Chantelle's Story - Episode Transcript

(TW: birth injury, forceps, trauma, surgery)

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! 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

Hello, hello and welcome. How are you doing? Thanks for all your messages again this week, especially the lovely voice note that I got from Canada. It was so nice to think that the conversations that we're having here in the UK are travelling far and wide, and I loved that image of you listening in your car on the way to work. So thank you for that. And apologies to the listener who said that she cried into her chicken pie while she was making it. We've all been there. I hope you're feeling a bit better now.

Right, at the end of the last series, I asked for your thoughts on what you'd like to hear and one of the suggestions that came back was about the need to discuss bowel incontinence - faecal incontinence - after childbirth. It's understandably something we very rarely hear about - a taboo within a taboo - but it doesn't mean it's not common. The charity MASIC, which is for Mothers with Anal Sphincter Injuries in Childbirth, estimates that one in ten women who have a vaginal delivery will have problems holding either poo or wind, so it's absolutely part of the picture and something that we desperately need to hear. I am so pleased to say that Chantelle Sandham, who is @tears_from_tearing on Instagram, agreed to share her story and she tells it with such grace and humour. She's a mum of three and by sheer coincidence, she only lives up the road. So when the UK COVID rules allowed it, we were able to meet in a local park in person.

Just a quick warning, we are going to talk about forceps birth and injuries in this episode.

Helen

If I ask you anything, that you don't feel comfortable answering, obviously just say no.

Chantelle

I am open to talk about anything.

Helen

Well, let's start then with when you first realised that this was going to be a problem.

Chantelle

This happened with my third baby. I did have quite a difficult first pregnancy and labour - that was ten years ago. I had my second baby six years ago - seven years ago - everything went fine. And then, I got a surprise pregnancy a third time and along came little Henry three years ago.

Because I had such a good second labour, I thought to myself that things were going to be as straightforward again for the third time, but maybe that was naive of me, to think that. And I went into labour myself, which was great, and then there was just a bit of an issue with the labour where he was a big baby and he got stuck. He wasn't in a very favourable position, so they used forceps to bring him along, but they didn't give me an episiotomy, so I tore because of that. And at the time, I felt like I knew that I had damaged my bum, because as soon as he was born, I said ‘I feel like the baby just came out of my bum’. And actually, that was true. But they stitched me there and then, and I went home. And for the first couple of weeks, I knew I was in a lot of pain and something wasn't right, but I didn't really… Everyone kept saying to me, ‘oh you've had a baby - you're going to be in pain’. And I just thought, that's the way it is.

I was having some accidents with going to the toilet - obviously for a poo - but I thought that was because I was walking slow so I wasn't making it. I never even thought about bowel problems from having a baby, ever - never ever. Even though I've worked with mums for years, and obviously I've got a lot of mum friends and had two babies. I didn't know.

Helen

No one talks about it, do they?

Chantelle

No. You don't sit at a playgroup and say ‘oh, yeah, I pee myself now I've had a baby’. That conversation has never happened.

Helen

Yeah. And so, obviously you hadn't realised there’d been quite a lot of damage, and that was pelvic floor damage as well as…?

Chantelle

Yeah, I know now that I've got damage to my anal sphincter and damage to the pudendal nerve and I've got a rectocele and also damage just generally to the pelvic floor, which is now really weak. We don't know exactly why. And they’re saying that it could be because of the delivery, or it could be cumulative because I’ve had three children.

Helen

So that's kind of what happened. And how did it progress? You said you didn't really realise at the time that it was going to be an issue - what was the moment when you were like, this is not okay?

Chantelle

As soon as the baby was born - you know, when everyone says it's really scary going for your first poo? Well, actually, I went to the toilet for a wee straight after I had him and I just went for a poo and there was no problem. And I was thinking, I was really proud of myself - like that's amazing, I've been and it wasn't even a worry. Because I've done this twice before and I was prepared for that horrible situation.

Helen

I know the one.

Chantelle

I was thinking, ‘oh, that was really good - I can go home now because I've had a poo’. I never, ever thought to myself that that was a problem. Until more recently actually - maybe two years later - when I thought that might have been the start of when things weren't right - straight away, since I had him. But I suppose, until the doctor said that things didn't look right down there - I think that's when I first realised, actually, I really do have a problem.

