Bonus Episode: Rachel Horne - Episode Transcript

<T/W: Birth story, birth injury, traumatic birth, venteuse>

Helen

Hi, I'm Helen, and this is Why Mums Don't Jump, busting taboos about leaks and lumps after childbirth. All the stuff that happens to your pelvic floor that no one ever talks about. Incontinence, prolapse, pelvic pain, problems that affect millions of women, one in three. And I'm one of them. I have a prolapse. My pelvic organs fell out of place after the birth of my second child five years ago. And if you told me then I'd be speaking about this stuff out loud, I would have told you to give your head a wobble.

Helen

Hi. So I know that I said that last week's episode was the last in the series and it was supposed to be, but then someone got in touch with me who I had been trying to get on the podcast, Rachel Horne, the newsreader from the Chris Evans Breakfast Show on Virgin Radio. I had emailed her a while back because she spoke about her urinary incontinence on air in front of hundreds of thousands of people on a live radio programme. And, well, if that's not tackling the stigma, then I don't know what is. So she kindly agreed to have this chat with me and we got through all kinds of things, from traumatic births to pelvic floor gadgets. There are such things, and the importance of putting yourself first when it comes to rehab, especially when you set yourself a big challenge.

Rachel

So, as you may be aware, Chris and Vassos are very into running. They do lots of marathons and Vassos is very involved with park run and stuff like that. And so from when I joined the team, which is almost two years ago now, they kept saying, oh, you come running with us, come and do the Amsterdam marathon with us, or come to Run Fest. And I'd always go, no, no, no, no, no - I was doing fitness, I would do like, boot camps and that sort of thing. But running I just wasn't doing. And there was a main reason why I wasn't doing running and it was pelvic floor issues and it was one of those things where I thought, you know, when I run, I have pelvic floor problems, so I will choose not to run and I will do other forms of exercise. And then it was last November, and Vassos was writing a book about running, I think his third book about running, and he wanted to kind of follow a story of somebody who didn't run and basically get them to run the marathon. And he would kind of do their training programme and help them along. So he was discussing it with me and he said, 'I think I'll get my wife to do it. So I'll speak to Caroline and get her to do it and get her on board and then that will work really well.' And I was going, 'Yeah, that's a great idea, I'm sure Caroline would be really into it.' Anyway then he came back into work the next day and he went no, no, no she was not up for it at all. But I was thinking, what about you?

And my initial reaction was that sort of you know when your tummy just drops, no, no, no, it's not me. And then I kind of thought, oh you know what, I was turning 40 in those sort of twelve months. It's the London Marathon. What a privilege to run the London Marathon. To do it with the support of somebody like Vassos, who knows everything there is to know about running. What is stopping me? Well, what's stopping me is my pelvic floor. And actually, if I'm going to sort it out, this is the perfect time to do it. So I said, right. Okay, actually. Right. Vassos, you're on. I'm going to do it, but I need to get myself sorted. And so he said, right, I'll draw you up a training timetable. You need to start doing some short runs between now and Christmas, and then we'll really get into it after Christmas. So I thought, right, I need to get myself sorted. So I spoke to a couple of people, 'Oh I might need to...does anybody know anybody?' And even those conversations were a little bit sort of, 'Does anybody have an issue or anybody sorted out this sort of thing?'

Yeah, so to give you my background, I had three children in three years, basically.

Helen

Wow.

Rachel

Three vaginal deliveries. The first one was quite traumatic. It was 27 hours labour. In the end, I was frozen up for a Caesarean, but they delivered him with ventouse and forceps in theatre. And at the time, I may have been told, but I don't remember being told I had a third degree tear, but I was unaware of it. So when I had my 2nd, 19 months later, we went for the midwifery led care, which was just, it was in the hospital, it was just on the other side of the corridor. Rooms were the same, it had a bouncing ball in it, but it meant if you did need medical intervention, it was just across the way. And we had this amazing midwife, and I gave birth on Christmas Day. And I remember I was up on my hands and knees and this amazing midwife was massaging my lower back, telling me where to push when the contractions came. And Alex says that as the baby crowned, he said the midwife gave a very sharp intake of breath and just went, oh did she have a third degree tear last time? And Alex said, I don't know, I don't think so. And she went, I think she did. And she's just gone right along the scar line.

