Urine Loss after VBAC - distraught and worried

[Emma1979]

Hi girls,
Hoping anyone can shed some light on an embarassing problem I am having 9 days after my VBAC... it was a long labour, big baby for my size, and a forceps delivery with 2nd degree tearing... as a result of all this i have found the recovery excrutiating, and if i had my time again would have booked in for an elective c-section - but that is not the reason for my post...
I am leaking urine, to the point of it being quite dehabilitating - i am constantly going to the toilet to empty my bladder to avoid any escaping involuntarily. i don't have to cough or sneeze or laugh, just sitting and standing, or bending over does the trick. i have tried not going to the toilet for a while to fill my bladder to see what happens, and it just means i run to the toilet leaking the whole way. i am also stinging 'down there' due to a constant trickle of urine on my skin (sorry tmi). i am using my baby's nappy rash cream but it is still stinging badly.
i have a doctor's appointment on thursday, but i am just so depressed about this and worried it is going to be permanent. i have heard of stress incontinence after childbirth, when coughing or sneezing etc - that i could handle, but this is excessive and is affecting my life. i feel like a bad mother to my toddler as i am either constantly feeding the baby, and when i'm not i am too scared to move in case of leakage. i can't play with her.

does anyone have any advice, has anyone had anything similar and did it get better? if so how long did it take? i have read some horror stories on the internet of it taking 12 months to get better. i just don't think i can go on like this. i am doing pelvic floor exercises which i am finding difficult, obviously my pelvic floor is shot - i don't know how long it is going to take to tone it back up again.

i am in tears every night over this. i just want to enjoy my newborn and instead i am devastated over what i have done to my body. please help.

[Inanna]

Hi Emma - congratulations on birthing your baby. I am sorry that this is happening. This does happen sometimes Emma & yes it can be helped.

You need to see your doctor for a referral to a post natal physio. Your bladder has had this big baby sitting on it for all this time & all of a sudden it's gone. This can happen post c/section also.

Your bladder needs to be retrained and the muscles strengthened. Usually this can be treated by physio. I understand how embarassed you feel & how uncomfortable this must feel. Get you partner to get you some incontinence pads for now - this will help with you feeling less able to move. Because movement is what is needed to help with this also.

I had incontinence after my 3rd baby - she was nearly 10lb (I'm a small frame). It rectified itself without too much work in a month or two.

Big hugs darling woman I do understand how uncomfortable this is.

[Curly]

I also had a second degree tear after a long labour and a forceps delivery and the recovery was horrendous. It was the memory of that which got me through my birth with DD (9lbs 6.5oz and NO drugs) because there was no way I was doing another forceps birth.

I felt very fragile both physically and emotionally for several weeks afterwards. Couldn't sit comfortably, running to the toilet and not quite making it and having to wipe my wee off the floor. And I was constipated, I remember shrieking with the pain in my stitches when I had a bowel movement.

Too frightened to go out to the shops or out for a walk because of lack of proximity to the toilet if I had to go "right now".

When I did my pelvic floor exercises it felt like nothing was happening at all, so frustrating.

But yes, I did recover perfectly. I know it took at least 2 months because at my six week check I was still having a bit of urine leakage but by that stage it was only stress incontinence. When the OB checked my pelvic floor muscles I was managing to isolate them momentarily so I just had to keep it up. (And no, DH and I hadn't attempted to DTD yet by then either, I was too scared!)

If you have a toddler running around it's going to be hard, you need to call in as many favours and help as possible.

Firstly, did the midwives show you how to sit on rolled up towels to take the pressure off your poor sore privates?

Salt baths - essential. At one point I was having 2 a day.

Lie down for at least 2 hours a day (not necessarily all at once, but this does not include sleeping time) to take the pressure off the area.

Don't get constipated, whatever you do, take Metamucil if you have to.

And yes, you just have to persist with the pelvic floor exercises, at least 4 times a day. You will gradually notice the improvement, and when you can hold for 5 seconds it's a real "Yes!" moment! It's so discouraging right now I know, but you have to keep going because that is what will stop the leaking.

Keep your water up because it will stop your urine from becoming acidic and irritating the area even more. Don't try to test your bladder too much, go to the loo as soon as you have to, but don't go "just in case" because that won't help your pelvic floor build up strength again.

When you can jump up and down with a full bladder and not leak, you'll know you have recovered, and I could do that at about 4 months post birth.

And as for being a bad mother to your toddler, you aren't, you are doing the best you can. The first few weeks are terrible because you are so aware that your toddler is getting so much less attention from you, the newborn takes up so much time and you are recovering physically as well. My DS watched so much TV, it drove me mad, but it was all I could do...and I didn't even have the physical discomfort or bladder leakage second time around, it's a very difficult time working out how to juggle two children when you haven't done it before. I don't envy you dealing with the forceps recovery at the same time. As soon as your DH/DP comes home he needs to take over with the toddler while you lie down with the baby to rest your pelvic floor.

This is a bit off topic, but as soon as you are up for it, take your baby to an osteopath for a post birth check up and iron-out. My DS has a mild scoliosis in his neck from the forceps birth. He needed regular treatment up to the age of 2 to keep everything free and moving easily and to maintain his posture because he was growing so fast. He now will need a check up 2 or 3 times a year, ongoing.

The forceps birth is a nightmare to recover from, but you can and will recover from it, you won't be leaking forever. Huge hugs to you.

[Emma1979]

thank you so much for your replies, i feel so much better now...
i saw my doctor and she has given me a referral to a physio... she said i should expect things to get better in the next two weeks... she also said they wouldn't really consider it a 'problem' until 3 months of pelvic floor exercises had been done... i am so hopeless at doing these, i can do them lying down, but sitting or standing - i can't even feel what i am doing!
she also said to stop going to the toilet just in case, as this could lead to big problems of my bladder shrinking etc... the thing is, i try to fill my bladder up but it just leaks out, its like it will not fill up.
oh well i suppose i will just keep trying the exercises and wait to see what the physio says... hopefully things improve...
thanks again.

[BellyBelly]

The other replies have been great advice... I just wanted to add that it's a common misconception that pelvic floor issues are from a vaginal birth... it's actually the weight of the pregnancy that gives the pelvic floor the workout and can cause pelvic floor issues. So even if you have a c/s you can still have the same complaint.

As for the stinging, wee in the shower or place a sauce bottle in your toilet filled with water if there is any external stinging. You may want to get some Ural satchets, which is a urinary alkaliser and will take out the sting of urination. Another thing to get onto is arnica. Its a homeopathic pill you can get from a health food store or chemist which even surgeons I know recommend, it promotes healing and helps bruising, and is very recommended post birth. I have used it after surgery before and recovered very well. You might like some extra vitamin c also, but at the very least, arnica to help healing downstairs.