WHY WAS MY POSTPARTUM CARE SO RUBBISH?

HEALTH, MOTHERHOOD, PREGNANCY, BIRTH & BABY'S

So much time and thought goes into the actual birth of a baby that what comes next is often a huge shock, both mentally and physically. And one we’re often not prepared for.

What happened to Zoe Gardiner after her second birth is shocking, and yet when she found herself in most need of care, there was none available. And this is what she wants to change. Zoe wants to raise awareness of what happens post-birth and offer a place where much-needed support is easily accessible, and I couldn’t agree more.

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38 weeks pregnant with my first baby, killing time and reading random posts on my Facebook ‘Due Date’ group. I stare in horror at a thread about postpartum care and what women are doing to help recover from childbirth.
Wait, what recovery?
I had read numerous books on childbirth, I had completed my hypnobirthing homework religiously, I had my birth bag packed and ready to go, filled to the brim with sleepsuits and nappies and breast pads.
I had not, for one second, considered that I would not walk out of that hospital feeling completely fine. I hadn’t even bought maternity pads.
It was 2013, I was 22, the first of my friends to have a baby and only the shiny, happy ‘One Born Every Minute’ mothers to go off.
I was not prepared.
Lots of things shocked me about my postpartum body.
The stretch marks that appeared from no-where, the squishy emptiness of my tummy, the stitches holding my perineum together. It hurt to laugh, to sit, to stand, to walk.
In labour, I struggled to get my midwife to listen to me and so I ended up giving birth on the hospital bed, on my back and, in lots of ways, I felt like I had failed. Like I’d done something wrong.
Almost seven years later, after eight months of sickness, suffering with hyperemesis gravidarum and iron-deficient anaemia, I gave birth to my most magical second baby.
At the end, it was just my baby and me as I used my hands to guide her up, out of me, out of the water and into the world, all by myself. In my own home, on my own terms.
It was the birth I had always dreamt of. With the fairy lights, the beautiful affirmation cards, the delicious food in bed afterwards.
She filled a hole in me that had been there for the longest time, and I cannot imagine my life without her.
I also thought I knew better this time. I had the extra big maternity pads, the witch hazel for my bath, the cold flannels waiting in the fridge.
My babies head measurement was on the 98th centile and she was born en caul with her amniotic sac still intact. It felt like trying to push out a water balloon, the pressure was unreal, and I tore in several places.
I had to have stitches to my perineum and my labia minora. I lay on my corner sofa, one leg on my sons Ikea step stool, the torch on my husband’s phone being used as the light source.
One of the stitches to my labia had gotten caught during suturing and the midwife had asked my permission to leave it as it was. She said she thought it would be fine and it would just take a bit longer to dissolve.
It can take up to a month for stitches to heal and yet most people are discharged from midwife led care 10 days post birth. So long as your baby is fit and healthy and you don’t appear to be completely unstable.
This is how I found myself not knowing where to turn, five weeks in, when I dared to look down and see why I was still hurting, still freshly bleeding, still unable to walk properly and found that one of my tears had not healed properly or, indeed, at all.
In fact, to my utter horror, I realised that I had a gaping hole, just left of my clitoris.
All the stitches had come apart, except for the one that had got stuck. That had formed a painful wound that was still bleeding.
I immediately contacted my midwife to be told she could no longer help me. That I would need to be referred to gynaecology. Referred back. Even though I had never fully healed.

I went straight to my GP, however, gender bias in the medical profession is quite rife and most women simply aren’t listened to. Following an examination, I was told that my vulva looked normal for post-birth.
Despite having no itchiness or other key symptoms, I was told that my pain was probably thrush. I was refused referral to gynaecology and sent off with a Canesten prescription.
Thankfully (and due to a large amount of privilege on my part) I found an amazing (private) women’s physio who listened to me and managed to arrange an emergency appointment and get me my referral.
Because I had already been discharged 10 days after birth, before I was fully healed, I had to go to the bottom of the waiting list for appointments.
I didn’t get seen by a consultant until I was 3.5 months postpartum.
I had an open, unhealed wound in one of the most sensitive areas in the whole body and I didn’t get any medical help for 3.5 months.
I couldn’t care for my baby by myself.
Walking her and rocking her made me bleed and the pain was unreal. I couldn’t hold her for too long or I would be in agony.
My husband had to help me during the day and make up his work hours during the night.
I missed out on all those fourth trimester cuddles and her early months are just a complete blur of pain and sadness.
As I was breastfeeding, my GP was not willing to prescribe me with any sort of pain relief and I had to manage my pain with cycling paracetamol and ibuprofen alongside eating lots of cake and crying.
Due to rising Covid cases in January 2021, all non-essential medical appointments were being cancelled and I was very lucky to get my consultant appointment.
She explained that I had hypergranulation – excessive scar tissue – around the tear to my labia and it was this that was causing the pain and the bleeding.
She thought cauterising the wound would help but told me she’d have to do it there and then. Due to the pandemic, she did not know when she would next be able to see me.
With no pain relief available, I had to sit there and try my hardest not to scream.
I managed to hold myself together as I walked back outside where my husband and my babies were waiting for me in the car. I cried the whole way home.
I then spent two weeks juggling a three-month-old baby with home-schooling a 7-year-old whilst trying to ignore the constant sharp stinging pain and the black, burnt skin that would fall off me every time I went to the toilet.
Thankfully, the procedure worked, and the pain mostly went away 4 months in.
However, I was left with a 6mm hole that I could not bring myself to look at, to touch or to acknowledge.
It made me feel sick thinking about it, and I felt like I’d lost this whole part of myself.

