Warning: This post contains graphic descriptions and images of birth trauma, and may be triggering for some readers.
After the birth of her first child, Stephanie Thompson suffered a severe pelvic organ prolapse. You can read about her experience in this article. Here, Stephanie shares how she copes with her condition every day.
Living with a prolapse.
First I want to run through the actual physical damage from my traumatic birth, what this means now and why we even need to work around these hurdles. I think being able to communicate this, and encouraging other women to speak out, is important. I would also like to add these hurdles and workarounds are on top of what is already a bullshit-hard job. Being a first-time (and second-time) parent is exhausting – lovingly exhausting, but exhausting.
Here is my official medical diagnosis: “Stephanie is presenting with a markedly symptomatic three compartment prolapse, the bladder leading against the background of severe ballooning and a complete right-sided avulsion … this means the right-hand side was disconnected or torn off the bone … the 4D pelvic floor imaging confirmed the clinical examination findings … bladder prolapse, minor descent uterus and a complete right-sided pelvic floor muscle tear.”
To put this in terms I understand, my pelvic floor is only half there. The right side is simply ‘flapping around in the breeze’. The left side is carrying the load, doing all the work. No wonder it gets tired trying to hold up all those organs.
Mums and non-mums answer questions about childbirth, and their answers were very different. Post continues below.
From my very first appointment with my doctor, there was always talk and an expectation about this end goal of having some kind of repair surgery, reattaching the right-side muscle back to the bone. That sounded pretty simple, and then I’d be fixed. Yay! Having the surgery just meant we had to be sure we were finished having babies, because having surgery was pointless if then taking the risk of it relapsing. After our son Louis was born our happy little family was complete. So very complete. It was time to get that repair work done and get back to being the old me, the mumma I wanted to be.
It was early January and some preliminary testing required prior to surgery – called urodynamics testing – had to be completed first. By the end of an appointment of being catheterised, poked and prodded in the vagina and anus, I received one of my biggest blows of all time: ‘Stephanie, I’m very sorry to have to tell you this, but the damage is too extensive. The conventional surgery option would likely have a 90 per cent failure rate.’
I was very much advised against surgery and told that ‘no current surgical method is available that can effectively reconstruct a pelvic floor muscle that has been damaged to such a degree’.
So this was the biggest hurdle – bigger by far than our legal bill. How do we get around this one? I’ve always been both a practical and creative thinker. If something doesn’t work, just try something else. And if that does not work, keep trying until you find that thing that works.
This time, however, we had reached the end of the road. We had nowhere else to go, nothing else to try to be fixed. It’s funny (but not haha funny) how we adjust to things better as time goes on. It was so hard to hear that news, but we had to move forward. And so we started getting even more creative.
Physical workarounds.
Below, I've provided a list of hurdles we have discovered along the way. More importantly, it also outlines how we have got around these hurdles. The workarounds are not recommendations coming from someone with a medical or professional background in pelvic floor function. They are just what have worked for us as a way of moving towards being as normal as we were before the birth.
During the process of final edits for my book, The Day My Vagina Broke, I thought I’d start sharing a few of these workarounds on a private Facebook group I created called Tips & Tricks for living with POP (pelvic organ prolapse). I didn’t want other women to wait months before this book was released to get some additional support. And what started as a few friends has grown exponentially with each week. A minimum of ten women have been requesting to join per day, from all around the world.
This tells me this is much bigger than me, and much bigger than I could have ever imagined. And to know it is so big and yet still so taboo feels overwhelming. I move through this by focusing on the small wins: helping at least one more woman who may be living in silence.
Pain when walking or standing.
Choose where you need to use your non-pain period each day. Mornings are best for me and pain increases with the hours in the day. I try to have planned breaks of sitting or, better yet, lying down during the day (although this is not always achievable). Meal prep, for example, is done in the morning or even on the weekend when I have more help at home.
Showering.
We bought a plastic chair for the shower. This helps me at night to wash my hair or shave my legs. Trying to lift one leg up makes the prolapse so much worse.
Baby tools.
Our first pram was too heavy for me to lift so we saved up and purchased a much lighter one that has two separate parts to make it easy to lift. And forget the nappy change table. We had a foam mat on the floor to reduce the lifting up and down. It is easier to sit down than try to lift all day.
Food.
I try to eat foods high in fibre to keep stools soft. And I take dietary fibre and a probiotic to avoid any straining when I eat junk food. Pushing and pressure are no good. Water is good. Finding that sweet spot of not too much or too little can be a bit tricky.
We have tried a range of the meal prep kits such as Hello Fresh. They made things easier in the sense we didn’t have to think (and they are very yummy), but a bit more prep was required compared to what we normally did. The best thing that works for us now is a two-week meal plan. Each fortnight, I sit down and decide what to have, only buy ingredients for those meals and prep for those meals. This takes away the element of having to think about what to have each day.
