The Things We Don’t Talk About After Birth (But Should)

Childbirth is a life-changing experience, often accompanied by a whirlwind of emotions, excitement, and joy. But while much of the focus is placed on the newborn, the physical and emotional recovery of the mother often takes a back seat. There are many aspects of post-birth recovery that we, as a society, rarely talk about—some of which can significantly impact a woman’s health and well-being. One of these often-overlooked issues is sphincter injury.

Sphincter injuries, which involve the muscles controlling bowel movements, can occur during childbirth, particularly in cases of vaginal delivery. Though it’s an important and, at times, distressing subject, it remains largely unspoken in many conversations surrounding the postpartum experience. In this blog, we’ll explore what sphincter injuries are, why they should be discussed more openly, and how women can address them to ensure proper recovery.

What Is Sphincter Injury?

A sphincter injury refers to damage to the muscles of the anal sphincter that control the opening and closing of the anus. During childbirth, particularly in cases of forceps-assisted delivery, a large baby, or a prolonged pushing stage, these muscles can tear. In some cases, the injury may extend to the anal canal, leading to a more severe tear known as an anal sphincter injury.

There are generally three degrees of tears:

1. First-degree tears: These involve the skin around the vagina.
2. Second-degree tears: These involve the vaginal muscles and deeper tissues.
3. Third-degree tears: These affect the anal sphincter muscles, which can lead to more complex complications.
4. Fourth-degree tears: These are the most severe, extending into the rectal mucosa.

Sphincter injuries typically occur during vaginal deliveries, especially if the baby is in a difficult position or if assistance like forceps or a vacuum is used. Despite being relatively common, sphincter injuries are often downplayed, and many women don’t receive enough information about them until they experience the consequences.

Why Don’t We Talk About Sphincter Injuries?

There’s a significant amount of societal silence surrounding certain aspects of childbirth. For many, discussing bodily functions like bowel control or the possibility of experiencing incontinence feels uncomfortable. This can lead to women feeling isolated or embarrassed about their symptoms.

Moreover, many healthcare professionals don’t always fully inform women about the potential risks during childbirth, including the possibility of sphincter injuries. The focus tends to be on the birth of the baby, with less attention given to the mother’s recovery and the long-term impact of injuries like these.

The lack of open discussion means that women are often left feeling unprepared for the physical consequences of childbirth. It also leads to a lack of understanding about the symptoms of sphincter injuries and the options available for recovery.

Symptoms of Sphincter Injury

In the immediate aftermath of childbirth, it’s not always obvious that a sphincter injury has occurred. In fact, many women are unaware of their injury until weeks or even months later. Some common symptoms of sphincter injury include:

• Incontinence: This may involve an inability to control bowel movements, leading to accidental leakage.
• Pain: Persistent pain during or after bowel movements, or general discomfort in the perineal area.
• Pelvic floor dysfunction: Difficulty controlling or holding in gas or stool.
• Prolonged difficulty healing: If you experience issues like excessive swelling or pain that doesn’t seem to improve, it could indicate a more severe injury.
• Altered sensation: A feeling of numbness or unusual sensations in the area around the anus or perineum.

These symptoms, particularly when they last beyond the early weeks of recovery, should be taken seriously. Women who experience them should seek medical attention to determine the extent of the injury and to discuss potential treatment options. For women experiencing unusual discharge, irritation, or discomfort after childbirth, taking an at-home yeast infection test can help identify potential imbalances in the vaginal microbiome and guide them toward the right treatment.

Why We Need to Talk More Openly About Sphincter Injuries

It’s essential that sphincter injuries are discussed more openly for several reasons:

1. Early Intervention and Treatment: The sooner a sphincter injury is diagnosed, the more effective the treatment will be. Early intervention can help prevent long-term complications, such as chronic incontinence or pelvic floor dysfunction. Women who are aware of the potential risks of sphincter injuries can seek immediate help if they experience symptoms, allowing for a quicker and more successful recovery.
2. Support and Normalisation: When these topics are left undiscussed, women may feel isolated, thinking that they are the only ones experiencing difficulties. This can lead to feelings of shame and frustration. By normalising these conversations, we can create a supportive environment where women feel safe sharing their experiences and accessing the care they need.
3. Improved Birth Planning and Education: Awareness of sphincter injuries can lead to more informed decisions during pregnancy and childbirth. For example, women may choose to discuss alternative birth plans with their doctors or midwives, especially if they have risk factors for these injuries. By being educated on the potential for sphincter injuries, they can make informed choices about the delivery process and recovery strategies.
4. Postpartum Care: A common myth is that the postpartum period is all about “getting back to normal” as quickly as possible. In truth, recovery after childbirth, particularly after an injury like this, is a gradual process. Discussing the potential for sphincter injuries helps women recognise that taking time to heal and seeking the right treatment is an essential part of the journey.

Treatment and Recovery from Sphincter Injury

The good news is that with the right care, many women with sphincter injuries can recover fully or significantly improve their condition. Treatment depends on the severity of the injury:

1. Conservative Management: For less severe injuries, pelvic floor exercises and physiotherapy can often help strengthen the muscles, improving bowel control and reducing pain. Pelvic floor rehabilitation can be an essential part of recovery, helping to restore muscle tone and function.
2. Surgical Intervention: In more severe cases, particularly for third- or fourth-degree tears, surgery may be required. Surgical repair, followed by physiotherapy, can help restore normal function. Surgery is usually performed within the first six months after the injury to prevent long-term complications.
3. Long-term Support: Women with severe sphincter injuries may require ongoing support, including the management of incontinence or pain, and may benefit from counselling or support groups to help them cope emotionally with the impact of their injury.

Childbirth is an incredible, transformative experience, but it’s important to recognise the physical toll it can take on a woman’s body. Sphincter injuries are just one of many issues that can arise during childbirth, yet they remain an under-discussed and misunderstood topic. By opening up conversations about these injuries, we can create a more supportive environment for women and ensure they have the information and resources they need to recover fully.

If you suspect you’ve experienced a sphincter injury after childbirth, don’t hesitate to seek medical advice. There is help available, and with the right care, recovery is possible. Let’s normalise the conversation around postpartum recovery so that all women can receive the care, attention, and understanding they truly deserve.

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Becky

Meet the award-nominated UK lifestyle blogger behind Spirited Puddle Jumper – a mum of three living in South East London! Becky shares the real ups and downs of family life, parenting tips, and lifestyle inspiration, proving that being a mum doesn’t mean you stop being fun or having other interests! Follow along for honest insights into UK family life and opinions on a whole range of topics, from travel and food, to beauty reviews, home and DIY, business and health and wellness.