April is Caesarean Awareness Month

April is Caesarean Awareness month which is concerned with raising awareness of the physical and emotional toll of the Caesarean epidemic, and the issues surrounding vaginal births after Caesarean deliveries.

How many women live with pelvic pain? Suffering in silence or having no alternative but to dull their symptoms with pain killers? How many suffer, not knowing where to turn for help after being told there is nothing physically wrong with them? Too many women are told the pain is all in their heads!

Many of my clients seeking treatment for pelvic floor pain syndromes have lived for years with pain and the associated depression, relationship stress, medication and pelvic floor dysfunction issues, before discovering other treatment and self help options are available.

Recently I’ve been involved in The International Motherhood Study www.motherhoodstudy.net with Dr. Angela Huntsman (Psychologist) and Jodie Hedley-Ward (writer, researcher). These fantastic women invited me to contribute specific pelvic floor questions to their online questionnaire about the impact of motherhood on women’s lives.

To date, almost 5,000 mothers have responded. Last week we met with the project statistician and discovered that more than 40 per cent of these mothers reported pain with intercourse following childbirth. Of course, many women do not experience pain and the associated conditions affecting the pelvic floor muscles, bladder and bowel following childbirth. These fortunate ones have little knowledge of the trauma experienced by sufferers.

Following childbirth, women are not routinely asked if they have incontinence, signs of prolapse or pain, let alone given information about where to seek treatment for these common post partum conditions. The disturbingly high rate of Caesarean section births around the world, plus the routine use of episiotomies, leaves obvious scars in women’s abdomens and pelvic floors.

Surgery is considered successful when the scars heal without infection. Many women develop tough adhesions and sensitive trigger points around the abdominal and episiotomy scars which can cause pelvic floor dysfunction and pain as the adhesions toughen with time. 

The interconnections between the layers of abdominal muscles and fascia and the pelvic floor mean that trigger points in scars typically refer pain to other areas of the pelvis. Pelvic or pelvic floor pain causes a woman to go through her day and night with her muscles clenched too tightly. Over time this can lead to an upgrading of her pain into a pelvic pain syndrome (vulvodynia).

In the interest of female pelvic health, it’s time to lobby our local health professionals involved with childbirth to (at the very least) include standard questions and treatment information to post partum mothers on incontinence, prolapse, scars and sexual pain. Empowering women with the correct relevant information will go a long way towards preventing unnecessary prolonged pain associated with treatable conditions, following childbirth and surgery.

Contributed by Mary O’Dwyer, pelvic floor physiotherapist with over 30 years of clinical and teaching experience. Mary’s book Hold it Sister! is out now. Sign up at www.holditsister.com for Mary’s newsletter, packed full of healthful information. You can also access archived newsletters and take a free Bladder & Orgasm Risk Profile, assessing your personal pelvic floor risk factors.