Helen

Oooh, my God.

Rachel

So I had him, I had him on gas and air. They then had to give me an epidural to do my stitches and send me into the theatre. Galling.

Helen

I can totally relate to that.

Rachel

Yeah. So then when it came to my third so we said, look, you know, third degree tear, two third degree tears, quite severe blood loss with both of them sort of borderline transfusion. They were like, okay, this time around, you've definitely got to be under medical care. And I had, so I had the midwife who was on duty, I had a student midwife who'd been following my pregnancy for her course. And so when I went into labour, she rocked up. And then I also had the midwife, the head midwife, who was on duty for that shift, who basically said to me 'I've seen your notes, you've had two third degree tears, you're not going to have another one. I've been working for 19 years and I've never had a third degree tear on a delivery and I'm not going to let you have one.'

Helen

Wow.

Rachel

Which was great to hear. So I remember with him, I was stood up in the room, so I was in like a medical gown and everything. It was much more medicalised, but they were allowing me to labour the way I needed to. They weren't sort of restricting me. So I was stood up and I had these three women around me and Alex, and I was having contractions and I said, 'Oh, this one's different, this one's different.' And they were like, 'No, you're fine, you're fine.' I was like, 'No, this one's different.' And the student midwife lifted up my gown and just went, 'Sh*t, baby's head!! And all three of them just went, 'Stop pushing!' And the three of them physically lifted me up, put me on the bed, and the head midwife, she was like, I've got to hold your perineum. Shoved her hand up, held it, and I delivered him with a second degree tear. So that was amazing.

Helen

I was going to say, that probably felt like quite an achievement!

Rachel

I was like, yay!! And so then she stitched me up and it was such a different experience because obviously with third degree tears with the first two and being on epidurals, I had a catheter in, I was in overnight. I didn't have any of the…sort of...it was all in theatre. So with my third, so she stitched me up and she said, right, if you want to just go and have a shower, bathroom is there. Sorry, what?

Helen

Wow.

Rachel

What? Midwife - Yeah, we'll go. We'll leave you to it.

Rachel

So he was already feeding at that point, so 'When he's finished feeding, give him to Alex and then you can go and have a shower and sort yourself out.' So that was very unreal. And I remember just sort of getting off the bed feeling so wobbly, but, yeah, getting into the shower. First time round, you pack that bag, don't you? With all your lovely body wash and your moisturiser and all of that.

Helen

And your makeup!

Rachel

Oh, yes, makeup for your new baby pictures! So I got into the shower and had a shower and that was amazing to be able to do that within, I think he was only about half an hour old. So then they said, you can go home. I can go home now? Yeah, you don't need to stay in overnight. And I said, to be honest, there's nowhere for me to sleep. All the grandparents were in the house and also there are two other children aged three and one and a half. I’d quite like a night in hospital!! So they said, well, given the blood loss on your previous deliveries, that will keep you in for 24 hours, just to keep an eye on you. That was good. So that was kind of my history.

So in terms of what I put my body through, there was very little recovery time in between each delivery. I then had three kids, all very young and running around doing that. And actually after I had my third...so I took a year's maternity leave with each, and then with my third, I took an extra year on top, so I had two years off with him. And you're just so physical. And I was aware that there were some issues, but it was nothing that was preventing me from doing what I felt I needed to do, which was keep these three children alive and they become your absolute priority and you just kind of fall down the list. As long as you're sort of clean and clothed, nothing else is a priority, really.

And I remember when Dara was about three...so I was leaking, I was wearing Tena Ladies, I was wearing incontinence pads, possibly not every day, but on and off, probably most days. And I thought, that's probably not the way we should be going forward. I was only in my mid-thirties at that point, so I went to the doctor and I said, look, I think I've got a bit of an issue. And they were great. And they said, look, we refer you to a Gynaecological physiotherapist, which was a mouthful. And I remember going to see her and I remember I had nobody to look after my youngest, so I had to take him with me. And then I remember, luckily, she had a whole box of toys because I had to lie up on a bed and she had to do an internal exam behind the curtain. And luckily there was this box of trucks, which thankfully kept him occupied, because if he put his head around the curtain….!

