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Photo: sarahwolfephotography

When the physiotherapist asked me how I felt about my recovery after the birth of my daughter she presented me with a scale from not concerned to very concerned. I told her the scale was missing how I really felt, which was let down. Let down that no one told me what the very real repercussions of a 'natural' birth might be. 

In fact natural birth makes it sound peaceful. Brands use the word natural to evoke feelings of trust and harmony; neither of these seem to really fit with many women’s experience of a natural birth. So let’s call it what it is, a vaginal delivery, and if you have one yours might never be the same again.

I was not a die hard for a vaginal delivery but there was no reason that put me in a category to consider or need a caesarean. Being an endurance athlete I was confident I had a strong pain threshold, most of my concern before the birth was around losing control of my bowels during the delivery and being naked in front of a team of medical staff. I gave little thought to the recovery.

Friends who’d had vaginal deliveries promoted that it was a much quicker recovery, ‘I walked back to my room afterwards,’ one said. Others celebrated that they could drive straight after rather than being on a five-week embargo and, of course, they could lift their baby without a problem. All these positives focus on the five or so weeks after birth, where I understand those that have had a caesarean do it tough.

But what has surprised me is how little people mentioned the after, after effects. I’m talking about the things that can last a lifetime after a vaginal delivery, such as a weak bladder, reduced feeling or even pain during sex, a heavy feeling in the vagina where your insides feel like they are falling out (and quite literally can be), and also the physical look of the vagina, which for many is never the same.

I, for one, was baffled when I took a mirror to examine the area. I first did this in the hospital a few days after the birth. Bruised and swollen is how I would explain it, with a long stretch of black stitches. With an ice-pack in my underpants I greeted my guests.

Months later, the stitches dissolved, bruising and swelling subsided I am quite literally left with a vagina that I do not recognise. Nobody told me about this. I have since mentioned it to friends and they shrug with indifference as if I am ungrateful. ‘Yeah but it’s worth it,’ one said. But I’m not sure it is. Of course I am grateful for the healthy child that we have but the repercussions for me physically are not minor.

I had a private obstetrician, one of Sydney’s best. When I think back to the consultations, it was mostly about the baby, and yes it should be of course, but very little was about the birth, and next to nothing about after. On reflection, I find this surprising. Women, understandably, might keep mum but surely obstetricians have a different obligation?

If I had been presented with some clear and simple possibilities, which every obstetrician would know, then I feel I could have made a more informed decision and been better prepared for the recovery.

The clear and simple possibilities if you have a vaginal delivery are that:

 - You may have a weak bladder for life;

 - You may not be able to run again, skip or throw a ball due to a weak pelvic floor; and

 - Your vagina may never look the same.

Before, after and after that pictures would assist with the final one. Stories of incontinence, not making it in time, sitting on the sidelines as your children play with your husband, declining invitations to join your friends in a fun run would help demonstrate the others.  

An understanding of these real possibilities would help women make a more informed decision about birth and their future health and surely put us in a better position mentally to deal with it if the possibilities do become a reality.

The consequences of a vaginal delivery can last a lifetime, and depending on your lifestyle, hobbies and relationship, these factors can drastically change how you live and challenge your sense of self.

I was as prepared as I thought I could be, I even took up the option to use an EPI-No, a balloon like device that can stretch the area for the delivery. I had reached a point where I could tolerate the size of my baby’s head, so why so much damage? The birth was what they term rapid. Until I experienced it I hadn’t realised that a ‘rapid’ birth is quite a shocking thing to experience.

A one hour labour from the water’s breaking, going from 4-8 centimetres in under 15 minutes, this is very rapid, but even a three-hour birth is considered quick. For me, there was no distinction between contractions. It was one hour of the excruciating peak of a contraction, with no idea when it might end. I screamed for help for the duration but no relief could be offered as it was all happening too quickly. No one could help me. 

I was in shock when my daughter was presented to me, I was pale and shaking uncontrollably. They had to give my daughter to my husband so I could ‘come to’. In the days that followed the shock continued and I felt genuine fear about ever doing it again and shame that if I had to do it again I would choose death and leave my child motherless. I still feel the same. It was absolutely brutal.

After announcing the arrival of our daughter the texts came flooding in, ‘Lucky you with the easy birth, mine took 20 hours!’ and ‘Wow that one popped out!’ Births are meant to be long and contractions gradual. Whilst physically it allows the body to stretch and open up, mentally the mother has a sense of some control, until the end. ‘It’s just a burning feeling’ someone said to me of the end, the crowning of the baby’s head. I have no distinct awareness of that bit of the birth, it was as painful as the rest and ‘just a burning feeling’ doesn’t quite explain it.

Rapid births are frightening and some women who have them choose not to have another child, others elect a caesarean or get to the hospital as soon as they feel a twinge. Perhaps you have to experience it to believe it, but I wouldn’t wish that upon anyone, let’s just say that this is one of those things where quicker is not better.

As for the vaginal delivery recovery, it’s a long road, and I’m at the beginning of it with weekly trips to the physio, Pilates and pelvic floor exercises.

It’s hard to know if I really would have made a different decision if I knew then what I do now. In fact, having heard all I have to say on the matter, a friend who had an emergency caesarean says she’d still opt for a ‘natural birth'. At least she would know what she’s in for and would be saved from searching online forums of new mothers (and there are many) to discover that what she’s dealing with is, in fact, to be expected.