United Brachial Plexus Network, Inc.

Hi,
I haven't posted in a while but wanted to report on physical therapy that I've been getting because of the injury I received during our son's birth. I know a lot of women had posted re: problems after the birth esp. with incontinence. Anyone experiencing this should try a physical therapist trained in working with these issues. I've had great success in four weeks time and just wish that I had started it earlier. I'd be happy to email anyone with more information. Thanks. Susan Morgan

Hello Susan,

I would be interested in learning more about this issue, for personal reasons as well as for a possible future article for Outreach. I know there are many of us moms out here who were injured along with our babies during our deliveries.

Thanks,
Bridget

I read this post with interest. Many moms do suffer injury during traumatic deliveries associated with shoulder dystocia. Usually the moms do not mention their injury when they first call me. After a period of time passes, the mom will call and very quietly ask if she can discuss a difficult issue with me. During that conversation the mom will first talk about her injury, often concerning a fistula or lack of sensation from vaginal trearing or trauma. In cases where the mom has suffered injury we will add the mother as a seperate plaintiff in the case.

If a mom has been injured during delivery she has every right to bring a case. If the physician does not appreciate the size of the baby and fails to perform a proper episitomy there can be severe vaginal tearing. The tearing is much more difficult to suture than an episiotomy.This and other trauma can lead to a range of medical problems for the moms.

I urge every mom who has suffered an injury, and is already going forward with a case for your child, to talk about the injury to your lawyer. You do have the right to be a plaintiff as well. I know it can be difficult to disucss some of these injuries, in particular lack of sexual sensation, but you should not have to go through life suffering in silence.

Ken Levine

A physician that treats my 3 yr. old with daytime e-stim here in Columbus, OH actually specializes in treating adults with incontinence with biofeedback and e-stim. She spoke at our awareness picnic in Oct. about e-stim for our bpi kids but I think she could do a talk on incontinence suffered by women who have had difficult births and draw an equally big crowd!

She considers this a noninvasive approach, sometimes helping the patient avoid surgery or at least postponing surgery until this procedure is tried. She has good results with her treatment. She actually patented a garment that a person can wear. It helps the patient strengthen the pelvic floor muscles. Unfortunately, I don't know how common this type of treatment is in other cities or states. I imagine what she does is pretty unique.

If anyone is from the Central Ohio area or even Ohio, I would recommend they contact her. E-mail me and I'll give you her contact information.

The treatment program is as Karen described in one of the replies. It involves estim and biofeedback as well as daily Kegel exercises. When I first saw a dr. re: this 9 months after Sam's birth, they wanted to do tons of invasive testing. At that time I was having both types of incontinence. He also told me that pt would help but if I had another child all gains would be lost. I've since found out that this isn't true.

I know this is a very difficult area for women to talk about but the estim and biofeedback are very non invasive. The first appt. is probably the worst just because the pt has to evaluate which muscles are strong, weak etc. After that you purchase a probe that you insert before your session. It has a long cord that is attached to it that you leave hanging out of the top of your trousers. The PT hooks you up to a biofeedback machine and measures your endurance and strength with a series of exercises. Then she hooks you up to an estim machine and you do more exercises with the estim. This doesn't hurt, just feels strange (anyone who has estim done on their kids should experience this anyway). More and more pts are being trained in this and I'm sure there has to be a network of therapists who do this.

Anyway, this has worked great for me. I'm sure if your injury is more serious then the more invasive testing would be necessary, and then possibly surgery.

It is so important that women get help with this. It isn't an area that should cause embarrasment or affect daily life. I'm confident enough now that I won't leak that I'm trying a kickboxing class tonight. That is something that I could never have done two months ago. Good luck to everyone dealing with this.

Susan

Just want to be very clear about the fact that two very different types of injury and treatment are currently being discussed in this thread.

Rectal-vaginal fistulas require surgical treatment to repair. Such surgeries do not have great success rates, but for those of us who have this type of injury, you know that we are pretty much willing to try anything to "fix" this dreadful problem. If a first surgery is not fully successful, a second surgery is generally recommended, and success rates drop thereafter.

In addition, women who have had rectal-vaginal fistulas and repairs are advised not to deliver vaginally in the future as the repair may be further damaged. C-sections with future pregnancies are advised. (This information was not provided to me by the ob/gyn who botched my son's delivery and who performed my first fistula repair - which was unsuccessful. He stated that I could easily deliver future babies vaginally. When I switched ob/gyn's and started to wake up to what had actually happened to us during delivery, my new ob/gyn could not believe that I had been told this. He was furious, I was simply shocked. Every ob/gyn that I have since had has reaffirmed that under no circumstances should a rectal-vaginal fistula repair patient deliver vaginally.)

Incontinence issues have far different treatment options and hopefully better chances for full or substantial recovery.

Bridget