Tag Archives: pelvic floor pain

Birth Injury – Common But Not Normal

Rant alert.

Each week women come into my office with a troubling problem that their doctor, midwife or even physical therapist has told them is normal.

I am here to tell you that:

Wetting your pants is not normal. Ever. Not if you just had a baby. Not if you are doing Crossfit. Not if you are walking on the beach. Not if you sneeze. Not if you are pregnant. If you are wetting your pants, there could be a few causes. The main ones are each that your pelvic floor muscles are too strong and tight or too weak and lax.

“Urinary incontinence,” the technical term for “leaking” or “wetting your pants” is common however. You don’t need to panic or feel bad. Many women experience less bladder control during pregnancy and birth. It is not a life sentence or an inevitability.

Seeing your organs from your vaginal opening is not normal. If, in any position, you can see your cervix, your bladder or bulging from your rectum into your vaginal opening, this is not normal. If you have to manually push your organs back up and in, that’s also not normal.

These are all signs of organ prolapse. Unfortunately, because many doctors don’t know what to do about organ prolapse, they tell many women that it is normal. Many women avoid sex, feel unsettled and sad about the state of their lady bits, and generally confused by the disconnect by what they are feeling and what their health care provider is reflecting back to them. It doesn’t have to be that way.

Pain during sex or avoiding sex is also not normal. Total aversion towards sex, pain upon penetration, or pain internally is not normal. “Low libido” is a term that seems to define a fixed thing, but actually refers to a whole combination of factors that could contribute to feeling what you might throw into the category of “low libido.”

All of these are common. There are many reasons you may experience pain during sex, including lack of lubrication (nursing requires a lot of moistening), lack of sufficient arousal time, lack of emotional connection, scar tissue that burns or is pulling the pelvic muscle tissue in different directions. “Low libido” is a term that seems to define a fixed thing, but actually refers to a whole combination of factors that could contribute to feeling what you might throw into the category of “low libido.” Aversion towards sex may be the visceral fear of returning to the area that had to completely reshape, resounding echoes of birth trauma, a changed view of what you want out of sex and relationship currently or physical birth injury that affects your relationship to your body.

The main reason to understand that these things are common but not normal is so that you can GET SOME HELP. If we see them as normal, that basically infers that we need to suck it up and live with it. When we understand that it is common, but not at all optimal functionally, we can do something about it!

SO, What can you do about it?

Healing is multi-faceted and individual, so I cannot give you one answer that fits for every woman. However, here are a few starting points.

1. If you haven’t already, explore yourself in a hand mirror. We often have a distorted image of what we look like, because of how we feel. Really look at your vulva, and see how it is. Allow for the feelings that come up. There may be real grief, surprise, or even relief. This will take everything out of the realm of imagination and allow you to see things as they really are.

2. Follow your intuition and what you see. If you KNOW something is not right, it isn’t. It doesn’t matter if someone tells you you’re are fine and normal. There is a reason that you are not feeling fine or normal. Find a pelvic floor physical therapist trained holistically by Tami Lynn Kent or a Sexological Bodyworker who has experience in working internally and seeing the whole of who you are. You need someone who can work sensitively. You may experience an emotional release or a resurgence of grief about your birth story. This is part of the healing process.

3. Be patient but not complacent. Being a new mom can put you in a fog, where everyone else’s needs overshadow yours. In fact, you may only be cursorily experience these symptoms- really feeling them. Some women don’t notice they are avoiding certain positions during sex because of pain, for instance. Taking care of an infant is a full-time job, balancing that with work and partnership can be overwhelming. It is understandable that some of these physical needs have slipped into the backdrop. But now that they are in your awareness, take action. Don’t push through exercises that you have a sinking feeling are exaggerating the symptoms you are feeling. Reach out for the help you need.

4. If you had a traumatic birth experience, not what other people consider traumatic, but what FEELS TO YOU like traumatic, it is CRUCIAL that you get support to process it. Pam England, author of Birthing from Within, offers online Birth Medicine sessions. I study with her, and I cannot recommend her highly enough. She is a true wise woman- she has worked in birth for over forty years and has medicine for each woman and each birth experience. I also highly recommend Somatic Experiencing trauma resolution. Better yet, someone trained in pelvic floor work together with trauma work. Resolving birth trauma is at the root of healing symptoms. Your body won’t let you skip this step. Invest in the step soon!

It is important that we “normal”ize the range of women’s birth experiences, including ecstatic ones and orgasmic ones, so that as women we expand our vision of what birth can be.

Pass this information on to your friends.  Women everywhere need to know that full healing from childbirth is possible, with the right support!

*Thanks to Jane Austin for this important linguistic distinction.