11 months and one day after the birth of my baby, I finally got the reconstructive surgery I needed.
I was sure to ask my consultant how to care for my new wound to give it the best chance at healing normally. I felt hopeful that I was a couple of weeks away from putting this whole thing behind me.
Sadly, that was not to be and eight days post-surgery two of my stitches came out and I could see the wound start to open.
I rang the hospital straight away and spent five hours sitting in the gynaecology clinic, waiting to see a doctor for them to tell me there was nothing they could do.
The wound did not look infected, my pain levels were normal for where I was in my recovery and, I was told, I had to accept it would not ‘look perfect’.
Fast forward to 14 days post-surgery.
I’m in the shower when the last stitch comes out and the whole thing separates.
Since they cut away the old scar tissue to stitch the tear back together, there’s now just a huge gap between my clitoris and the left side of my labia minora.
I don’t know how long I stood there crying.
I don’t know what to do next.
I have set up Postpartum Matters to raise awareness of the issues facing people post-birth.
I want to gather information from as many people as possible – from all birthing people across the UK, from all intersections and minority groups – so we can go forward and push for change to this broken system.
I want us to come together and fight against the systems that constantly shove us to the bottom and tell us just to suck it up and deal with it. Systems that tell us that our pain and suffering is all in our heads.
From sharing my story on social media, I have been blown away by the amount of people who have had a similar experience.
So far I have heard from women who have been repaired wrong, women who have been abandoned and left to care for scars with no help or advice. Women who have been ignored when things go wrong, women who have lived their whole lives with disfigurements, being told it is just par for the course.
Whilst my story is a hard one, no doubt made harder by the pandemic, my story is not uncommon.
And yet it is something we never speak of.
I certainly had no idea and, despite my best efforts, was definitely not prepared.
I do not know of any other situation where you can be discharged from care when you are not yet fully healed.
And I certainly cannot imagine a man being made to walk around with an open wound on his penis, being told he’s probably just got a bit of an infection and has he tried paracetamol?
‘Continuity of carer’ is where the birthing person has one, dedicated midwife who cares for them throughout pregnancy, birth and postpartum.
This allows people time to build a trusting relationship with their care giver and has been shown to improve health outcomes for both mother and baby. You are much more likely to report an issue or ask for help from someone you feel comfortable with.
I am aware that the role out of this model is far from complete and I’m sure we could write another list on the topic of maternity care – especially in the aftermath of the pandemic.
However, as someone who was lucky enough to have their community midwife be present at their birth, I can say first-hand that continuity of carer works, and I felt so incredibly safe with my midwife during my pregnancy and birth.
The problem with the current model is the definition of postpartum and the guidelines that are being followed when midwives consider you safe to be discharged.
Ten days is not long enough for you to know if you are okay.
For many people, six weeks is not long enough to know if they are okay.
We need to push for change.
We are not simply vessels that bring life to then be thrown aside, broken and no longer of use.
A healthy baby is not the bottom line of birth. You matter too.
Change needs to happen so that people are not discharged from midwifery led care until both the baby AND the mother are fully well and fully healed. Whether that be ten days post-birth, six weeks post-birth or longer.
Anything else is simply not good enough.

* For more information on Postpartum Matters, visit Zoe’s website postpartummatters.co.uk

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HELPFUL RESOURCES:

Doula UK: Doula.org.uk

NHS: nhs.uk/pregnancy/labour-and-birth/after-the-birth

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‘But why is there blood in the toilet?’ ‘But why do people die and are they just sleeping?’ and “But why do adults drink beer and what does it do?’ are some of the tricky questions I tackle in my debut book BUT WHY? which is available to order now and also on audiobook.

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FANCY SOME MORE?

