Postnatal Recovery Part 1: Becoming a Tena Lady

Sometimes I think I am a little naive or slow on the uptake. Believe it or not, for years I casually wondered what exactly Tena lady was for. I didn't quite get why someone would need a pantyliner everyday for those 'oops moments' unless their menstrual cycle was so irregular a woman would literally have no idea when it might start. But is that such a common condition that it warrants a major brand that can afford so much advertising? They must be selling A LOT!! So when I finally paid attention I realised it was for bladder problems, and I thought ok now the product makes more sense, but the same question arose: really, that many women have continence issues? Apparently so. And no one talks about it.

Not until I had my own baby did I have an insight on this silent epidemic. Having done a little research, I understand that there are several medical reasons that someone, male or female, may be affected by bladder incontinence such as stroke, Alzheimer’s or MS, nonetheless the vast majority of sufferers are women who have had babies. Getting accurate figures is difficult as many suffer in silence or are told that it's 'normal' after having a baby. However, from the small bit of research I have done almost every woman I have spoken to has had some degree of bladder continence issue since giving birth (no matter what kind of birth they had) and for many it is not a temporary problem.

Sadly, post-natal pelvic rehabilitation is virtually non-existent in the UK. I believe it is a major women's health issue that is being ignored and leads to serious health problems in the long term. The NHS website acknowledges that "up to half of all women who have had children are affected by some degree of prolapse" [1] yet there is no standard post-natal care to address this. By comparison in France, as I later discovered, they recognise this need and provide la rééducation périnéale – a course of 10 or so sessions of physiotherapy specifically aimed at realigning and strengthening the pelvic floor. This is offered by the state to every woman after giving birth as part of their national healthcare. As one French midwife put it “Childbirth has a traumatic impact on the perineum. When you hurt your knee skiing, physical therapy is covered by insurance here. Why should it be any different?[2]

Having worked regularly with my core and pelvic floor in my yoga practise for many years, I really noticed when it was gone after I gave birth. My body was no longer mine. It was heavy and achey, I could barely walk down the street. It felt like my insides were falling out, and unknown to me at that time they were, or at least heading that way. My 6 week check-up left me none the wiser as to what had happened to my body, in fact the only physical exam I had was having my blood pressure checked. Having gone to the Herculean effort of showering, washing my hair and finding clean matching undies for my appointment I was somewhat miffed that there was no pelvic exam. After all, during pregnancy medical staff seem to be in there at every opportunity! Apparently once the baby is born, a woman's pelvis and the organs therein are no longer of any concern. I asked whether I exercise now, including running, and was told absolutely, just take it easy.

So I strapped up my boobs and tried to go for a gentle jog. The joy of the sense of freedom and movement was very short lived when I found that taking a longer stride resulted in serious leaking. WTF? No one had told me about this. After self-examination, and quite a lot of googling I diagnosed myself with diastasis, cystocele and rectocele. I went to the GP to confirm diagnosis and get referred for treatment. His attitude was, "well you've had a baby, you're not going to be the same again. If it's not better in a few months we can look at surgery." I sat on the bench outside and cried. I went home and looked at the sorts of surgery available and their consequences and cried a bit more. None of them was an option I was willing to take. So after a few days of self-pity and despair, fearing I may never be fully active again, and never be the mum I want to be, I got angry. Determined not to be consigned to a limited life and convinced there must be another way, I started investigating exactly what was going on with my body and seeking out a better solution.

Hopefully some GP’s are better informed than mine was, but even still it’s hard to get decent post-natal care in the NHS. And ladies, there is so much more that can be done before even contemplating something as radical and risky as surgery! In a nutshell I went back to my anatomy books and my yoga books, got back online and looked into all kinds of non-surgical approaches (some weird, some wonderful!) and settled on a private specialist physio and an online exercise plan alongside my yoga practise. Today my body is in a very different place (I hardly ever use tena now) and I want to share what I’ve learnt with you so hopefully many more women can avoid surgery and live happier more active lives.

Part 2 of my recovery blog will explain what diastasis and prolapses are so you can really understand what is happening internally and avoid things that worsen them.

Part 3 will then describe the solutions that worked for me and give lots of information of where you can seek help and support.