I only mentioned it on the off chance. She didn't even ask about anything down there, she just said to me, how are you feeling? And I just said, all things are not quite right. And that's when we realised something was horribly wrong. It was about eight weeks on and there were still stitches and bruising and I was having problems holding everything - wind… I'm all right with my wee, that's one thing I've got going for me. Other than that, everything just wasn't right in there.

Helen

It's really hard, isn't it? Because it is funny like that when you've had a vaginal birth anyway. I remember being in the doctors a few weeks later and having that moment of ‘I know I'm going to sneeze, and I am crossing my legs’. And it's like that when you've had a baby anyway, so it must be hard to know what's normal and what is more serious.

Chantelle

Yeah. And when I mentioned it to the midwives who came to the house - the community midwives - no one ever checked again. So after I delivered him and had my stitches done there, no one ever looked there again until my GP did eight weeks later. I don't know, I didn't really ask for anybody to look. But every time I said that I didn't think something was right, the answer was ‘well you've had a baby - you're going to be in pain’. And then I thought to myself, I'm being really soft - like, I've had three, I should know this now. But in the back of my mind I knew that something really wasn't right.

Helen

That was three years ago. For people who have no idea what bowel incontinence is like to live with, how is that for you?

Chantelle

So it changes absolutely everything in your life. Nothing can be last minute or unplanned. If someone said to me now, ‘I just want to nip somewhere’ - I couldn't just nip somewhere.

Maybe if I tell you how a day would go, if I’m planning to do something. At one point, I had quite unhealthy coping mechanisms. If I had to go to work, for instance, into the office, I wouldn't eat all day. I'd wake up in the morning and not eat at all, because obviously eating is going to make you have a bowel movement. I'd take medication like Imodium, even though I've not got loose stools. It slows everything down - and I am allowed to take that - so I would take that. I'd have to get up extra early to see if I did need to open my bowels before I go somewhere. So before my kids would get up, I might have to wake up an hour or two earlier than them.

Helen

And we all know how early kids get up.

Chantelle

Especially when you have one that doesn't sleep! As well, I have difficulty because everything is quite slow there and I've got nerve and muscle damage. Sometimes it's difficult opening my bowels, so I might have to do an irrigation and that can take maybe an hour to do.

Helen

Can I ask you what that means?

Chantelle

Yeah, of course. It's basically where you insert warmish water into your rectum and it flushes everything out. There's different systems that you can get. I'm not really a pro at all the systems, but generally you can have one with a small amount of water that you might use and you just do that yourself on the toilet. It has a comb with lubrication that you put into your bum and then you sort of flush warm water. You can get them at spas and stuff - if you wanted to clear your insides out. It’s a thing that people apparently pay for, but I get it for free on the NHS.

So I have one where it's like a bag that you fill with warm water. You hang it up in your bathroom and then you insert it into your bottom - a tube - and it pumps warm water and it helps you evacuate your bowels, basically. So glamorous. And so easy to do when you've got three children, obviously. Banging on the door, asking ‘what are you doing, Mummy?’.

Helen

Oh my goodness. So you are there at some crazy time in the morning, doing this in the bathroom.

Chantelle

Yeah, so some people do it every day. Or you can just do it if you're having a problem, or if you're going somewhere that day. So you might do all that before you've woken the kids up in the morning. It's just a big change to routine, isn't it? And obviously children and life is not predictable, so of course one of your children will wake up when you're trying to do that and want to use the toilet and then they're like, ‘what the hell is going on in here?’.

So I can't just nip out, because what if I did have an accident? And obviously I'm not okay with pooing myself, but I'm coping with it a bit better than what I was. But it's not okay to go to ASDA and poo yourself, and carry on walking around doing your shopping. You can't do that. Obviously it's shameful, it's embarrassing, it's uncomfortable and it's a taboo subject. It's not socially acceptable to go and poo yourself anywhere. You can't just go about and think ‘it's my problem and I'm not bothered what people think’, because you can't go about doing it.

Helen

I love how you talk about it. It’s so matter of fact - ‘it just is, and I get on with it and do what I need to do’ - but there must have been some horrible times. You must have had times where you've just wanted to not leave the house, maybe?