Helen

I've been there. Oh, yeah, I've been for a pessary fitting with two under fours and an iPad and a promise of sweets. You can have sweets but do not look round the curtain!

Rachel

Whatever it takes! And this physio, she was lovely. I had been in between seeing the GP and seeing the physio, which took a couple of months to get the referral through. I'd been doing the exercises because also I hadn't been doing any exercises, so I'd been doing the exercises and I did find there was improvement. So I think when I saw the physio and I said, look, there has been improvement. And also, I think we can be very guilty. Women can be very guilty of not putting our hands up and saying, actually, I need to be sorted, I need to come first and I need to be fixed. And so I was just like, you know what? There's been some improvement. I'll just keep doing the exercises, it's fine. And I guess she probably thought okay, well, if she says it's fine, then it's fine. She was like, okay, just keep doing the exercises. If there are any future problems, do get back in touch with your GP. So that was kind of that, really. And I kept doing the exercises for a bit, and then I stopped doing the exercises because I had three children and a career, and it's easier to wear a pad than to do the exercises, if I'm honest.

So it came to the marathon and I thought, well, this is not going to be pretty if I don't get this sorted. So I spoke to a friend who said, I know a great female physio who is good at pelvic floor stuff. So I went to see Emma James, and the woman is a godsend. So I went in, I went to see her in before Christmas, and I went into the room and she was sat there and she just said, so tell me your story. And you just say, 'Oh, okay. And there's just that release in just talking about yourself. So nice to talk about yourself!'

Helen

When do you ever get a chance to kind of go through that or process that or just have that space to explore it?

Rachel

Yeah. And she just sat there, she just listened. And then she said, 'Okay, we can fix this.' And I just burst into tears because I felt heard. And it's not that other people in my life weren't listening to me, I just wasn't talking because I didn't have the time or the space, because I had so many other things and so many other people to look after before me. And it was like a huge weight lifted off me. And she said, I think it is just as you said, three kids in three years and tears, and your muscles are just exhausted and injured. And I remember listening to one of your podcasts, Helen, and you talk about how it's an injury, and once you put that in your head, it's how you reframe your thinking. It's an injury that needs to be fixed. If I had an Achilles injury in my ankle or if I had a shoulder injury which was stopping me from doing a sport that I loved, I would do everything in my part to get that fixed. So why am I not fixing this injury?

Helen

Yeah, that blew my mind, that. I don't know why I'd never thought about it in those terms, but I just hadn't. And like you say, once you reframe it, it makes it less scary actually, and less all present and all powerful.

Rachel

And also it makes it seem less self indulgent to want to fix it. Because I think there's very much this sense that wearing an incontinence pad or not being able to jump is almost a badge of honour. Like, it's what we go through as women, and it's not, you know getting an injury from running is not what you go through as a runner. It is to an extent, but then the rest of the journey is that you fix that. Having incontinence issues because you've had children, yes, it is part of the story, but you've got to get to the next chapter where you fix it, you don't just put up with it. And I think so many of us just accept it as part of motherhood. And not just motherhood, so many women who haven't had children suffer from it. And I think it's so important that, like you've said, you treat it as an injury.

People talk about mental health issues and somebody close to me talks about it, as in, if she had a broken leg, she would put a cast on it. So if she has mental health issues, she uses medication or meditation to fix it. If you have incontinence issues, you fix it with exercise, possibly with surgery for some people. But it is not just something that you should have to put up with and that you should be quiet about, it's something that can be fixed.

Helen

Yeah, it's not just a byproduct of having children, it's not something you have to put up with, it's not just a full stop.

Rachel

Yes, so my situation had become worse and I was wearing an incontinence pad every single day. I didn't leak every day, but there was always the possibility of a sneeze or running to catch the tube or just one of the kids catching me unawares. And depending on what you're wearing, that could go either way. And I think the point at which I started wearing one every day...so my eldest had a music concert at school. He was only in year four. He’d been playing the saxophone for a year or two, and I was determined to make this music concert. And it was at 6 o’clock and I was getting the tube out of London, and I strategised it down to the last minute. I'd asked him to put him on at the end of the concert, so I'd, like, rushed out. I was still working at the BBC at the time, so I was doing the business bulletins on BBC News. So I'd rushed from the studio, literally ran from the studio to the tube, still in a full face of makeup, got to the tube, made my train, got to my station where I'd parked my car, jumped in the car, drove to the school. I was getting texts from other mums who were there saying he's at the end, he's not on yet, there's six to go before him.

