FTM questions bad postp/ recto/perineo?

Submitted by ppkate on July 31, 2017 - 7:39pm
Body: 

Hello all,
I have been reading these threads for over a month but only posting now - have a 3 month old and having trouble finding time to post! I noticed something wrong immediately after giving birth - believe I have a rectocele? But not entirely sure.

Pregnancy was pretty normalish, I left my OB for a midwife early in care as I wanted to avoid birth interventions (now I think I should have stuck with an OB maybe or gotten an epidural). I had really bad lower back pain so much that it was very difficult to walk at about 30 weeks, after a long car trip, I could barely walk but I pushed through it and kept forcing myself to walk miles every day. I also have always been active and lifted heavy things - I lifted a bed and couch while heavily pregnant. Had some straining and constipation issues which I now know is bad but the midwife didn't seem concerned when I complained about it. In the end of pregnancy, I had to pee so often at night I was waking up like every hour. I felt like I had a full bladder but didnt - I just assumed this was baby on my bladder but maybe I was starting to prolapse?? maybe a tiny bit of dribbling at night when I was really big? Also noticed a hernia about halfway through - seemed to be inguinal. Showed midwife but she didnt say much.

Birth was incredibly painful and my contractions started out 1.5 minutes apart, after 18 hours of labor, had very fast second stage, the nurse and midwife suggested birthing stool (which was too small for me I think) I instinctively wanted to lean forward to birth standing but took suggestions and ended up squatting in a bad position and basically leaning back to blow out my organs. I agreed as I was in so much pain and out of my mind, anyways I now cringe as I think this is what has caused my problems - I pushed incredibly hard - the midwife just kept saying "do what your body tells you" - I felt the urge to push and immense pressure but I also pushed beyond that with all my might, my legs were shaking as I leveraged my body against them to push. I didnt know I could do so much damage to myself. I was freaking out about him getting stuck or something happening to him and when he went backwards after crowning, I kind of went wild and pushed like I was dying (thought I was dying) and then pushed between contractions when his head was out to get his shoulders out. He was over 9 pounds as well with huge shoulders..He was born in about 14 min pushing, suffered a "1.5 degree tear" but really a 2 - or a 3 in my opinion. Checked myself about a week later and there were no stitches, went back and midwife restitched the area .... still left about 1 cm more open than before. Had granulation tissue that was silver nitrated x 2 at 10 and 11 weeks. After birth I was encouraged to be up and I was walking and lifting the next day I felt really weak and lost 30-35 pounds in 2 days.
I have always had bad posture and have history of eating disorders, sucking in stomach and my hip bones stuck out - stupid "tucking posture". wouldnt be surprised if my bowels were messed up by years of abuse. Anyways I have been trying my best to adopt the posture and purchased the FAFP dvd.

Now I have bad hip pain, lower back pain, rectal pain,. fissure, pressure, incomplete and very difficult evac feeling/ multiple trips, was splinting the peri area but now doesnt work, cant find a bulge to push on in vagina. I do have that falling out tampon feeling at times, have been trying not to strain and have been changing my toilet position, taking dulcolax and magnesium (which has made my baby have loose watery stools :( It seems like it has gotten worse and is incredibly painful now.
I cant find a rectocele however, and its bad when I immediately have to go to the bathroom in them morning but it cant come out - have to push on anal area, and seems like my sphincter has hypertrophied or something. I cant even pass gas! It all just feels like very weak in the area and bulgey around my peri and butt. Ive had 2 OBs and a midwife check my rectovaginal septum. I also found out I tore up the back wall of my vagina not just down the perineum. The midwife and OB said the tissue was thinned. The other OB denied anything wrong on exam and no bulge but I was laying down said I may have a "perineocele" but need to heal more and come back in 4 months. It doesn't make sense because why would the rectum be all loose and inflated - from straining to push baby out??? I tried to do self exam but cant see any bulges, its almost like no opening just pink tissue and I cant feel any bulges. Know it is bad from symptoms, however.
I have been walking in posture, tried to swim but felt like water was going up there - sucks.
I have been very depressed about this. Surgery scares me so much and the slippery slope that can happen - but I don't think I am as strong as all of you to live with this. It hurts, I totally didn't expect this or even know this could happen. I feel like the birth was a disaster and I have let my body down/ didnt listen to it. OB says could be from fast delivery and pudendal nerve damage?

I know from reading on here that postpartum healing takes awhile and can get better but seems mostly with incontinence and bladder - which I don't have. However, I dont feel like I can live with these symptoms. Its almost like my rectum has no muscles and I have this image of it just lying flat. Has anyone had this heal or get better at least? Could it be something else besides POP or something more complex/ Im really still in the agony stage of accepting this as I had no problems going to the bathroom before this and now its like taking over my life.

I read Christine wrote that the vaginal sphincter is dmg forever and cant be repaired - because I tore, and then was stitched up the back wall does that mean the two sides can no longer move independently?? (Like a posterior colp without any benefits) ??
Is it poss to have rectocele going opposite way?
Sorry for long post and bad editing- new baby. BTW Im 30, wanted another child but now am scared and cant imagine how much worse things will get. This has taken away all my joys. I read about surgery and some haven't changed since the victorian age ... awful:( I feel so bad because my baby is so amazing and didn't do anything but I find myself regretting having a child, or would have educated myself better to avoid this. I keep thinking it was the birth and pushing that caused and that is all my fault.
Anyways, thank you all for being here and the help you have given all women.
-K

Forum:

Christine

August 1, 2017 - 12:24pm

Dear Kate,

Congratulations on the birth of your beautiful son! I am very happy you are so aware and introspective, which will make all the difference going forward. There is no surgical solution for what you are experiencing.

