Childbirth: Mum left feeling dirty by incontinence injuries

“It’s isolating, debilitating and makes you feel dirty.”

Too many women deal with bowel incontinence as a result of injuries during childbirth, according to a charity.

Masic’s Anna Clements said stigma and a lack of information meant women were unaware of the medical support available.

The Welsh Government has said a plan will be published in the summer on how health authorities should provide “quality health services for women”.

A coalition of charities said it was one of several ways women experience poor health outcomes.

Women need to be listened to, not just dismissed and said, ‘That’s what happens with childbirth – just go ahead,'” added Ms. Clements.

Masic supports women who have suffered anal sphincter injuries – a problem so stigmatized that few will share their symptoms with anyone.

Ms Clements said the charity has mainly helped women who “have had third and fourth degree tears – that’s the damage done to your anal sphincter”.

“It’s a traumatic injury in the pelvic area, usually in the perineum,” she added.

But she is fortunate that her own injury 13 years ago was so serious that she was treated immediately.

Ms Clements, from Nottingham, received a procedure called sacral nerve stimulation, which helped control incontinence, but said going perimenopause at 46 could mean the symptoms “come back with a vengeance”.

“It’s affected my relationship with my husband, my work, my social groups — the way people respond to you — it affects everything.”

Eventually, the injury meant she had to quit a job she loved.

“At first I had no idea what the injury was – I didn’t dare look and I didn’t feel comfortable knowing what was really going on.

“I figured once I got a fix it would go back to normal. Apparently, I’ve now found that’s not the case.”

Cardiff and Vale Health Board has opened a new pelvic health center to improve care for patients who have suffered similar injuries.

Anna Clements said this is a model that could be used more broadly as current healthcare is “a zip code lottery”.

Julie Cornish, a colorectal surgeon, was instrumental in setting up the center, which helps patients with a prolapsed pelvic floor, incontinence and bowel dysfunction.

“These are really common conditions – they mainly affect women but can also affect men,” she said.

Clinics for things like bowel, bladder or gynecological problems are held concurrently at the center which is based at Barry Hospital, Vale of Glamorgan.

This means that patients can get advice from different specialists immediately without having to join separate waiting lists, which significantly reduces waiting times.

Ms Cornish acknowledged the numbers currently seeking help are “the tip of the iceberg” due to the stigma.

“We usually see patients who have had problems for five, seven or even ten years.

“Those who come to us quickly are the ones who have really significant problems, but those in the middle just take it. And it’s only when something triggers it — an event or a disaster — that means they leave and seek help.”

Ms Cornish added that “we need to talk about it”.

She said there are “a number of people who feel ashamed or embarrassed because they think they’re the only person – but they really aren’t.

“Whoever seeks help, gets help.”

The Women’s Health Wales coalition, which brings together more than 60 organisations, has produced a report claiming medicines and health services are not meeting the needs of female patients.

The coalition is made up of charities, royal colleges, patient groups and the British Heart Foundation Cymru and Fair Treatment for the Women of Wales (FTWW).

“Health inequalities are widespread in Wales, from lack of access to specialized services to a lack of appropriate data,” said Gemma Roberts, policy and public affairs manager at the British Heart Foundation Cymru.

“So the Welsh Government’s plan needs to be ambitious to ensure a whole life-course approach to women’s health, embracing all areas where women’s opportunities differ, such as heart attack care.”

Debbie Shaffer, founder of FTWW, added that patient involvement is crucial.

“Patients are often the experts through experience in their own care and can identify areas for improvement for the future – their insights are invaluable.

“We call on the Welsh Government and Health Authorities in Wales to commit to continuing this level of commitment – nothing about us, without us.”

A Welsh Government spokeswoman said: “Our Women’s Health Implementation Group is continuing with important work to support women’s health, including establishing a network of Pelvic Health and Wellbeing Coordinators and overseeing the appointment of a dedicated Endometriosis Nurse in each health department.”