Chantelle

Well, there has been, yeah. I've had really, really down times because of this. I don't wholly remember the first year of Henry's life, which is really sad, but I think that's a natural defence or reflex of your mind - to block out things that are really difficult. So when everyone was going to play groups or enjoying things with the babies, I didn't get to do those things. But I don't really remember the things that I did do with him, even if it was just at home. So I look back at pictures from the first year and I don't remember ‘oh, Nancy got that jumper’ or ‘I remember that day’. I don't really recall any of that, which is really strange because I can recall that from my first baby ten years ago. I think that's just me - my mind - blocking out a really difficult and low time.

As well, everyone kept saying that it must be really hard. And I kept telling everyone, ‘no, I'm absolutely fine, I'm not traumatised by the birth, I've not got postnatal depression’. Because I was just trying to get on with things. I didn't really tell anybody in the first year. And I've had really low times, especially when I've been waiting for surgery and things have been going slow and things have been worsening, then it has been really difficult. I have felt like I didn't want to get up in the morning and I didn't want to go anywhere or do anything. It has been a really, really difficult time - I don't know where the three years have gone.

Helen

You said you didn't really tell people, so did you just manage to hide it?

Chantelle

Sort of? My partner started university the day after I had Henry, so he wasn't around much. He'd been waiting to go to university for years and I didn't want him to have a reason not to go. Obviously he was there when I gave birth, he knew that things were difficult. But I didn't always tell him the full extent, and obviously I would hide things. Like if I had an accident in the night or in the morning or whatever, then I just wouldn't say anything to him. So I was hoping that he just wouldn't know. And I think he did know - obviously he does know now - but he didn't know the full extent of things, I don't think. And I don't know how I hid that, really, because everyone knows now.

Helen

Was there a moment when you told him about it all, or did it all just come out over time?

Chantelle

I think it's just come out over time and more recently, really - maybe over the last year. He obviously knows everything, but this obviously impacts your relationships, your intimacy, your ability to do spontaneous things. When you've got kids and you look outside and the weather is nice, you think let's go to a park. It's not as simple as that for me. So I made excuses, I think, for the first year. And then I just thought, I need be open and honest with people and get all the help that I can. And I realised I needed to tell him more, so I did. I didn't really tell my friends that much. I did manage to go places and do things, but there were a lot of accidents along the way.

I don't really know what he thought of it, but in the end, when I was at my worst I'd say - about a year ago-ish - he left university because he needed to work. I was off work and my sick pay was coming to an end. So it did really impact him as well. He got a foundation degree - he finished two years - but he wasn't able to finish his last year, so I always felt quite guilty about that.

And having a normal - well, I’m not really normal at all - but having a partner, you expect to be more intimate with them. Especially as we've been together 14 years, there's not much that we get embarrassed about, but it did impact all that. And then there's other tensions. At one point he was probably wondering why I wasn't being intimate with him. That's the impact that it's really had at home. And the kids as well wonder why we can’t just do things sometimes? Or why do we not go on holidays anymore? It has a massive, massive impact.

Helen

You say you can't just go to the park. What would it take for you to be able to get out on that trip to the park on a sunny day? What would you need to do?

Chantelle

So some days I'd know that I'd be okay, or I'd risk it. But I'd have to think to myself, ‘right, later we're going to go to the park so I won't eat anything this morning and I’ll take a medication’. And I always have to take spare clothes with me. I don't know where I'm going to get changed in the park if I was here, for instance - I'm not going to go in the bushes and get changed. The fact is that it could happen anywhere. It's really just an unpredictable thing, so it does just take a lot of preparation. It's sad, really, not being able to be that spontaneous anymore with the kids. Because we used to just all of a sudden say, let's get in the car and go somewhere, and that can't be the case. I'm planning everything that I've never had to before, even the littlest things.

Helen

Talk to me about the treatment, then. You obviously saw doctors early on - where has that taken you over the three years?

Chantelle

They obviously like to do things slowly. They want you to start off with lower level treatment, so I started with physio and doing pelvic floor exercises. Although they identified that I've got actual damage to the anal sphincter, you can improve your continence with pelvic floor exercises. Some people do them and they're absolutely fine and don't have a problem again. So they tried all that with me at first and it's never made any difference to me. Then they can refer you to things like biofeedback - I don't really know much about that.