We really have no way of knowing exactly which tissues or nerves are causing the worst symptoms. Also, we only deal in generalities here and provide education, not medical advice.

However, I can offer a few ideas.

Obviously, you were set up for this condition a long time ago, and pushing against the birthing stool when you really needed to be on hands and knees was the coup de grâce. I do not agree with the common midwifery suggestion to “do what your body tells you”, because it’s very hard to know exactly what your body is telling you when you are in such an altered state and you have not been educated by a maternal line or birth custom.

What is needed in midwifery (OB is hopeless in this regard) is an understanding of the true anatomy of the female body, how the pelvis actually moves, and the physiology of the birth process itself. To see how the pelvis opens in natural human birth, click here. Now rotate that image in your mind onto a birthing stool, with tailbone tucked under instead of maximally lifted, and you can visualize how the geometry of birth is greatly compromised in such positions.

I think it is very possible that you are experiencing intussusception as your primary symptom. This is when intraabdominal pressure has been so great that it has peeled off the lining of the rectal wall, which has now telescoped down onto itself to obstruct defecation. There is no surgical treatment for this, which does not come without extreme risk of lifelong and far more debilitating symptoms.

It is also true that estradiol supports the female anal sphincter, and when estrogen levels are low, as in the breastfeeding mother, the anus itself can become bulgy, squishy, and hemorrhoid-like. I experienced this myself at menopause, and drinking 2 large mugs of red clover tea every morning, which I continue to do to this day, quickly and completely resolved the symptoms. Red clover is a powerful phytoestrogen that has high affinity for the estrogen beta receptor, which causes normal transcription at the level of our DNA. Check with your local herbalist, but I believe after pregnancy red clover is extremely safe - for 1,000 years it has been known as our major anti-cancer herb. The reason why is that metabolites of the different forms of estrogen can cause some of our most catastrophic diseases. Phytoestrogens have high affinity for the beta receptors these metabolites would otherwise occupy. ***During gestation, I believe powerful phytoestrogens can play a role in sex differentiation, so it should be avoided during that time.***

You have a variation of the same pelvic organ prolapse we are all working with here. Yours seems to be in the “back passage”, which I addressed in a blog post a few years ago: https://wholewoman.com/blog/?p=948.

I believe you are aggravating the situation with the laxatives. You need to heal your bowel by providing naturally fermented foods and a low-meat diet. A little raw sauerkraut or raw milk yogurt would be infinitely better. A little raw, local honey each day would support the mucus membranes of your bladder and bowel. Vaginal honey may be very helpful as well. We older women are applying raw honey high on the vaginal walls once or twice a day to re-create the microbial ecosystem present during the reproductive years when estradiol levels are high. It works like magic (thank you Mother Nature!)

Vaginal honey may very well help resolve your hip pain as well. The hip synovial membrane has its own microbiome, which is very susceptible to contracting bad bacteria and producing painful symptoms. Our WW Practitioner Jannelle Rethus in Australia, who has been a successful chiropractor for over 30 years, is seeing very good results with regular use of vaginal honey for relieving chronic hip pain. Amazing but true!

You are very bright and have a good grasp of the WW work. I would be shocked if within 6 months of responding to your symptoms in these ways you weren’t feeling markedly improved. A good diet, using WW toileting position, and WW posture are essential.

Please begin to consider birthing vaginally again - this time to improve your symptoms, not make them worse, because now you will be educated as to how your body is supposed to work. When the baby is moving through your vagina (in an open pelvic position), her head and body are pushing the rectum and bladder into their normal positions. We have many mothers here who have gone on to birth 2 and 3 times post-prolapse.

Trust in your body, and always remember that our bodies don’t end at the boundary of our skin, but extend out into nature.

Wishing you well,

Christine

ppkate

August 2, 2017 - 2:37am

Dear Christine,
Thank you for the kind reply and fascinating information. You have a wealth of knowledge. Not sure about the red clover ( how interesting this is) -if its safe for breastfeeding a boy, with the phytoestrogen?? I will try it as soon as I can. It is hard to get over the fact that my decision to go with a midwife and trust that labor is natural, has changed my life forever - wish I could go back in time. This birth was in a hospital btw. Didn't expect to have a baby and feel like life is destroyed. I will take your advice and really appreciate it. What did you mean by another vaginal birth improving symptoms - just because it will be easier if done the right way? Thank you again.

Christine

August 2, 2017 - 10:54am

In some important ways a hospital birth is a hospital birth, even with “nurse midwives” in attendance. Hopefully you can shift your focus now to taking more responsibility for how you manage your body. Read old posts by fullofgrace, alemama, and granolamom. These women all had “WW babies” post-prolapse. None of their symptoms were made worse by vaginal birth, as they were improving overall. The body is perfectly designed to birth while protecting against prolapse. Keeping the uterus forward postpartum is essential. The estrogen beta receptor really has anti-estrogenic functions. It is a misconception that phytoestrogens add more estrogen to the body. However, estrogenic plants like hops do have high affinity for the estrogen alpha receptor, so it is not cut n dried.