I thought it was stupendous, giving birth. I felt like an Amazon, pushing out those wonder-children – long and hefty, smooth pudgy skin, so tender under my hand. It was a miracle of world-making to see a whole human unfurl from my womb. But this other shocking reality: torn flesh, lumpy stitches, burning urine, painful pooing. A visceral damage – but one I thought would be short-lived.
When I had my two children over 30 years ago, I was a fan of the policy of the public hospital birthing centre: 24-hours-then-home-you-go. I thought I only needed an overnight or two in hospital before I whizzed home with our newborn. I didn’t see any sense in medicalising birth. It was, after all, a natural process. There was little awareness of or planning for the time a body needed for healing and repair.
I thought, if I can do this, I can do anything. When we arrived home with our firstborn, I refused to cancel the dinner with friends who were coming to stay the night. Yes, I said, it was a straightforward birth and how lucky am I? Of course I’m fine; no issues. I didn’t know what damage would come later.
I didn’t know how much rest a birthing body needs. I didn’t know the elders understood this, that lying-in is a tradition for a reason. I thought offers of help were outmoded notions of old-fashioned womanhood. I didn’t know that lying down and staying home would have let my body knit itself back together just a little bit more. That there’s a humility in resting – the humility of finitude.
***
In the last 30 years I have seen physiotherapists who specialise in women’s health. In my case, this is a euphemism for pelvic floor health. And pelvic floor health is a euphemism for collapsing muscles and sagging organs – in turn euphemisms for the control I did not know I was giving up when I had those babies.
By the time I reach my 40s, comedian Judith Lucy says it for me – “Your pelvic floor is fucked? Get it carpeted!”
I asked a midwife once why she thought labour was so intense and painful. She looked at me unblinkingly and said, “It’s to prepare you for what’s ahead.”
In my 50s, 20 years after those babies, and after years of Pilates and physiotherapy, I have surgery. My prolapsed vaginal walls are lined with mesh, tightened and tucked. When the surgeon shows me a sample of the mesh, I look away. Who wants a kind of flywire embedded in their vaginal walls? It turns out I am one of the lucky ones. Many women have significant pain with this mesh – there are court cases and class actions.
The surgeon is a good technician, a bad communicator. If a patient rings his rooms, the snippy receptionists cut them short. So, my women’s health physiotherapist is my guide in preparation and follow-up to surgery. This physiotherapist has been an early leader in the field of pelvic floor recovery, and my questions make sense to her. I secretly dub her my Cheerful Coach: she is as colourful as a rainbow lorikeet.
During the surgery, in addition to the mesh work, a sling is inserted to stop my uterus from collapsing into my vagina. The surgeon has also recommended a hysterectomy but a conversation with my GP changes my mind.
I ask: “How will they extract my uterus if they’re doing keyhole surgery?”
She says: “They will mince it up inside you and extract it piece by piece.”
I decide I will not do this. No, I say, don’t take her. Support her.
So they put in the sling. I imagine it as a kind of hammock where my uterus can put her feet up and relax after all the work of month-by-month readiness, and child holding, and the fearsome effort of expelling the baby from its inside swimming pool. But why do I wait until my 50s to give her time to put her feet up?
When I ask Cheerful Coach how to describe the surgical intervention, she calls it “pelvic reconstruction” – right off the bat. This feels a lot better than the misery embodied in the word prolapse and the thought of embedded flywire. Prolapse has always invoked a sense of failure, as if I have somehow collapsed and not managed to keep myself intact.
On my physiotherapist’s watch I take six weeks bed rest post-surgery. No lifting, no weight-bearing, nothing heavier than a kettle of water. The rest makes sense; it gives the best chance for healing. And after secretly dreading its enforcement, I relish it. Who knew there was so much space in a day, that you could watch the shifting of the light, the movement of leaves, the pedestrian life in the street? Who knew that you could imbibe deep tranches of sleep, long spells of silence, inhabit other worlds narrated on audiobooks?
Rest works. It doesn’t heal everything but it helps. I wish I’d known that when I had my babies. For me, the compulsion to keep going compromised the chance of ever really recovering from giving birth. I wish there’d been a shape of living that made it possible to honour the work of birthing. It took me too long to unpick the narrative of being constantly time-poor and living life at speed, to pause as opposed to collapsing with exhaustion.
There is no relapse, no further prolapse; it seems my private parts have now restored themselves. I am grateful for skilled surgery and proud of my recovery. I return to Pilates, attending weekly classes that build my core strength and help me integrate new awarenesses of posture and breath. And all these things help.
Then comes that obstacle – a weakening for which it feels there is no help.
***
Because now, in my 60s, this new problem. My faeces leak. Never large amounts, just teasers. Sometimes a lurking smear, sometimes like small pebbles. This will happen when I least expect it to. There’s no warning, no urgency, no pressure. I have a bowel motion, I think it is finished, I go on with my life and move about.
But my body has not finished.
