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Pelvic Floor Damage in Childbirth
By Dawn Lewis
A recent experience has me wondering about women’s health. Three weeks ago, in an SMRT class I was teaching in Tucson, I had an experience with a young woman I will call Ayla. Throughout the first day of class, I could hear Ayla telling her partner that she was uncomfortable and that everything her partner did hurt. At the end of the day, Ayla was standing at the front of the room, holding onto a table, unable to straighten up. I asked her if she was okay. She said she just needed a few minutes. She began to talk about how she hadn’t let anyone touch her in years, since she gave birth to her son and tore during the birth, which resulted in 30 stitches.
I asked her to lay down on the massage table closest to us. She did. I began to palpate her shoulders, which is where she said she was feeling the pain at that moment. Both of my teaching assistants came over and began to touch her. We all had the same look on our faces. I told her that I felt like she had quite a bit of fluid in her tissues. My TA’s then verbally confirmed that they felt the same thing. She had systemic fluid buildup in her tissues. She said that since the birth of her son three years before she only urinates once a day, no matter how much fluid she drinks.
My take on this is that Ayla’s kidneys were unable to even receive the fluid that should come to them on a daily basis. So much urine was backed up in her urinary system that the system could not take in any more fluid. This led to the fluid leaching into the tissues in her entire body. She was extremely tender to the touch. The fluid was creating toxicity in all the tissues in her body. This is a dangerous situation, as I explained to Ayla, and could, in my opinion, lead to kidney failure, sepsis, high blood pressure, a heart attack, a stroke, etc.
Throughout the class we worked with Ayla. By the end she had urinated almost 10 times in three days. Her story, though, hit a personal cord for me. My daughter had a similar childbirth experience, but with many more stitches. An inability to fully empty her bladder is one of her symptoms when her scar tissue is not controlled. Ayla and my daughter are the same age. I felt that Ayla’s situation could have led to death or the development of permanent damage that left her disabled. What would have happened to my daughter had she not been the daughter of a therapist?
How many women in the world are left with pelvic floor damage after giving birth, are unable to have sex, unable to urinate, and walking around in pain? How many women have seen their sex lives ruined because the scar tissue causes too much pain when intercourse is attempted? Has this led to the loss of their current relationship? And possibly led them to have no other relationships? What has this done to their bodies through time?
Just as a hypothetical, imagine a woman who is married and pregnant with her first child. During child birth, she experiences a pelvic floor muscle tear and receives stitches. Six to eight weeks later when she attempts to have intercourse with her husband, she is in too much pain and unable to have intercourse. She is too embarrassed to talk about what she considers a “failure” and refuses to try again. She finally informs her doctor, who tells her to “just give it time.” But how much time? When she is willing to attempt intercourse, the pain stops her each time. The passage of time is not fixing the issue.
Along with the damage to her personal relationships, her body hurts much of the time. She exercises less, and is unable to play the way she wants to with her child. She gains weight as she moves less. The systemic fluid in her tissues cause her pain everywhere in her body and with everything that she does. This is not the picture of a desired life, but I suspect it happens to more women than we realize.
A colleague of mine recently said, “my body feels so much better after our trades. What do people do without, well, without…..I mean, how do people age without, well, us.” Then yesterday, a client said the same thing to me. He said, “you have kept me mobile and saved my life on more than one occasion. I don’t know how people do life without someone like you.” I suspect he meant quality of life instead actual life. My daughter concurs. Ayla was a sharp warning for both of us. It was a picture into what could have happened to her had I not been her mother or had I not pursued the things I have in life.
Ayla told me that she had recently begun having intercourse again after three years. I told her that she needed to make sure she knew who the vaginal PT in town was, she needed to think of intercourse as therapy and do it once or twice a week, and if she did not have a partner at any time, she needed – and I apologize if I offend anyone – a crystal phalis, which she could freeze and use to do therapy on herself.
I see women, young and older, on a regular basis who have had physical trauma during childbirth. It saddens me that some of these women have waited years, and sometimes decades, to get the help they need. They have spent much of their lives not living well because they chose to have a child. So often they do not request the help they need because the area of the body their trauma is in is a private area and they are embarrassed or ashamed.
But this is not about whatever shame or embarrassment we have around our bodies or our sex lives. Not speaking up about the consequences of the scar tissue created by the pelvic floor damage caused during childbirth can be life threatening – and I mean actual life and quality of life. I am ecstatic that the bodywork modality I created decades ago, Spontaneous Muscle Release Technique or SMRT, has helped my own daughter, Ayla, and the women I see. It is fantastic that other bodywork modalities can help women who are having this issue. But therapists generally do not work on the abdomen without a reason, and there are so many women who simply do not speak up. That needs to change immediately.