Toilet.
I recently watched a YouTube clip on how to ‘use’ the toilet with a prolapse to avoid pushing down. (The process is hard to explain so check out the clip by going to YouTube and searching ‘how to empty your bowels without straining’. You’ll see you have to make some weird sounds, but it works.) I only do it at home. I use this technique in conjunction with a step stool to raise the knees. I also try to know where the next bathroom will be, and apps are available that can tell you this.
Just like the kids, I go before we leave the house and when we arrive at our destination. It might be a bit over the top, but I go often to avoid wetting myself. I also always take a spare change of clothes for me too, in case I don’t make it – or the public toilet is not okay.
Exercise.
Exercise is my way to feel better both physically and mentally. As someone who once loved triathlons, I miss running a lot! Finding exercise that works for me has taken a lot of trial and error. I now know sitting is better than standing, and lying down is better than sitting.
Finally finding the right exercise physiologist has made all the difference. My program is tailored and adjusted each week. My exercises are done lying down on a ‘reformer’ bed. Knowing how to actually do a pelvic floor ‘lift’ was imperative, and this was done with specialist 3D scanners and medical instruments so I could physically see on the screen what a good lift looked like and felt like. (Turns out it was very different from the ones I thought I was doing right.)
Getting out of bed or off the floor.
Instead of sitting up like when doing an ab crunch, to get up I roll to the side and flip onto all fours, and then use my legs to push my body up so no pressure is placed on the tummy. And I always think about engaging the pelvic floor before getting up.
Lifting little people.
This is a hard one. We worked around the nappy change thing, but lifting in and out of the cot or pram is unavoidable. It was easier when they were super little, and Elsie ended up in a ‘big girl’ bed before she was two, which meant no more lifting. Now they are a little older, Elsie doesn't need any help and I get Louis to climb up as much as he can, and just support him. When they cry I sit on the ground to hug them. I do lift when I can, but try to get them to climb up on a chair so I’m only lifting halfway, and then we sit on that chair to cuddle. And I always brace or engage my pelvic floor first.
Washing.
For a little while I would manage each load of washing by walking a few things at a time to the clothes line. Then I got smart and purchased a portable line with wheels. Then I got even smarter (with the help of my amazing exercise physiologist, Karlie) and purchased a washing trolley just like the one my nanny used for her Hills Hoist.
Making the bed.
This is a job I leave for hubby. Or I ask my family to help when they visit. (We have found that family and friends like to feel helpful. When they are asked to help with something specific, they are more than happy to do so.)
Period.
That time of the month is horrible. No more tampons, because they simply can’t stay in. Pads are the only option. I didn’t swim for a week out of every month, until I was put onto the new swimmers and undies that are designed for this very thing. I only use the swimmers right towards the end, for the last day or so of my period. A few different brands sell these specialised undergarments now, and I personally use Modibodi.
Cleaning.
When we can afford it, we use Airtasker to get someone in to help me vacuum, mop and scrub the bathroom. The best lifesaver for me was the robot vacuum. Two small children sure do make a big mess when eating three times a day (or more). Our poor robot vacuum sure does get a workout. Along the way I also discovered that a steam mop is much easier to use than a conventional one, with less friction and so less effort required.
Strange but super helpful.
I was struggling at night-time bathing and the clean-up afterwards. Trying to carry the dirty pile of clothes around to the laundry was not helping my symptoms. I asked Tom a random question: to save me walking all the way around to the laundry, could he just cut the door in half so I could throw the clothes into the basket from the hallway. He looked at me strangely, and then did just that. He created an internal barn-style door so no-one else has to know but us (until now, anyway). The point here is to try to think outside the box (pardon the pun).
Pain management.
I have avoided the big gun pain meds from the GP because I didn’t want to add another layer of complexity to this already hard situation. I have wrongly used self-medicated legal pain meds in the past (by this I mean wine). That only works for a very short period of time. I’m not drinking like that anymore after I had one glass too many one day and the pressure on the prolapse from vomiting far outweighed any benefit of numbing the pain.
Again, sitting is better than standing and lying is better than sitting. Being horizontal is the best thing for the prolapse, and the longer the better. This may not be practical but it works for me. We have discovered along the way that saying I’m in pain doesn’t really help – anyone. So we’ve come up with a scale: 1 to 4 means I’m okay but should start thinking about our next rest, 4 to 7 means I need to take a break for a bit, and 8 to 10 means I’m done, and you need to take over until I’m okay again.
This is an edited excerpt from Stephanie Thompson’s new book, The Day My Vagina Broke, $29.95 from Publish Central. It is available to purchase on Woodslane.
For more information and resources about birth trauma, visit the Australasian Birth Trauma Association.
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