– READ Laura Dockrill’s terrifying experience of Postpartum Psychosis and how, with support, she began her recovery.

– READ how Deborah Caldicott found peace, in her raw and relatable list on Birth Trauma Therapy.

– LISTEN to hypnobirthing teacher Hollie de Cruz on Honestly podcast as she talks Birth and how it can be transformative.

OR HOW ABOUT WRITING A LIST?

Find submission guidelines here. All writers and topics are welcome.

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WHY WAS MY POSTPARTUM CARE SO RUBBISH?

So much time and thought goes into the actual birth of a baby that what comes next is often a huge shock, both mentally and physically. And one we’re often not prepared for.

———————————————————————–

38 weeks pregnant with my first baby, killing time and reading random posts on my Facebook ‘Due Date’ group. I stare in horror at a thread about postpartum care and what women are doing to help recover from childbirth.

Wait, what recovery?

I had read numerous books on childbirth, I had completed my hypnobirthing homework religiously, I had my birth bag packed and ready to go, filled to the brim with sleepsuits and nappies and breast pads.

I had not, for one second, considered that I would not walk out of that hospital feeling completely fine. I hadn’t even bought maternity pads.

It was 2013, I was 22, the first of my friends to have a baby and only the shiny, happy ‘One Born Every Minute’ mothers to go off.

I was not prepared.

Lots of things shocked me about my postpartum body.

The stretch marks that appeared from no-where, the squishy emptiness of my tummy, the stitches holding my perineum together. It hurt to laugh, to sit, to stand, to walk.

In labour, I struggled to get my midwife to listen to me and so I ended up giving birth on the hospital bed, on my back and, in lots of ways, I felt like I had failed. Like I’d done something wrong.

Almost seven years later, after eight months of sickness, suffering with hyperemesis gravidarum and iron-deficient anaemia, I gave birth to my most magical second baby.

At the end, it was just my baby and me as I used my hands to guide her up, out of me, out of the water and into the world, all by myself. In my own home, on my own terms.

It was the birth I had always dreamt of. With the fairy lights, the beautiful affirmation cards, the delicious food in bed afterwards.

She filled a hole in me that had been there for the longest time, and I cannot imagine my life without her.

I also thought I knew better this time. I had the extra big maternity pads, the witch hazel for my bath, the cold flannels waiting in the fridge.

My babies head measurement was on the 98th centile and she was born en caul with her amniotic sac still intact. It felt like trying to push out a water balloon, the pressure was unreal, and I tore in several places.

I had to have stitches to my perineum and my labia minora. I lay on my corner sofa, one leg on my sons Ikea step stool, the torch on my husband’s phone being used as the light source.

One of the stitches to my labia had gotten caught during suturing and the midwife had asked my permission to leave it as it was. She said she thought it would be fine and it would just take a bit longer to dissolve.

It can take up to a month for stitches to heal and yet most people are discharged from midwife led care 10 days post birth. So long as your baby is fit and healthy and you don’t appear to be completely unstable.

This is how I found myself not knowing where to turn, five weeks in, when I dared to look down and see why I was still hurting, still freshly bleeding, still unable to walk properly and found that one of my tears had not healed properly or, indeed, at all.

In fact, to my utter horror, I realised that I had a gaping hole, just left of my clitoris.

All the stitches had come apart, except for the one that had got stuck. That had formed a painful wound that was still bleeding.

I immediately contacted my midwife to be told she could no longer help me. That I would need to be referred to gynaecology. Referred back. Even though I had never fully healed.

I went straight to my GP, however, gender bias in the medical profession is quite rife and most women simply aren’t listened to. Following an examination, I was told that my vulva looked normal for post-birth.

Despite having no itchiness or other key symptoms, I was told that my pain was probably thrush. I was refused referral to gynaecology and sent off with a Canesten prescription.

Thankfully (and due to a large amount of privilege on my part) I found an amazing (private) women’s physio who listened to me and managed to arrange an emergency appointment and get me my referral.

Because I had already been discharged 10 days after birth, before I was fully healed, I had to go to the bottom of the waiting list for appointments.

I didn’t get seen by a consultant until I was 3.5 months postpartum.

I had an open, unhealed wound in one of the most sensitive areas in the whole body and I didn’t get any medical help for 3.5 months.

I couldn’t care for my baby by myself.

Walking her and rocking her made me bleed and the pain was unreal. I couldn’t hold her for too long or I would be in agony.

My husband had to help me during the day and make up his work hours during the night.

I missed out on all those fourth trimester cuddles and her early months are just a complete blur of pain and sadness.

