Birth Stories

Undiagnosed Third Degree Tear – Leanne’s Story

undiagnosed third degree tear leanne

Trigger Warning: This birth story contains details of vaginal birth, undiagnosed third degree tear, faecal incontinence, ileostomy surgery and hospital neglect. . If you are triggered by these topics you may wish to skip this blog or read it once you have support available. If you are seeking support for your birth trauma, you may wish to contact our Peer Support Service.

Dear ABTA family

Firstly I would like to start by saying I’m so thankful I have 2 beautiful children without whom I am not sure this tale would be as positive as it is.

In 2009 two days before his due date I gave birth to my first child, my beautiful and healthy son. It was a vaginal birth without any medication or interventions, other than the rupturing of my membrane (waters were broken).  I suffered some tearing which was stitched up by the OB.  It was here that I realised local anaesthetic was ineffective for me and this made the experience very painful.  This was added to my notes.  There was no mention of how many stitches or what ‘degree’ of tearing there was. Whilst in hospital my stitches burst and I was inspected by a nurse and ward supervisor who told me “it’s fine, it can happen”.  I had no pain and we left hospital on cloud nine, in that happy glow that some lucky new parents experience.

In the following days I got a rash from my neck to my feet which my GP later confirmed was an Ecoli infection. I was instructed to return to my OB as my wound was infected. My OB redid the stitches, again the local anaesthetic was ineffective, but this time without that natural oxytocin present from birth, the pain was excruciating!!!!!  I had flashbacks of my labour, the physical labour pains all over again and now had to sit on these fresh stitches to drive home.  Once home I had to sit on the stitches again to feed my boy as I was yet to master, or even attempt, breast feeding lying down.

Several days later those stitches also burst. I honestly wondered if I was immune to the stitching thread…I wondered if my body was rejecting them…was I causing this myself? I blamed myself for years and years wondering if I was in fact a broken human?!   After discussions with my OB I was again reassured “it can happen” and for any future births I would need an episiotomy to ‘have a clean cut that would be repaired properly’.  That all made sense and I felt I was in good hands.

Over the coming weeks and months I lost complete control of my farts.  I passed wind anytime and anywhere. When I returned to work I was in the lift with my boss, just the two of us…. I farted.  I explained ‘since having my son, etc’(… OH MY GOD kill me now!!!)  I was so embarrassed.  I mentioned this loss of control at every appointment with my maternal health nurse but was only told to “keep an eye on it”. Yeah. Sure.

At the 12 month mark I was pregnant with our second child and we gladly returned to the same OB, hoping to repeat the cloud nine experience that we had with our son. After all, the hospital had been great (the double bed, the private room, the 5 day stay), the nurses were all excellent, providing extra help with breastfeeding etc. We were really looking forward to a repeat experience.

At the first appointment the burst stitches, ecoli and loss of control of wind were all discussed. My history of local anaesthetic being ineffective was already on file.  It was agreed the best course of action would be another vaginal birth with an episiotomy, an IV of antibiotics for the susceptibility of ecoli infection and, regarding the flatulence – “it can happen”. This all seemed reasonable.  I was in good hands. We felt confident and excited.

My daughter was born on her due date.  She and I laboured for 14 hours, 12 of them in hospital.  We returned to the exact same room where I’d had my son (for me this was a comfort) and we were looking forward to seeing the first girl of the family.  Again I had my membrane (waters) manually broken and again laboured without pain relief medication.

The time to push arrived and unfortunately, very unfortunately, there was no Doctor and no midwife in the room.  I was crowning and with only my husband by my side we knew something was wrong. I had given birth before and knew this pain was different. I screammmmmmed for help but none came.  We were both terrified and that fear was etched on both of our faces. (This moment would repeat in my dreams for years to come.)  My husband slammed on the emergency button to no avail. He wanted to go and get help, and I left fingernail marks in his arm pleading with him to stay. Thank goodness he did! She was coming, with or without help!

RRRRRRRRRRRRIIIIIIIIIIIIIIIIIIIIPPPPPPPPPPPPPPPPPPPPPPP I felt and heard myself tear from the inside, and WHHHOOOOSHHHHhhhhh out came our daughter, skidding, flying out of me.  She skidded so quickly that my husband caught her with his hand at the end of the bed and I felt the tug of the umbilical cord on my vagina and leg.  He grabbed her and lifted her straight onto me just as 4 midwives arrived at the door.  

