Natural birth has been my lifelong desire. For some reason, I wanted to feel everything from the first contraction to the moment of the final push, the relieving feeling of the baby sliding out of me after the big push to deliver the head and shoulder. Weird, right?
So it was that I got pregnant again, 16 years after birthing my first born. As usual, I was elated and looked forward to the D-day, my delivery date. The pregnancy was uneventful, until the 36th week when I went for an ultrasound scan. The sonographer couldn’t contain himself at the site of the baby’s head and told me to expect to birth a very large baby as the head was ‘too big’. I couldn’t fathom what ‘too big’ was but prayed it shouldn’t be a deformity.
At the 38th week mark, I went for another scan and was told the baby was 3.6kg. That wasn’t too big to me because I birthed my first at 3.1kg, 16 years before then, when I was a mere teenager.
I was induced very early in the morning of Sunday, 26th July 2015. By 3pm same day, I had dilated to five cm without pains or contractions. I was then moved to the delivery ward from where things picked up quickly. Labor pains started when I was six cm dilated. The pains came 30 seconds apart and believe me, it was severe.
By 8 pm, I was fully dilated and ready to deliver. I was cheered on and encouraged to push. Push, I did and the midwife exclaimed that the baby’s head was really large when it presented. Her tone got me worried and too scared to continue pushing. Abdominal pressure was applied and out came the baby after a big push.
He. Was. Large. A whooping 4.9kg!
I couldn’t believe such a large baby had come out of me as I had no history of diabetes, gestational or regular. He was laid on my bosom while the cord was clamped. I watched as he was being cleaned up and was grateful. Grateful that my unusually long pregnancy (so I thought) had finally culminated in a healthy baby.
It was on the following day that the full impact of birthing a big baby dawned on me. I had a big tear; a fourth degree tear. I had torn badly while pushing out the baby. The tear was so bad it took an hour and a few minutes to repair.
I couldn’t use the toilet as the stitches were killing. The tear narrowly missed my perineum. That was the first shocker I got. Others who gave birth to smaller babies were up and doing before me. I was hospitalized for a while longer to enable me heal considerably before going home.
I stayed in the hospital for seven days. With my first child, I healed after a week because I had an episiotomy, a little cut to aid delivery. In this case, the baby tore me on his way out. I couldn’t do sitz baths due to other complications (vaginal prolapse). Walking was painful. The stitches were tight and when pubic hair reappeared, it added to my discomfort.
I couldn’t feel my rectum. Try as I would, I couldn’t feel it. I laid a complaint before I was discharged and it was attributed to numbness from the stitches. I was told it would get better. It didn’t. I couldn’t hold back feces and urine. I pooped before I even knew I was pressed. I couldn’t for the life of me even sense that I had to empty my bowls!
This got me back to the doctor’s office where I was asked a barrage of questions and eventually asked to go lay on the doctor’s examination table for a check. I self-consciously laid down, took off my undies and was checked. The doctor inserted a gloved finger into my rectum and asked me to squeeze it as if I was holding back poop. I tried all I could but couldn’t squeeze. After a few tries and other checks, I was diagnosed with anal or fecal incontinence.
What is anal or Fecal Incontinence? I asked the doctor with fear written all over me. She looked at me sternly and said ‘This is a situation where you are unable to control your bowel. Faces drop or leak out of your anus unexpectedly. In some cases like this, you cannot even sense when you need to poop’. I was now frightened. The thought of wearing diapers got me crying.
I was told this happened to me specifically because the sphincter muscle was affected when I tore during delivery. This muscle is responsible for holding stool in the rectum. Other common causes of fecal incontinence are weakness of the sphincter muscle due to age, surgery, rectal prolapse, rectocele (where the wall of the rectum protrudes into the vagina), aftermath of a stroke or Crohn’s disease.
You have to consider these conditions when choosing your birth plan. It would have been safer for me to have a caesarian section considering my risk factors and the size of the baby.
I was horrified when I was told if I did not regain control of my rectum before my 6th week post-natal checkup, I would have to go in for surgery to repair it. The surgery was not guaranteed but would be the best option aimed at fixing the problem. The doctor also advised me to do a lot of Kegel exercise while hoping for the best. I was not given any medications.
With continued Kegels, prayers and the passage of time, I regained feelings in my rectum. It started gradually and by the tenth week after childbirth, I had regained full use of the muscle. While it lasted, I couldn’t leave the house for fear of messing myself up in public. Intimacy was entirely out of it as I was still sore from the tear, coupled with fecal incontinence.
In addition, after a previous pregnancy I had noticed something like a ball protruding out of my vagina while I had sitz baths. The protruding was worse after the birth of my second baby, virtually protruding out of my vagina and rubbing between my inner thighs. It was scary and I had to talk to fellow new moms, a good number of them admitted to facing similar issues and said it will get normal with time. I wasn’t having that so off to the hospital I went.
On getting there, I was reprimanded for opting for natural birth and for having another baby so soon. That baby was also large, four kilograms. The truth is that no one gave me an option of a caesarian section (although I doubt if I would have taken it), neither was I at that time educated on the dangers of birthing a big baby.
The doctor checked and confirmed my fear: I had vaginal prolapse. This is a situation whereby the pelvic organs (uterus, bladder, and rectum) fall out of the vaginal opening due to weakening of the pelvic floor muscles. I was told there were several types of prolapse and a date was fixed for me to go back to the hospital so they could identify the type I had and proffer a solution.
Out of fear (based on the effects of surgical correction of vaginal prolapse I saw on the internet) and the fact that the condition is painless, I never went back to the doctor. Now I cannot sit on the toilet for too long, neither can I squat down or lift heavy things. I live with it. Sometimes during intimacy, it feels like my perineum is tearing and I’m very self-conscious. The sight of a pregnant woman gets me scared. I feel like screaming at the top of my voice, telling her to opt for Caesarian section and not bring forth vaginally.