Last updated Sept. 21, 2017.
Having a baby is exciting! A new little person is coming into your family and your life is going to change forever. But pregnancy is really hard on your body, and so is labor and delivery. In fact, many people don’t know just how hard it is.
We think of birth injuries as affecting babies, but they also affect mothers — you’re pushing a large baby through a small passage with a lot of important organs and body parts nearby. However, many women aren’t aware of what kinds of birth injuries can happen and what to look for. And birth injuries to mothers are frequently not diagnosed, meaning women suffer from serious symptoms and never get treatment.
Here are some quick facts:
- Urinary incontinence and some pain are normal for the first few weeks after delivery;
- Major bleeding, fecal incontinence, or persistent urinary incontinence or pain may indicate a birth injury and require medical attention;
- Only 3-5% of perineal tears, one of the most common birth injuries for mothers, are diagnosed at delivery;
- 35-40% of women suffer perineal tears during delivery;
- Up to 30% of women may have undiagnosed pelvic fractures from childbirth;
- Up to 41% of women may have undiagnosed pelvic floor muscle damage from childbirth;
- Half of women suffer incontinence for more than a year after delivery.
So how do you know if you have a birth injury? And why are we missing so many diagnoses?
How to Tell If You Have a Birth Injury
There are a lot of birth injuries that can affect the mother: perineal tears, damage to the pelvic floor muscles, damage to nearby organs, pelvic fractures, obstetric fistulas, back injuries, and more. But many women aren’t getting diagnosed.
Part of the problem with figuring out if you have a birth injury is that these kinds of injuries are both taboo and complicated. After pregnancy, you can expect to have some bleeding and maybe some urinary incontinence — your pelvic floor muscles, uterus, and vagina have been through a lot. You’re also going to be sore for a few weeks. Those are all normal (if not particularly pleasant) parts of recovering from pregnancy and you probably don’t need to worry about them.
But if these problems don’t go away, you may need to give your doctor a call. If you’re experiencing serious bleeding or fecal incontinence, you need to seek medical attention right away. If your pain and urinary incontinence last for more than a few weeks, it’s also time to go see a doctor. Those can be signs that your pelvic floor muscles are damaged or that you’ve experienced a perineal tear.
Perineal tearing, for example, is one of the most common injuries and it affects way more women than you’d think — 35% to 40%! However, only 3-5% of those tears are diagnosed at delivery. About 22% of new mothers still have perineal pain 2 months after delivery and 10% still have pain after more than a year.
And fecal incontinence in older women has been linked to undiagnosed perineal tears from childbirth.
Pelvic Fractures and Plevic Floor Muscle Tears
It’s not just perineal tears, either. A study from the University of Michigan found that 30% of the 68 women they examined had evidence of pelvic fractures and 41% had pelvic floor muscles tears, none of which had ever been diagnosed. Half of women still suffered from incontinence more than a year after delivery.
If you have pain during urination, bowel movements, or sex, that can also be a sign of an undiagnosed injury. And if you have back pain for more than a month or two, you’ll need to see a doctor — that can be a sign of a pelvic fracture or back injury.
Sometimes, birth injuries to the mother don’t just occur during a natural delivery. Although C-sections are the most common surgery performed in the United States, mistakes happen. The bladder is the most frequent organ damaged.
One study published in Current Women’s Health Reviews Journal noted that when a mother is injured and separated from her baby, it may delay initiation of breastfeeding or even wanting to breastfeed at all.
Although surgical injuries to the bladder are infrequent during cesarean section, providers need to be aware of potential complications in order to appropriately counsel patients and also prepare themselves for possible intraoperative complications. Potential ramifications of bladder injury include prolonged operative time, urinary tract infection, prolonged indwelling catheter time, and formation of vesicouterine or vesicovaginal fistula.
In many cases, symptoms of an undiagnosed birth injury won’t just go away without treatment. They may affect you for the rest of your life. So you should always seek treatment if you think something is wrong.
Missed Diagnoses: Taboo, or Too Much Focus on Baby?
So why are we missing these serious, sometimes debilitating injuries? Partly it’s because women just don’t get that much medical attention after delivery — the focus is on the health of the baby. Most insurance companies only cover a single visit to your OB/GYN after you give birth, and that often involves just a pelvic exam. That exam can’t detect internal tearing or fractures, and your OB/GYN isn’t actually trained to deal with those things, anyway.
Another reason is that it has historically been socially unacceptable to talk about these kinds of symptoms. We expect childbirth to be painful and when we suffer symptoms like urinary and fecal incontinence or regular pain during sex; we don’t want to talk about it. It’s embarrassing. And it may feel like it’s our fault rather than an injury — if only we had done more Kegel exercises!
And when women do bring their symptoms to their doctors, they’re often dismissed. Again, there’s that expectation that childbirth is painful. Plus, many doctors simply don’t know enough about these kinds of injuries to make a real diagnosis.
To make matters worse, all of this can contribute to postpartum depression. Pain, feelings of embarrassment about your symptoms, feelings of inadequacy for not bouncing right back into action after delivery, tension with your partner over painful sex or debilitating symptoms, the stress of having a newborn — all that adds up to a lot of emotional weight.
And in a vicious cycle, that kind of depression may make you even less likely to seek treatment.
Caring for Yourself After Pregnancy
Let’s face it — labor and delivery are going to hurt. And you may have bleeding and leaking and pain for a little while. But if your symptoms last, go see your doctor. Insist on a full examination and don’t take no for an answer.
You know your body better than anyone else, and you should trust your gut if you think something is wrong. You may need to get a second opinion — that’s OK! It’s better than facing years of pain or incontinence. And if you’re feeling down or depressed or having thoughts of suicide, please reach out to someone close to you or to a professional to seek treatment.
The more women talk about and seek treatment for their birth injuries, the more these issues will come into the spotlight. They’ll become less taboo and the medical profession will pay more attention to them. Having a child is something special and beautiful — and it doesn’t have to ruin your health.
Get Help with an Undiagnosed Birth Injury
If you do seek treatment, it can be costly. Pain, medical care, and missed work due to injuries can seriously impact your wallet. Raising a new baby is expensive enough.
If you find that you have a birth injury that your doctor failed to diagnose, you may have a legal claim for compensation. It may be a case of medical malpractice.
If you believe your doctor should have caught your injury and did not, we may be able to help. Contact Safe Birth Project today for a free consultation.