“Help my vagina is broken!!”
Were the words a friend said to me when I went to congratulate her on the birth of her beautiful new baby boy. She was in a state of shear panic, absolutely horrified that she ‘might never be able to have sex again’.
I was working on the maternity ward at the time and the midwife had asked me to go and see the lady in room 5, who I then realised was a friend of mine (one of the hazards of living on a small island). From a medical perspective she’d had a ‘normal vaginal birth’ with a couple of labial tears and a second degree tear, she had been pushing for a perfectly reasonable 30mins and no instruments or assistance was needed. But she had had these tears and of course substantial tears at the devastation of what this may mean for her future. A young girl never to have a decent sex life again, were her first thoughts after having her baby. I tried my best to verbally reassure her but this was not helping so offered to examine her, a look of relief came over her face, ‘Oh please, could you? Would you mind? Is this what you do for your job?’, she asked all three questions at once, confused “I thought you were a physiotherapist?”.
And as a matter of fact it is what I do for my job and I’m a physiotherapist. As a pelvic health specialist my role with my friend, and 100’s of women like her, is to examine and establish what is wrong, then help her to understand what is wrong, how best to help her heal and then how best to help her return to her previous normal function – aka to be able to have sex without a broken vagina.
‘So it’s broken, isn’t it?’, she said, white as a ghost a tear trickling down her cheek.
My response, “ No, it’s not broken at all, it is absolutely fine and completely normal for just 6 hours after a vaginal delivery, but I imagine it feels nothing like normal right now. You have a couple of high labial tears that come up either side of your clitoris which have been stitched really nicely and a second degree tear which has also been stitched really well, I’ll explain what that means in a second… and there is just a little bit of bruising but the wounds are really clean. Can you do a pelvic floor contraction for me? Imagine you are just stopping yourself from going for a pee and you can just imagine your are lifting the front part of your vagina up”.
I could see a slight quiver of the muscles around the entrance to the vagina and a very slight tightening of the muscles of the perineum (the part of muscle and skin between the vagina and the anus).
“That’s great, well done I can see the superficial pelvic floor muscles working a little, could you feel that?”, I asked.
“Yes, I think so, it’s difficult to tell what I can feel down there. So you think its going to be ok?”.
“I think everything is going to be just fine” I reassured her. But it wasn’t just reassurance for her, I too was reassured that the wounds were neatly stitched and really clean and her muscles were working, if only just a little bit, and also importantly that she could actually start to feel them working. I went on to explain what the labial tears were and what a second degree tear was, how she could help the wounds to heal well and how to rehabilitate the pelvic floor muscles. She seemed happy enough when I left to see my next lady.
It was not until a few years later though that she reminded me again how she felt at that time, and how pivotal that first appointment had been for her. How she genuinely had felt that she was broken, but felt afterwards that there was hope, and that she had a plan in place to help get better.
Not every woman is able to be seen by a Pelvic Health Physiotherapist straight after they have delivered their baby and some women, like Jane, can carry on through life still feeling like Jane did after she had her baby.