The leakages become more frequent – every week or two instead of months apart. My physiotherapist offers ways to manage this. I wear the disposable liners used for menstruation, but I’m terrified I will smell. I ask my GP if she has managed people with faecal incontinence. The GP shakes her head. I drop my gaze. I do not like feeling exceptional – not like this.
I ask Cheerful Coach about shame. Why does this feel so mortifying? More than once, throughout the years, health professionals have seen that I was blaming myself for my body’s apparent failures. “This is not your fault,” they’d said. But while I’d heard them and sensed their compassion, that default setting had a tidal pull.
Cheerful Coach explains: “When we lived in caves, if you were incontinent, the wild animals could smell you. You were a danger to the tribe.”
A sense of relief: this shame belongs in the reptilian part of the brain.
Through a mutual friend, I meet a woman who has experienced far more dire episodes than my small embarrassments. She tells me the worst. While travelling in Europe in an ancient town, she could not find a toilet. In the end, on her way to the tiny bathroom at the back of a public bar, she lost an entire bowel motion. She describes it as the most abject experience of her life.
We talk about fear and our forebears and what happened to their bodies. I wonder whether my problem will grow worse – what will become of me.
And none of my friends talk about faecal incontinence. It’s the last bastion, the last boundary of body-shaming. The only place I ever hear faecal incontinence referred to is in relation to aged care, where it’s spoken of with the nose wrinkled.
Yet one in 25 women will experience it. That’s 4% of us.
***
Is it a betrayal to speak the harsh truth that childbirth can cost a mother’s body in ways that will never fully repair? To speak only of the wonderment of a new human?
To tell, or not to tell? Is it a conspiracy of silence or a wise withholding?
Which is why I deliberate for so long before I tell my daughter. Eventually I tell her exactly what is happening. She is considered. She is thoughtful. She asks excellent questions. I’m relieved – for her and for myself. Because I had felt ashamed and thought she would feel ashamed of me. She is calm and respectful: “Can you get some more help?”
***
I see a colorectal specialist. Colon. Rectum. These words sound too much like what they are. Colon: so slippery, like a python, like raw sausages. And the rectum: just plain ugly.
In the operating theatre this surgeon inserts a tiny balloon into my backside to test the responsiveness of my sacral nerve. When the balloon is inflated, I can feel its movements. This is a good sign. I am then given anaesthetic, and he inspects my rectum and colon.
Afterwards, the specialist explains what he’s found in this investigation. My sphincter has lost its elasticity. He regrets he cannot just give me a new one. It is a not-funny joke.
I have a question: did he find anything to explain the lack of warning?
“No,” he says. “All normal. Nothing wrong with the sacral nerve.”
Conversation finished. Nothing to be done.
I am an elastic band willing to stretch every which way until the spring has gone, and there is only sag. A human with no bounce: dammit. That’s not me. I will not be that person, that worn-out, useless rubber band.
In the end, I find a physio who specialises in faecal incontinence. Yes, you need to know there are these people. And the practice is so busy there’s a wait of several months. I wish I could tell you the colorectal specialist referred me to her. He did not.
This physiotherapist wastes no time and asks very specific questions. She does not talk too much. Things are reduced to their essentials. I think of her as an efficient angel. She’s busy, but there is a distilled quietness in her speaking, a watchfulness in her eye contact.
She says: “An empty bowel can’t leak.” She will teach me to empty my bowels.
Regularly.
There are dietary considerations, hydration needs. There is psyllium husk, the flavourless painless way of swallowing roughage. There are issues of routine and rhythm.
Her advice works. Occasionally there is some leaking, but less often and less distressing.
When I check in with the woman who had the abject experience, she says: “I’m organised now. I’ve learned how to keep my bowels regular and empty.” She’s told her worst story to one other friend. “It was so terrible we ended up laughing. All those people rapping on the door while I was trying to clean up the bathroom!”
***
The narratives about the impacts of childbirth fall too readily into the “you can do it” brand of sports prowess. Vulnerabilities are only mentioned as things to be overcome. I formed a belief that the failure to securely hold parts of my body was a personal shortcoming. If only I’d done enough pelvic floor exercises, things would be different.
But this shame does not belong to my body. This shame belongs to a society that is built around extraction. It is an unholy truth that just as we fail to respect the Earth and allow its replenishment, bodies themselves are not allowed to rest. Most of us are scared of stillness.
But I don’t want to tie this up too neatly. I know I carry an awkward vulnerability, and while it is manageable now, when I grow into old age I will become less capable. I cringe when I think of the impact on those around me.
I can’t not be glad I had children, I like them too much. I’m lucky I had the privilege of becoming a mother, and becoming a grandmother is full of astonishments. All over again, there’s a cascading delight in witnessing a new human awakening to life.
For now, I am grateful for the sweet places that exist between people. The places of belonging and laughter, the places of intimacy, mercy and grace. I know there are times when laughter can defeat the shame that is projected on to women’s bodies. The shame does not belong in me, but still it hovers in the unspoken, in the stories none of us want to tell.