In slow motion I still see it – they were all in various stages of dressing… one putting on glasses, one tying up her apron, one adjusting her gloves and all of them slowly coming towards us, to where the action had already taken place. The time I needed them had passed.  The damage was done.  My husband balanced our daughter on my chest.  I had nothing left.  The silence was deafening.  My midwife eventually said “oh you weren’t joking” (to being ready to push) and over and over again for years I wondered if I should have said more or said it differently.  I have felt so guilty that I didn’t kick up more fuss to get the attention we needed.  After all we were in the right place and at the right time, weren’t we….? How could this happen?

The cord was clamped and cut and THEN my OB arrived.  In silence he strode to my bedside, pressed too hard on my tummy and hurt me. “What are you doing?” I cried at him. “You still have to deliver the placenta”.  I’d forgotten!  More pain! It was all too much. Placenta delivered. Then without any explanation I was immediately tied into stirrups and my OB attempted to begin the stitching.  The local anaesthetic was again administered in 6 jabs, but again, was ineffective. I was screaming, pleading, “no, no, no, please no, I can’t”. I honestly thought at that moment that I literally could take no more.  He agreed, said “I think you are too traumatised. I’ll do this under general anaesthetic”.   I was so relieved. I knew I could not cope with the stitching procedure – I was already SPENT.

We were left for several hours in the birthing suite without any assistance (or midwife). All the while we were unable to avoid the sound of other labouring mums howling on the ward. It was terrible.  I couldn’t get off the bed and I was covered in blood.  Molly was on my chest and I was still shaking. My husband used the only bloodied blanket from under me to cover us as I begged him not to leave the room for even a second.  All the time I was thinking of course someone will be coming in at any moment to help (like last time, a beautiful shower, help on and off the bed, help getting dressed, help, care, attention, kindness all through the evening).  This time, nothing.  Eventually another nurse arrived and said they needed the room but the maternity ward was full, so I would have to spend the night in paediatrics.  Fine. Whatever.

So covered in blood, literally from my face to my feet, my husband dressed me and we moved to the other room. My parents arrived, both of them horrified at how we’d been treated and trying to enjoy that special first moment with their only granddaughter, knowing the shocking experience their own daughter had endured.  Our faces showed only half the terrible truth.

Next morning we were moved back to the maternity ward, again thankfully we thought, to the same room where we had been with our son.  (“Ok, ok, ok, we can do this! Same room, same experience. Yes, this is all going to be ok.  Put the birth out of your mind, and just get this train back on the track!!”)

Hours later I went to the toilet to find poo on my pad.  I called the nurse who checked my wound. “You’ve got a gaping wound. What are they going to do about that?”
“I’ve been told I’ll have a repair under General Anaesthetic”.
“Ok, great.”

Next shift, another nurse, another check. 

Next day, another nurse, another check. 

5 days in hospital, 10 nurses, 5 ward supervisor visits.  All checking. All asking what’s going on here… NOT ONE made any arrangements for me! Not one! No one followed up with the Dr.  Not one rang through to theatre and checked if I was on the list. Not one. On Day 5, I was discharged from hospital with my anatomy unrecognisable, a gaping wound and with faeces falling out of me.

We coped as best we could. However due to my incontinence I was barely able to leave the house.  I continued breastfeeding and tried to enjoy having 2 healthy, beautiful children.  No matter how wonderful home life was though I was now unable to sleep, I had flash backs and if I lay on my back in a certain position, I felt like I was giving birth all over again… and tearing all over again.   I cannot even tell you about my post-baby bleeding…

We visited several different Hospitals, Doctors, Misters and Specialists.  We literally just existed between appointments.  I was not getting worse – well, how? – but I was not getting better either.  I was literally torn completely through from front to back.

breastfeeding-birth-trauma

With invasive (and embarrassing!!) internal testing it was finally discovered that I had sustained an undiagnosed third degree tear to my internal sphincter from my first born 2 years prior.  I saw the scarring on the ultrasound scans. This specialist was soooo cross, he literally couldn’t believe we’d had this baby in Australia, let alone Melbourne.  He went on to say, almost yelling, “not being able to hold wind, stitches bursting multiple times and the ecoli infection were all red flags”. He was furious and said if we had not had any more children, that first injury would have slackened and weakened and left me fecally incontinent within 5 years and I would need a permanent colostomy bag.  “How did this happen???” … we could not answer, we too had no idea.

In an ideal world I would have been sent for an internal ultrasound post birth, had a diagnosis, and had the wound repaired before considering a second pregnancy.

