Nobody Told Me: Pelvic Floor And The Danger Zone

Feministparent - 5 Jun 17

I think it’s safe to say today was not my finest hour. In the words of Hollie McNish, I had a real ‘nobody told me’[i] moment. If you haven’t read her book, it’s a seriously funny and brutally honest look at motherhood, so you really should.

As I sat on the loo in a café too far from home, I called my sister in a desperate attempt to acquire a spare piece of clean fabric that would cover my ass and stop me having to walk home in my now compromised running leggings. I felt distressed and somehow alone. This is something I knew could happen when I was in a nursing home – but now at the age of thirty-three?

I guess my story starts with the birth of my son seventeen months ago. After an extremely quick labour, perineal tearing and a retained placenta, you could say that my pelvic floor took a beating. Since then I’ve been aware of things like needing to pee all the time and on occasion leaking urine, but that’s something I’ve come to learn is pretty common amongst mums, and I kind of considered it part of my motherhood badge of honour. Having done a gazillion pelvic floor exercises, I felt that I was on the road to mending the damage that was done.

When I first got back into running after my son was born, I joined my local Parkrun which I’ve come to love. The whole run-coffee-cake-post-run banter routine on a Saturday morning with a group of friends has become one of the highlights of my week. And until recently, as long as I didn’t eat or drink too much or too close to my morning run, my pelvic floor was pretty well behaved.

In the last few months however, finding that running has sparked my competitive spirit, I’ve been doing a bit more training in order to improve my time. Running with the buggy (and baby of course) and doing a bit of strength training a La Beachbody Shaun T. Feeling good! It’s ironic really, cause in many ways my body is doing me proud. My 5k personal best is down to 22 minutes, and I’m still happily breastfeeding my toddler. But one day out on a run, my body failed me so spectacularly that it left me feeling pretty bad about myself.

The first time it happened I was pushing myself to beat my PB from the week before. I didn’t even notice it at the time, but at some point in the exertion I had a case of ‘Mr leaky bowel’; it helps to lessen the embarrassment factor if I imagine I’m explaining it to my toddler; plus now I’ve named it that I think it has a certain friendly ring to it. I was hopeful it was a one-off and I could just forget about the whole fateful episode. But it’s now happened on a few more occasions – I’ve identified the ‘danger zone’ as somewhere around the 7.00 min per mile mark.

The problem of incontinence is likely a lot more prevalent than we realise; it’s difficult to accurately measure because the condition is thought to be under-reported due to the shame and embarrassment associated[ii]. That said, it’s estimated that urinary incontinence affects between 3-6 million people in the UK[iii] and it’s a problem that affects women twice as much as men[iv].

Many people aren’t even aware that the pelvic floor muscles play an important role in bowel as well as urinary continence[v]. It’s reported that bowel incontinence affects between 2%-6% of women after childbirth. In women who had severe perineal laceration this figures rises to somewhere between17% – 62%[vi]. So where are all these women? I hate to think they’re all suffering in silence but I’ve never heard anyone talk about it.

Even among my own social groups I’m aware how off-limits this kind of chat can be. It’s not the kind of topic I feel I can breezily segue into during our post-run debrief over coffee. On the other hand, urinary incontinence seems to be a hot topic for mums and one that has come to be totally acceptable and I applaud that.

But we need to be able to talk about the really hard stuff and how it affects our day-to-day life, self-confidence and relationships. Women’s bodies during pregnancy, childbirth and beyond are amazing. When all is going well they should be celebrated but when things go wrong we need to have proper support in place and let women know it’s OK not to be OK. For starters, why isn’t the topic of pelvic floor and incontinence covered in mainstream antenatal education? Teaching mothers-to-be about how to look after this important muscle group and what to do when it’s not working as it should would surely help, not least let us know we’re not alone.

There’s a long wait to be referred to specialist Physiotherapist through your GP in the UK, but if the condition is seriously affecting you then that’s definitely the thing to do. For more moderate cases, should mums just be left to put up with this distressing condition?

In France, all new mothers are offered pelvic floor ‘re-education’[vii] to assess and improve the effectiveness of these muscles and as a result far fewer women suffer from incontinence. In her book on parenthood[viii] charting the different approaches taken in France versus Anglo-Saxon countries, Druckerman says “Before my first re-education, I had only been vaguely aware that I had a perineum…In France, getting a women’s pelvic floor back into shape is a priority”,

The truth is, I feel like if I didn’t have such a supportive husband; friends to speak honestly to; and writing as an outlet to deal with challenges of motherhood such as this, it would be a massive knock to my confidence. So whatever your danger zone is, don’t suffer in silence. I think a hashtag could be good here so if anyone has any inspiration for one to share motherhood struggles then let me know @feministparent1

[i] H McNish, Nobody Told Me: Poetry and Parenthood, Blackfriars

[ii] B Carlin and F Leong, Female pelvic health and reconstructive surgery, pg. 2

[iii] Bladder Control Advice http://www.bladder-control.co.uk/definition/facts-statistics/index.htm

[iv] British Journal of Medical Practitioners http://www.bjmp.org/content/female-urinary-incontinence-primary-care-management

[v] Chartered Society of Physiotherapy http://www.csp.org.uk/your-health/conditions/incontinence

[vi] Eason et al, Anal Incontinence after childbirth http://pubmedcentralcanada.ca/pmcc/articles/PMC99311/pdf/20020205s00015p326.pdf

[vii] Harvey, Gillian. French mothers don’t suffer from bladder incontinence. And nor should you

https://www.theguardian.com/commentisfree/2016/nov/02/french-mothers-bladder-incontinence-nadia-sawalha

[viii] P Druckerman, French Children Don’t Throw Food, Transworld Books

Feministparent

Ultimate Scrabble champion; likes running, apple crumble and quiet days around the house. Lives in Scotland with husband and baby boy. Follow me on twitter at feministparent1

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