Helen

I know about this. Biofeedback is where they can use a device - sometimes it's an electronic device, sometimes it's just a plastic device - but basically it's a way that you can see if you're doing your pelvic floor exercises properly. So sometimes they put a probe or something into your vagina and then that registers the squeeze on it.

Chantelle

Yeah, so they can do that rectally as well.

Helen

Oh, right.

Chantelle

But I couldn't tolerate that because of the nerve damage and stuff.

Helen

Painful.

Chantelle

Yeah. So I did have a home device. So you put the probe - it's attached to a little computer thing, like a tens machine - and you insert the probe into the vagina and you do your pelvic floor exercise. But this one had electrical stimulation and it helped contract your pelvic floor, which is a very strange sensation, but apparently it works. It didn't improve my bowel continence, but I'm still really working on all my pelvic floor things because I need to make myself in the best shape for surgery and make things stronger.

Helen

So surgery is the thing that's coming down the line?

Chantelle

It is. In lockdown, in July, I started with a new problem - which was the least glamorous thing of this - which was passing stool from my vagina.

Helen

Oh, gosh.

Chantelle

I know. At one point I wondered if it was happening earlier on, but then I thought, no, I don't think that's happening. And then one day it just obviously was happening. So I rang the colorectal surgeon - because I was already under them - and they got me in as an urgent appointment. They couldn't find where it was coming from, on an MRI scan or anything. And I've never had an infection because of it and or anything like that. So they just said, let's get you in for surgery. We're going to try some more - different - biofeedback, and then we're going to try a nerve simulator in your back, which helps send a message to your brain to help you control your bowels.

Helen

Wow.

Chantelle

They were going to try all these other things, but decided actually, surgery then was the best starting point, really. So I’ve not got a date yet. I've been waiting a long time. I'm going to have surgery and it's going to be quite a big surgery with a big recovery. What they're going to do is - it sounds really drastic and I suppose it is really drastic - they're going to basically separate - open the back wall of the vagina into the bottom, separate it right down - and then they're going to do an overlapping technique to heal anything up there. So basically bring everything closer together, repair any prolapse that's there on the back wall, and at the same time, it will repair any fistula - any holes - that are in between. Then they're going to rebuild my perineum, because that's nonexistent, no idea where that went. And then they're going to repair my anal sphincter and they're going to do that all in one surgery. So it's going to be a little stay in hospital for a few days, which might be nice - bit of peace and quiet. And from that, hopefully it'll help. They don't think it'll help my pain, because that's nerve damage. It's just not going to help my pain and it could make my pain worse, but I feel that my quality of life would be so much better if I've got control of my bowels, then I'll be able to manage pain better. So I've made that decision to have surgery.

Helen

Yeah. And that's kind of hopefully what the future looks like then, doesn't it? Not perfectly back to how things were, but a better quality of life.

Chantelle

Yeah. And the surgery has a lifespan. Sometimes a repair of an anal sphincter can only last ten years or whatever. And I think it can be similar for prolapse surgery, can't it? But I feel ten years from now, I'll have a 20 year old and a 17 year old, and Henry will be 13. I know it's not everything about the children, but I feel like I'll be in a whole different place to deal with that then.

Helen

And you don't know how things are going to progress over ten years - the technologies around this kind of stuff, the treatments. There might be other things that are even better.

Chantelle

Yeah, there might be. And I think it's really clever that they can do that now, isn't it? That they can make that repair and that they can do all the tests. I'm just hoping that it is soon. It's been quite difficult in lockdown because they've not been able to tell me when the surgery would be, and not knowing is really, really difficult. If they said to me, it's definitely going ahead in a year, then even if it's a year away, I can work towards that. But for me, not knowing has been the most difficult thing. Especially when it came to Henry's birthday, because I've been thinking, in September, three years I've been like this. When really I should have been thinking, I've done really well to get through the last three years. I've been trying to turn my thinking around and think a little bit more positively. I've been having counselling as well, for a year, which has really helped me and made me think about things a bit differently.

Helen

There must be so many women who are experiencing this now and, like you in the early days, kind of haven't told anyone and are just really mortified by it. What would you say to them? I mean, do you remember being in their position?