It was 4 months before we FINALLY found a surgeon who was prepared to operate on me.  As it turned out, the hurdles just kept coming.  In order to have a repair done I needed to have a “bag”.  Before surgery I was booked in for both a colostomy bag (off the large intestine) AND an ileostomy (off the small intestine).  There was no guarantee that either would be possible, but the best case scenario was an ileostomy for a few months, then repair to my perineum, vagina and anus, then a reversal of the ileostomy bag and ‘to learn to poo again’.  If this was best case scenario I literally didn’t even allow myself to think of worst case. 

surgery prep birth trauma

I tried to ween my daughter off the breast for 2 months, but she absolutely refused. We tried expensive formula, cheap formula, different formula, expressed milk, cow’s milk, this teet, that teet, this bottle, that bottle, me leaving the house so someone else would have to do it…. We exhausted every avenue.  We tried everything but she only wanted to be breastfed.  It was a blessing in hindsight. 

breastfeeding-birth-trauma

We were in unchartered territory and very ill-equipped.  We didn’t even know what questions to ask. We didn’t know anything!!! It was so scary, unknown and it was especially difficult to trust all of these different opinions as we had no medical experience, and neither of us had had any surgery prior to this event.

We both found it hard to trust anyone anymore.  We had been severely let down from our hospital experience (and only months later learned the true extent of the damage the hospital experience had caused).  We felt completely alone.  Exposed. Vulnerable. Out of control. Helpless. Invisible. Betrayed. I had lost count of the number of times I’d been poked and prodded and I wondered if these doctors and nurses had even seen my face.  It was absolutely humiliating.  I would have given anything to go back to the ‘farting in the lift’ embarrassment…. This was completely off the scale, and we were not equipped.

I did have successful ileostomy surgery, and in total had 6 operations in 6 months.  I was in hospital for weeks at a time.  The shock of waking up with a stoma is a moment I will never, ever, ever forget.  It was the first time I’d even seen one, and it was on me!!  I vomited all over myself and was utterly disgusted at the look of it.  It was absolutely horrific.  

ileostomy bag birth trauma

When I came to from operations I would have the breast pump on both boobs, the nurses did it for me, I needed to express this milk out as it had mixtures of drugs that I could not pass on to my daughter.  She had to wait 24 hours in these times for a feed.  One screaming, unfed child that my husband had to manage.  

I was hooked up to multiple machines, I had pic lines in multiple locations as my veins were breaking down and I was having a whopping 6 litres of fluid a day.  Breast feeding needed 2 litres, stoma needed 2 litres and normal bodily function needed 2 litres.  (Now anyone would feel sick with 6 litres of fluid in their body.)  It was nauseating and I was physically bloated. And again, a new level of pain had been reached.  The ileostomy pain. Skin burned raw from digestive acid and then accidentally being bumped or kicked during feeding was just par for the course. I still feel those pains and have reached down over the years expecting to feel the stoma there, it is almost like a phantom stoma that will always exist.

undiagnosed third degree tear

My daughter still refused to be bottle fed and, as I was not allowed to have her stay in the hospital with me,  my husband had to bring her in every day.  That meant that our 6 month old, our 2 year old, my husband and I were cramped into small hospital rooms, in and out of different hospitals for 6 months.  My husband was unable to work as he was needed to care for me and the children.  Times were very difficult…

Not only did I have these physical issues and pain to contend with, we were now experiencing financial hardship too.  There was no income, unimaginable expenses and no prospect of improvement in the known future.  We didn’t even qualify for Centrelink due to our previous year’s earnings. Ridiculous but oh so stressful…. Another day, another stress.  It’s hard to put into words the complete and utter devastation we felt in those times.  It finally broke both my mind and my spirit. 

birth trauma treatment

At the 18 month mark, after a ‘successful’ repair but being left with faecal incontinence, I started having panic attacks, sometimes up to 20 a day.  Unlike most people’s attacks, mine weren’t heart palpitations and shortness of breath, but instead nausea and diarrhoea. Yep, diarrhoea with incontinence.  A new level of suffering and humiliation was reached.  When I looked in the toilet I didn’t see sausages I saw shoelaces and now, with diarrhoea, I couldn’t even hold it in. I had S##T running down my leg!!! I had no control, no feeling and it was painful to excessively wipe my now red raw bottom.  I was in nappies.  It was a time I will never forget.  My son, my daughter and I were ALL in nappies together.  Who would have thought that at 34yo it would even be possible?  My son was toilet trained and out of nappies before I was.

