Many physios who go down the pathway of women’s health and pelvic health physiotherapy, do so after the birth of their own child/children.

Some do so because their experience has opened their eyes to the magic of understanding more about the birth process and the changes, many positive to their bodies and to their lives from producing another human being.

Others do so because the experience has been quite traumatic and has had a serious impact on their own well-being, both physical and psychological. One such pelvic health physio is Nadine Brown, who is happy to openly talk about her personal journey and hence there is her name and there are photos. I have chatted with Nadine at a couple of professional development gigs about issues and I asked Nadine would she be happy to share her story and write a blog for me and she has. Nadine’s story follows.

“The world breaks every one and afterward many are strong at the broken places.”
― Ernest Hemingway

When Sue asked me to write a blog for her about my birth story, I had two thoughts. The first, “Wow, Sue wants ME to write a blog for HER website!”, and second, “How can I put into words, the emotions I have felt as a result of the physical changes I experienced since having my son nineteen months ago?”

My birth story goes like many others. Vaginal delivery, gas for pain relief, no major tearing or medical issues (small amount of internal stitches), discharged from hospital, healthy big baby, tick tick tick.

But it would seem, as time went on, things just weren’t right “down there”. It was not until many months after the birth, I was told that the birth of my healthy, robust, 9lb “steak n chips” baby boy, left me with anterior wall prolapse and levator avulsion (LA) – a complete detachment of one of the pelvic floor muscles from the pubic bone.

I was devastated.

Being a physiotherapist, with a special interest in pelvic health, I regularly treat women who bear the physical and ultimately, mental health ramifications of birth injuries. I get comments such as “No one told me this would happen”, and “I can’t do the things I used to do, I’m miserable, I had no idea it would be like this”.

They are grieving.

They grieve their pre-baby body.

They grieve their intimate relationships and sexual confidence.

They grieve not being able to just throw on the runners and go for a jog. They’ve lost confidence in their body. And they believe they can never go back. This is grief and it is very real. The realisation that I too had these birth injuries, put me into the cycle of grief.

What are the stages of grief, as we know it in the mainstream? Denial, Anger, Bargaining, Depression and Acceptance.  I know unequivocally, I went through each.

I was in denial. Denial that my baby came so fast, that even my midwives were shocked. Denial that I didn’t get the elective caesarean that I had planned.

There was anger, that despite trying my best to mitigate the risks of a vaginal delivery (because there are many, which are finally being brought to more mainstream attention thanks to social media), I was suffering physically and would for a long time post-birth. Anger that I fought SO. HARD. for an elective caesarean birth but I felt bullied by the midwife when I was vulnerable with horrible scare tactics and I didn’t get the caesar. Anger that I didn’t just bounce back. Anger that some friends didn’t quite understand why I wasn’t the old me.

Bargaining – “Well maybe I can just walk-jog instead of proper running” “Maybe I can just swing a lighter kettlebell?”.

Depression was the worst. It was a black hole, I described it to my girlfriends as quicksand. I could feel myself going down but I couldn’t stop it. I filled out depression questionnaire after questionnaire with medical professionals, they always came up as ‘Severe Postnatal Depression & Anxiety (PNDA)’. I knew it, I felt it, because I was a sleep deprived new mum with no village support and the realisation that my “self” was profoundly different – forever.

I put on 20kgs during my pregnancy, and lost 25 in the months following – I became unwell, and postnatal depression hit me like a freight train. I also lost confidence in being able to offer advice and help to other mums from a professional standpoint. How could I possibly help others if I couldn’t help myself? I had so much healing to do physically and mentally. My social media was that of a doting, yet very tired mum with a beautiful baby boy. Smiling happy faces, pram walks and a squishy sleeping infant. Yet, I was paralysed by PNDA, that had me struggling to even leave the house some days. I finally admitted that I needed help to come to terms with some of what I was feeling, as well as the rage and anger that sometimes comes with being a parent of a baby who never sleeps. I realised I couldn’t process my grief alone anymore. 

Right now, I’m working on acceptance. It is a process, but I’m ok with the healing, however long that takes. I see the purpose in my pain now, purpose in my journey. And like any good Women’s Health Physio, I’m diligently doing my pelvic floor exercises and slowly re-entering the exercise world that I loved so dearly before I had my son. I see hope, I see effective treatments that will give me my confidence and quality of life back. I see intimacy with my partner again. And running around with my son.

I’m sharing my story as a way of reaching out to so many mums who are going through these changes. The 4th trimester – the postnatal period -is not a race, it’s not a competition. It’s not all #fitmum #blessed. It’s not even just about the baby. It’s about the birth of a mother. There can be overwhelming joy, but also polarizing grief.

If you are going through this right now, please know there is help. There is HOPE. Make self-care a priority. Start by talking to your GP. Find a good one who will listen. And most of all, be patient and kind to yourself, Mumma, this is one hell of a tough gig.

Thanks Nadine for this very personal blog. It’s always difficult and somewhat confronting ‘to come out’ with struggles such as PNDA and disclose the pelvic floor issues that you may be personally having, but as one who has had pelvic floor dysfunction for nearly 30 years, I do think it helps patients to understand that there is life after a birth which changes your anatomy and they feel somewhat comforted by the pelvic health physio who is living the symptoms the patient is experiencing.

Good luck on your continuing rehabilitation and remember it’s a life-long committment (your rehab AND your job- once the pelvic health bug gets you, you become passionate about it forever) and keep focussing on what you know you CAN do not what you think you CAN”T do. There is still lots of fun to be had from life -especially one enriched with a (non-sleeping) baby!!

If this blog has raised any issues for you contact Lifeline 131114 or Beyond Blue

The Australasian Birth Trauma Association (ABTA) not only has an active Facebook group which you can join and participate in conversations, but also has recently instituted a Peer2Peer counselling service to help support women who have suffered a birth trauma. Check out the facebook group page for more details.