So I pulled up and I had to park quite far down from the school cos loads of people were parked, and I ran from my car. And as I ran, I could feel myself (pause from Rachel as she struggled to speak at this point)... and I didn't want to miss it. And I ran into the hall and I got in at the back just before he went up and I saw him and I was so proud of him, but I had to hold my bag in front of me. I was wearing a blue dress and it looked like somebody had just thrown a pint of water at me.

Helen

I'm sorry. That is so rubbish. And there'll be so many other women who have had that experience, not in that same school hall, but in different walks of life. At work, in the office, in a meeting, whatever it is.

Rachel

But I made the concert and he was brilliant!

Helen

You did!! Because you're a mum and you're like, whatever, I'm going to be there.

Rachel

Even if I'm going to wet myself, I will be there. So from that point, I started wearing a pad every day, and that was probably two years before then, deciding to do the marathon and deciding that I needed to get it sorted. So, yes. Emma has been amazing. I think if anybody can find a woman's physio who can really hear them, oh, my word, hold on to that woman tightly. So she was like, right, you're trying to run a marathon, it's not ideal. I'd rather have had maybe six months with you before you started trying to do something that intense on your body. But we'll work with what we've got, so we went for a sort of multipronged attack using the Pelviva. Have you seen these Pelviva things?

Helen

Yeah, a little bit. I'm really interested. There's a lot of, I think what is called Femtech around at the moment, and I think it's really interesting and I'd like to know more about it. Things that kind of do little electric pulses into your pelvic floor to train it.

Rachel

Yeah, so I've done three different things and they're probably at three different sort of price points. So I've used the Secret Whispers, which I think are a brilliant way for anybody to start. Now she actually, she contacted me and Emma after she heard me talking on the radio about it, and she sent me a set of her Secret Whispers.

Helen

That's weights?

Rachel

Secret whispers are like weights. They look like small ping pong balls.

Helen

It all sounds crazy, doesn't it?!

Rachel

That's hilarious.

Helen

Get some vaginal weights!

Rachel

Fantastic! They kind of sit in a sort of white silicone sort of holder. You push them up into you. I mean, some people might need to use a lubricant, but they're very soft. They do go in quite easily and then you do your 15 quick pulses and you're up for three in the lift, hold for five, down for three floors. You do all of that, but with the weights in to increase the work that your muscles are doing. And those are very inexpensive and they've been great because you can do them whenever.

Then I've also been using the Pelviva and that looks like a large tampon, it sits in your vagina and it does like little pulses, but it does it all so you don't have to do those contractions. And with that, you can sit down and watch telly or you can walk around. Today I had a Pelviva in, was doing a sort of six minute hit work out of like squats and lunges to, again, really get those muscles working. And to really get the most out of it. With the Pelviva, they recommend that you do one every other day for three months. So that full course is about 600 quid, which is quite expensive. But I think even if you just buy, you can buy them in a much smaller packet just to see if it works for you. And then there's the Pelvi Power chair, which is like this Game of Thrones sort of hilarious piece of kit.

Helen

I saw a picture of it on your Instagram, like a dentist chair or something!

Rachel

It's like a dentist chair for your vagina. So you sit on it and they turn it on and they can increase the intensity. But it's essentially a magnetic coil that sits under the seat and it feels like there's an army of, like tiny little elves with little hammers, like, hammering up underneath your bum.

So I've tried all three of those, but I was also doing all of the marathon training as well. So I was running half marathons doing 16 miles. So I was still leaking and leaking significantly, like on the longer runs. Like when I did my 16 mile run, I wore a maxi pad and had to squat behind a hedge to change my entirely full maxi pad while my friend looked out for dog walkers. Like, kind of after about 12 miles. Then we hit March. Marathon gets cancelled. Everybody goes into lock down.

Helen

Of course! Right, yeah.

Rachel

Everything stops. And like everybody else, I'm suddenly working from home, broadcasting from the front room while also homeschooling three children with Alex's help. But he's doing all his HomeTasking stuff. He's busier than he's ever been. Your Tesco shop has gone from 15 minutes online to a three hour event while you're queuing and getting around the store. All those things that we used to be able to get help with, with school, with cleaning the house, all of that is now we're doing all of that. So everything else just went to the backburner.