As I was breastfeeding, my GP was not willing to prescribe me with any sort of pain relief and I had to manage my pain with cycling paracetamol and ibuprofen alongside eating lots of cake and crying.

Due to rising Covid cases in January 2021, all non-essential medical appointments were being cancelled and I was very lucky to get my consultant appointment.

She explained that I had hypergranulation – excessive scar tissue – around the tear to my labia and it was this that was causing the pain and the bleeding.

She thought cauterising the wound would help but told me she’d have to do it there and then. Due to the pandemic, she did not know when she would next be able to see me.

With no pain relief available, I had to sit there and try my hardest not to scream.

I managed to hold myself together as I walked back outside where my husband and my babies were waiting for me in the car. I cried the whole way home.

I then spent two weeks juggling a three-month-old baby with home-schooling a 7-year-old whilst trying to ignore the constant sharp stinging pain and the black, burnt skin that would fall off me every time I went to the toilet.

Thankfully, the procedure worked, and the pain mostly went away 4 months in.

However, I was left with a 6mm hole that I could not bring myself to look at, to touch or to acknowledge.

It made me feel sick thinking about it, and I felt like I’d lost this whole part of myself.

11 months and one day after the birth of my baby, I finally got the reconstructive surgery I needed.

I was sure to ask my consultant how to care for my new wound to give it the best chance at healing normally. I felt hopeful that I was a couple of weeks away from putting this whole thing behind me.

Sadly, that was not to be and eight days post-surgery two of my stitches came out and I could see the wound start to open.

I rang the hospital straight away and spent five hours sitting in the gynaecology clinic, waiting to see a doctor for them to tell me there was nothing they could do.

The wound did not look infected, my pain levels were normal for where I was in my recovery and, I was told, I had to accept it would not ‘look perfect’.

Fast forward to 14 days post-surgery.

I’m in the shower when the last stitch comes out and the whole thing separates.

Since they cut away the old scar tissue to stitch the tear back together, there’s now just a huge gap between my clitoris and the left side of my labia minora.

I don’t know how long I stood there crying.

I don’t know what to do next.

I have set up Postpartum Matters to raise awareness of the issues facing people post-birth.

I want to gather information from as many people as possible – from all birthing people across the UK, from all intersections and minority groups – so we can go forward and push for change to this broken system.

I want us to come together and fight against the systems that constantly shove us to the bottom and tell us just to suck it up and deal with it. Systems that tell us that our pain and suffering is all in our heads.

From sharing my story on social media, I have been blown away by the amount of people who have had a similar experience.

So far I have heard from women who have been repaired wrong, women who have been abandoned and left to care for scars with no help or advice. Women who have been ignored when things go wrong, women who have lived their whole lives with disfigurements, being told it is just par for the course.

Whilst my story is a hard one, no doubt made harder by the pandemic, my story is not uncommon.

And yet it is something we never speak of.

I certainly had no idea and, despite my best efforts, was definitely not prepared.

I do not know of any other situation where you can be discharged from care when you are not yet fully healed.

And I certainly cannot imagine a man being made to walk around with an open wound on his penis, being told he’s probably just got a bit of an infection and has he tried paracetamol?

‘Continuity of carer’ is where the birthing person has one, dedicated midwife who cares for them throughout pregnancy, birth and postpartum.

This allows people time to build a trusting relationship with their care giver and has been shown to improve health outcomes for both mother and baby. You are much more likely to report an issue or ask for help from someone you feel comfortable with.

I am aware that the role out of this model is far from complete and I’m sure we could write another list on the topic of maternity care – especially in the aftermath of the pandemic.

However, as someone who was lucky enough to have their community midwife be present at their birth, I can say first-hand that continuity of carer works, and I felt so incredibly safe with my midwife during my pregnancy and birth.

The problem with the current model is the definition of postpartum and the guidelines that are being followed when midwives consider you safe to be discharged.

Ten days is not long enough for you to know if you are okay.

For many people, six weeks is not long enough to know if they are okay.

We need to push for change.

We are not simply vessels that bring life to then be thrown aside, broken and no longer of use.

A healthy baby is not the bottom line of birth. You matter too.

Change needs to happen so that people are not discharged from midwifery led care until both the baby AND the mother are fully well and fully healed. Whether that be ten days post-birth, six weeks post-birth or longer.

Anything else is simply not good enough.

* For more information on Postpartum Matters, visit Zoe’s website postpartummatters.co.uk

———————————————————————–

HELPFUL RESOURCES:

‘But why is there blood in the toilet?’ ‘But why do people die and are they just sleeping?’ and “But why do adults drink beer and what does it do?’ are some of the tricky questions I tackle in my debut book BUT WHY? which is available to order now and also on audiobook.