and nurture yourself and your baby and take that healing seriously is also really important in making sure that you do allow your body to heal.

Yeah. And I think the important thing to notice that I wouldn’t change anything about my birth experience, so yeah. I think there’s this tendency to try to locate where we went wrong, but I had none of the risk factors for a severe tear. When we look at things like a large baby gestational diabetes in terms of age and all those things, I have none of them.

And. I think there was a time where I had a conversation. There was a time where I have had a conversation with my midwife about if I was to have another baby, what could we try to do differently? And she navigated that with incredible sensitivity, but I still walked away from it thinking. Oh maybe this was my fault.

And prior to that, I had felt like a rock star. I was like, I rocked this birth. I went through this major surgery look at me, go I’m incredible. And after that conversation, I started to have this doubt creep in of, oh, maybe it was my fault. My pushing stage. I was incredibly vocal. I was, I did not calmly breathe the baby out.

I had chose to sit on the birth ball the entire time, which has that squatting position, which puts a lot of strain on the paraniem. I birth standing up, which has slightly higher rates of tears. And so then I started to think, oh, maybe this is my fault. Maybe I should have been more calm.

Maybe I should have been more relaxed. Maybe I should’ve been more compliant. But at the end of the day, I birthed instinctively and undisturbed. And that is the most protective thing when it comes to reducing your risks of severe tears. And it’s so easy with hindsight to go maybe I should have done that differently.

Maybe we should have done that differently, but. We can’t make decisions from hindsight. And secondly, the birth unfolded with such speed and such intensity that no one really had the time and we couldn’t have anticipated that. This is how it would have unfolded likely the tent just resulted from the fact that she was so incredibly quick.

So I think it’s really important that regardless. How these tears happen that, we don’t blame ourselves for them. And I think it’s incredible that we’ve birthed our babies and that we’ve gone through this experiences, having a tear and having it repaired. And it’s really tricky territory.

If you start to try to identify what you did wrong, what you could’ve done better because at the end of the day, if you’ve made informed decisions, Along the way that’s all you can do. And we do understand that things still happen in birth. And that was the case here. It was just a case of bad luck I believe.

And I wouldn’t have made any different decisions. And in fact, I think that had we been planning a hospital birth, it would have been a worse outcome. Likely she would have been born in the car. Firstly, I had really only about 20 intense minutes of labor. The rest is very manageable. I was happy at home.

I wouldn’t have considered leaving the hospital until that 20 minute period. We are more than 20 minutes away from the hospital. So I think that she probably would have been born in the car. I, if I had been going through the hospital system, she was born at 41 plus three. So we likely would have been talked into an induction beforehand.

Inductions have higher rates of tearing. I think that was really important for me to know that I had made informed decisions, the whole way that I had this incredibly positive, empowering birth, and sometimes things happen. And when they did happen, when something did, air quotes go wrong, it was handled incredibly efficiently.

It was handled no different to how it would have in a hospital. And we still had those moments of real, bonding and connection and choice leading up to it. Alongside the poor me was intense gratitude, firstly, that it wasn’t worse. Secondly, that it was handled so efficiently and effectively.

And thirdly, that I’d had the opportunity to have that incredible birth to really empower me to then deal with what was to come and I’m only 10 days in and there’s still a lot. A long journey. So I’ll see I’m a pelvic floor physiotherapist in about a week. And then six weeks postpartum, I’ll see the surgeon at three months postpartum.

So then there’ll be able to really explore what my, what the function is like and if everything’s repairing well. But in terms of my experience so far, it’s been far more positive and far less scary and painful. I imagined it would be. So I think that is really important to share because there’s such a lack of information yeah.

Available on what there’s plenty of information on tape, but so little discussion around what that experience is like for women. And it can be really isolating, we’re dealing with a really sensitive part of the body and there’s a lot of shame associated with that, especially if it affects things like continents and your sex life.

I think it’s important to share that so far, my experience has been better than I anticipated and important. Yeah. Seek to get that you felt that was a right thing to repair it because there is also a cohort of women who have not sought that and have then lived for many years with something that potentially could have been repaired.

And that’s a much bigger obstacle to go back up or a number of years and say can you have this repaired? Yeah, huge. And I think that is something that the pelvic floor physiotherapist women’s health physio said to me after she said the silver lining of third degree TEDS is that we actually really stay on top of management and repairs and recovery.

And we really make sure that we are keeping you on the right track. Whereas in the past, I think they had not received the appropriate care and attention. So really grateful that it was handled so incredibly well. Awesome.

Oh, and the last thing I wanted to add is that I did actually probably about a week postpartum. Yeah. I got the courage up to have a look with the mirror, which I didn’t get to use during the birth, the mirror I intended to watch the baby crown with, during birth that did not get used. I said to my husband, all right, I think I’m ready.

I’m ready to see the damage. I’m going to take a look. And he was kinda like, oh, do you want to do, that’s probably still really swollen. And that kind of, don’t be too hard on yourself. It’ll continue to heal and change. But I went and had a look and I came out and I said to my husband, I reckon it looks better than before.

Low-key I think they’ve done me a favor, firstly, and I know that’s a concern for a lot of women. Firstly, Volvo’s vaginas are weird and men don’t know what they look like anymore. They’re all so unique and different. I don’t think anyone would notice. And secondly, it looks far better than I anticipated.

If that’s a concern of yours rest assured I think they’re incredibly good at what they do. And so far it looks great. Yeah. And that’s a fantastic place to wrap up on is just trusting your body and knowing that the way that our bodies look. ALS, and it’s actually quite incredible how much your body returns and repairs, not to the same thing, but returns to a healthful state.

And that’s a mind shift for sure. And I think, we have a long journey to go, but so far it’s been a beautiful, yeah. Connecting and empowering experience for my husband and I, and he’s really supported me and marveled at what I’ve been through. So I think that’s a concern for a lot of people, but it can be more positive than you imagine.

Wonderful place to wrap up. Thanks for sharing your story. Thanks for letting me tell it.

Yeah.

Kelly and Bree


kelly@birthofamother.com.au
brianna@birthofamother.com.au

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