Chantelle

Yeah, I remember feeling like I was the only person that this happened to. The only person that poos themselves, the only person that has these feelings. As well, it gives you - I can't say, resentment towards your baby, but I had a lot of guilt because I felt that I couldn't do the same things with this baby as I did with the other two. And I felt like a really terrible person. Even though I'm obviously a professional person, I've worked with parents for years, I just felt like no one else had ever felt this way.

So I think one day - I didn't google search, I think I came across a birth trauma site on Facebook. And I was like, oh, right. Okay. Some people have had similar things. And then one day, I just saw a post from somebody that was about this - that they were pooing themselves. And I was thinking, oh, my God, someone else poos themselves. So then I thought, there's two people in the world. So I think I messaged them or started a bit of a conversation, and they said you should try this page or that page. And the next minute, there were hundreds of women that were having the same issue. I just thought, oh, my God, I didn't know. And I felt like my life became so much more… I was really sad that there were so many other people, but obviously, you're not alone, are you? Like, wow!

And people were giving me tips and advice. I didn't know that there were other ways at this point. I was having physio, but I had never considered other things. I think someone mentioned to me, have you tried irrigation? I was like, ‘Hell, no, I'm not doing that!’. But when I spoke to all these people, all of a sudden, I wanted to try absolutely everything because I want to make my quality of life better. So when I started meeting people, I thought to myself ‘I want to speak up for people, I want to start doing things’. That's when I got Instagram going and I'm not embarrassed about talking about it anymore. Over the past six to nine months, I started doing lives and podcasts and speaking with other people. I've got a little WhatsApp group - we’re called The Fairy Bum Mothers - and we just talk about poo every day and family life and about difficulties, and that really, really helps.

Helen

It has amazed me what a difference it's made. I think my problems are very much on the lighter end of the scale, but just through reaching out on Instagram, talking to other people, the weight is lifted, isn't it? And a lot of what you're dealing with, for me especially, was the mental load of it. The feeling of I am on my own and the shame of it, and I'm not normal and I'm broken - and those kinds of feelings have really been lifted by talking to other people. A lot of the messages that get through the podcast are saying thanks for talking about it, you've given us hope. Actually, when I asked last series what sort of episodes people wanted to hear in this series, one of the ones that they wanted to hear was from someone like you, someone who's got bowel incontinence, because it’s the taboo of taboos. We can just about manage as a society, maybe, to talk about urinary incontinence, but nobody talks about this.

Chantelle

You go to baby massage and people might say they had a tear when they had a baby, or had some stitches, but I think, really, we can say I poo myself now because I had a baby. I didn't do this to myself, so I shouldn't be embarrassed about it. And it wasn't done maliciously or it's nothing for me to be ashamed of - everybody poos, it's a normal bodily function, just mine's been a bit wrong at the minute. I do feel like we should be trying to talk about it, but I understand as well that people aren't as forthcoming as what I have been and people don't always want to talk about it as much, but I'm here, I'm spreading the word of pooing yourself.

Helen

You're on a mission, aren't you? I can see it in your eyes.

Chantelle

Yeah. I think we just need to be out there and talking about it. I don't ever want to say normalising it, but I want to show that we're out there and that there's somebody else. Even if one person feels a bit better about it, then I feel like the mission is accomplished, isn’t it.

Helen

Yay!

Helen

To those of you who requested this episode, I really hope it's helped you feel less alone and that you can get the support you need to move forwards. You can follow Chantelle, who I think is wonderful, on Instagram at tears underscore from underscore tearing (@tears_from_tearing). I'll put a link to that and to the charity MASIC in the show notes.

In the next episode, more taboos about sex and relationships - the impact of pelvic floor dysfunction between the sheets. I'll be speaking to the women's health physio, Jilly Bond, and I promise we will all learn something.

You've been listening to Why Mums Don't Jump with me, Helen Ledwick. I am not a medical professional, so please don't take anything you hear as medical advice, but do get involved. Subscribe, post a review if you can. Tell me what you think, and please spread the word. Tell everyone and anyone you know.

You can find me on Instagram @whymumsdontjump or online at whymumsdontjump.com

Bye for now.