Helen

And routine as well. It just goes out of the window. So if you’d managed to sort of pocket in those little times for yourself where you could do a few pelvic floors or whatever it is, it just blew up didn't it.

Rachel

It's just gone. So everything kind of stopped. But for me, what I kept doing was I was like, right, I don't have to do these long runs, but I'm going to keep running for my mental health, because I had found was, that's what I had discovered was that I loved running and I had not done it for so long because of pelvic floor things. And I've done other, you know I do some personal training sessions, I do yoga on an app on my phone, I do boot camp. I really enjoyed that. But actually, the running, I found a freedom in it and a real sort of independence, and I loved running on my own and I loved running with a friend. Obviously, locked down, I couldn't run with a friend. I was running on my own again. But we were really lucky where we live, there's loads of trails through woods and stuff, and that was just so I loved…one day I went for a run one day, and I went running towards the woods, there was nobody there. And I just ran screaming at the top of my voice and it was so liberating!!! I came out the other end of the woods and there was a woman there with her dog and I was like, oh sorry, did you just hear me screaming in the woods?! She said, no, I didn't, actually. I was like, oh, good. But if you want to have a scream, those words are the place to do it. And she's like, I might just give it a try. But it was fantastic!

Helen

It always makes me think of Phoebe out of friends, you know, how she runs in that really mad style, kind of legs and arms going all over the place!

Rachel

No one watches running! It's not about technique, it's about freedom. But what I did realise was that I was running 3 miles, I could do 3 miles dry.

Helen

And that was an improvement?

Rachel

Oh, unbelievable. So I would say by sort of six weeks to two months after I started seeing Emma, I had stopped wearing pads every day. And I will be forever grateful to her for that. And now that lockdown is easing and the marathon may or may not be happening in the autumn, I think we're going to hear about that quite soon. I want to do it when it happens, whether it happens in the autumn, whether it happens next spring, I want to do it. But I've also said to Emma, I think the idea that I could run 24 miles dry is probably unrealistic. No matter how much work we do, that is a huge impact on your body. What I want to get to, I would like to get to 5 miles dry by September, because I would love to do a five mile run and at the end of it, meet my husband and my kids for a coffee without having to firstly deal with a heavy wet pad, sodden leggings, and let's be honest, sometimes a little bit of nappy rash. That's where I want to get to, if I can get to that. I would be so proud of my body. To have recovered from going through the birth, the carrying and the birth of three children. To have recovered to run 5 miles dry would be magical to me.

Helen

Not everyone is going to be looking to run a marathon, but it seems to me that with the right support, there is progress to be made. I think it's always worth saying that I have no affiliation with any of the products that were mentioned. As you heard Rachel say, some of them have been gifted to her and technology for pelvic floors, femtech and research around that, I just think it's fascinating. It's definitely something I'm interested in exploring. So hopefully in the next series we'll be talking about that. None of this, of course, is intended as medical advice, so please seek out your own professional help. But don't ignore your issues. Put yourself first for once. And if returning to running or other kinds of exercise is important to you, then I can really recommend that you listen to episode six of this series, Finding Fitness, for some great advice on how to do that safely. And if you're new to all of this, then please do listen to episode two, Pelvic Floor Problems 101. It's the conversation I wish I'd had when I first found out about my prolapse.

A couple of other quick things to mention - lovely Luce Brett from episode five launches her book this week on Thursday the 25th of June. It's called PMSL: Or how I literally pissed myself laughing and survived the last taboo to tell the tale.

And after the runaway success of episode eight, Pop Club, last week, I'm so glad to say that Pop Clubs are being formed via my Instagram page right now. So if you're looking to meet other women with pelvic floor dysfunction I know that sounds really weird, but I think it could be brilliant. Then check out @whymumsdon'tjump on Instagram and get involved. Tell me what you think. Spread the word. Tell a friend or spam a WhatsApp group. Let's end the stigma together. You've been listening to Why Mums Don't Jump with me, Helen Ledwick. You can find me on Instagram or you can find me online at whymumsdontjump.com. Bye for now.