For Queensland’s Rhiannah Pohlman, it’s taken a long time to be able to tell her birth story without crying. But it’s a story she wants to tell.
When Pohlman gave birth to her son Noah, she suffered a fourth degree tear during delivery. A fourth degree tear is the worst kind, going through the perineum, all the way from the vagina to the anal canal. Today, four years later, she’s still suffering the effects.
“I deal with faecal incontinence and flatulence incontinence,” Pohlman tells Mamamia. “It really disrupts your quality of life.”
Mums and non-mums answer questions about childbirth. Post continues below.
She says on bad days, something as simple as a trip to the shops is too much for her.
“Trying to go shopping is horrible because it leaks and it’s painful. If I have a lot of leakage that day and I’m walking around, it’s basically like nappy rash.”
The flatulence is a problem because it’s “so taboo”.
“I can’t not fart, so trying to hold it in – because you want to respect people around you – that’s difficult and it’s painful. You get really bloated.”
Pohlman also has a fistula – a hole between the vagina and rectum – which causes “poo leaking out the vagina sometimes”.
“They say it’s eradicated in developed countries, but I live with that,” she says. “I’m surprised I don’t get too many urinary tract infections or anything.”
Pohlman didn’t know much about the risks of tearing before she gave birth to her son. She was overdue, and was induced.
“That took three days, from being induced to having the baby,” she remembers. “It was a very long process.”
On the third day, when a doctor told Pohlman she was still only 4cm dilated, she asked for a c-section. But two hours later, as she was being wheeled into the operating theatre, she was told she was 9cm dilated and would have to try to push the baby out.
“I was pushing for two hours and they said, ‘We’re going to get the vacuum,’ because nothing was happening. That’s one of the risk factors for a fourth degree tear, the vacuum or forceps.”
After the delivery, Pohlman only got to hold her son briefly before he was taken away with his dad. She was put under a general anaesthetic to have the tear stitched up.
“The way they would say it was as if it was my fault,” she remembers. “They never said, ‘The vacuum’s going to increase your risk of tearing.’ It was never even mentioned. Nothing was done to prevent it.”
Other risk factors for a fourth degree tear include the birth being a woman’s first vaginal delivery, and the baby being large. Noah had a big head circumference. Pohlman also believes being induced was a factor.
After Pohlman was stitched up, she was told that incontinence was a possibility. A physio visited her on the third day.