It took at least 6 years to gain reasonable faecal continence.  It was a difficult time as physically I was doing quite well, until I had a panic attack and then I’d be back to square one.  I worked really hard on improving my wellbeing from the inside. I began with counselling (the 3rd one was the one for me), EFT Tapping (Emotional Freedom Technique) of which I am a huge advocate and continue to this day, Art Therapy (pottery, painting) which I also continue to do, Bowen Therapy, Vibrational Healing, Massage, TRE (Trauma Release Exercises or ‘tremoring’) and mindfulness.  

The outward appearance became lost in this turmoil – the weight gain, body image issues, scarring all became just nothing, compared to my soul being damaged.  I lost my identity, my purpose, myself, and me as I knew me was no longer. That is what I concentrated on – finding a new, deeply buried self.  I built myself again from the rubble, piece by piece.  I had to learn to love myself as a new version, all the while grieving the loss of the person I had been, and with whom I had been extremely happy.

I consistently challenged myself and my diagnosis along the way.  I was told I would not be able to walk around the block without wearing a nappy and, having enjoyed daily 5km runs and PT this was another shocking blow.  So I embarked on my own pilgrimage (My 77 day pilgrimage) where I walked every day for 77 days.  I literally started walking a few houses down and back to my letterbox, then a few times back and forth, not daring to be too far away from the toilet.  (It was very hard to be at the corner and need the toilet!)  So I kept the route nearby and repetitive.  As I worked up my strength, and my courage to trust my body, I ended up walking over 100 consecutive days and got up to 13kms a day, all without EVER having an accident! Hurrah!

I would like to express how my journey seems like mine, but this could not be further from the truth.  Every one of us in my family has been impacted by this birth trauma.  Me of course, from the above that is clear, but my husband has suffered enormously, both emotionally and physically.  From seeing his wife go through all this, to being let down by multiple incidences in hospitals, surgeries, and medical centres, to dealing with both children’s needs single-handedly, he had zero time for himself.  The exhaustion, heart ache and need to balance dealing with all of these issues took its toll during those difficult times as did all the domestic duties of shopping, cleaning, cooking, gardening and being a full-time carer.  Eventually, once he returned to work, he also carried the burden of being our sole provider.

Since I was classified disabled and no longer able to work this responsibility loomed large and is often unspoken for the sole financial provider.  Over the years it has been a recurring struggle as understandably work places changed and the desire to move on, change positions, change responsibilities were saddled with the added burden of having to remain employed for the sake of the family.

My children have also suffered.  My son is now attending his 3rd school because we moved to a more affordable suburb.  He lost his friendships with those with whom he grew up.  My daughter suffers from anxiety – crippling, abandonment anxiety.  It is totally understandable that she felt ‘abandoned’ given she was only 6 months old and her Mum was not there to provide the basics of food, security and safety. (Mum’s here, but she can’t feed me, why? I need food, where’s mum? It kills me to think of it…)  It is also totally understandable that over the years she freaked out if I disappeared from her view…  I have had to navigate her insecurities, (some of which I created unwittingly) on a daily basis.  Separation anxiety has lasted for 9 years and is still ongoing.  I get it.

Her weight at 6 months was on the 50th percentile, by 12 months (after the 6 months of my operations) she’d dropped to the 5th and was on watch for ‘failure to thrive’.  She suffered multiple burst ear drums and severe as they were, she had to weigh 10kg to get grommets.  She weighed 9.6kg.  Due to her ear issues she had only 25% hearing for the first 2 years of her life and underwent speech therapy sessions prior to commencing school. She also had several sessions with psychologists and social skills classes to assist with her progress.

It has been a rollercoaster with several ups and downs. Honestly now I have more ups and more good days, and the resilience to deal better with the down days.  I did my best and when I look back I realise my best was enough.

clinicians birth trauma

Now I try to help other mums by sharing my story to midwives, Doctors, clinicians and midwifery students.  I regularly speak at hospitals (from 20 to 200 people) and I have involved myself in #betterbirthsvic project which aims to reduce 3rd & 4th degree tears in Victorian hospitals.  I have suggested changes in policy at some hospitals too, (regarding access to psychology support post birth) and the wonderful willingness of these hospitals to really, really see the impact birth trauma on families has implemented these changes.

All in all we are a very happy family and we have certainly found our silver lining. Oh my goodness, just imagine what our life might have been without all this unnecessary heartache, pain and trauma.  Wouldn’t that have been great?  However, I would like you all to know that there is hope and the rainbow can always be found in the rain.

Your best is enough.

If you would like to connect with a mum who has experienced birth after birth trauma, please contact our Peer2Peer Support service to connect with one of our Peer Mentors.

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