*Jade’s Story, Canada

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I got pregnant at 19 unplanned with my fiance newly engaged for 3 months. My pregnancy was very simple, low risk, no complication, and I was attended by midwives. In Canada support is slowly building for midwives and I assumed that since the option was available and they were governed by the provincial health care and a college of their own that I would be in safe hands.

May 7 2017 I began to have regular 3 minutes apart 1 minute long Braxton Hicks contractions at 6pm. My midwife came and encouraged me to drink water as my son’s heart rate was 160 bpm. The heart rate came down and my midwife then left at 10 pm. By 12am I was having contractions that were very strong and dysfunctional, my midwife came back to our home and informed us that I was experiencing coupling contractions where I would be in pain for 7 minutes with 3 peaks and then I would have a 1 minute rest. This was the process for the next 4 hours during my labor. I labored on my bed on a sitting position for 1.5 hours and the rest of the time I was in the birthing pool in a semi reclined position.

By 4am my body began to push on its own. This is where I began to panic and fight my body. I refused to push during the contractions which caused me more pain and distress it my midwives did not address my concerns. My water broke during pushing and there was meconium found. I was having a hard time allowing my son to be born and faught for 2 hours, tensing my body the whole time from fear and there was no intervention from the midwives. They finally transferred me to the toilet at 5:40 am.

At this point things got a little hairy. My fiance was supporting me on the toilet and my midwife was there. I felt so much pressure and pain and my midwife told me “don’t worry that’s just stretching” to which I replied “no that’s tearing”. She then left to the dining room which was out of eye sight from the bathroom and during that 2 to 3 minutes she was gone my son crowned too fast and took me with him. My fiance yelled to the midwives to come. At this point I no longer felt pain, I didn’t know it then but now I know that I tore through all of my nerves and so I couldn’t feel a thing. My midwife tried to get me to lean back which I couldn’t do so I stood up and we manoevered my son out and onto my chest. He was 9 pounds 2.5 ounces and 21 inches long. All I remember is how sore I was and I was having a hard time sitting on the toilet so I asked if we could move to the bed. When I stood up I could feel something was wrong; it’s hard to explain but if you have ever broken something like a finger and it felt wrong but didn’t hurt that’s how my bottom felt.

Anyways we layed down on the bed where my placenta was delivered after a pitocin shot and my son’s cord was clamped and cut after the cord stopped pulsing. I remember my midwife inspecting my perineum without any flashlight and she did not check my rectum. I asked “what’s the damage?” she said I have a 2nd degree tear and a little first degree on the perineal skin. She stitched me up in 45 minutes, I was given instruction regarding group b strep and meconium for my son and large bleeding for me and the midwives left.

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During the first 24 hours I notice flatulence that felt like it was coming out of my vagina. I mentioned it to my midwife at the 24 hour check up but I was told due to swelling it can roll and bubble a little and should resolve on its own.

One week post partum I had liquid fecal matter incontinence which burned so bad on the stitches and 1.5 weeks post partum I had soft fecal matter incontinence which pushed through my fistula into my vagina. At that point I was rationalizing things and thought maybe things have rearranged a little after birth. I did take a mirror to that area and I found my bum was a gaping hole and my perineum was so tiny. I can’t even explain how distressed I was. Dr. Google was my friend for that week.

I saw my midwife 2 weeks post partum and re expressed my concern regarding the flatulence and included the information about the incontinence and gaping anus and my concern that my tear was worse than thought, to which I was told “weak muscles after child birth are normal just do kegels”. Though upon arriving home I found solid fecal matter in my vagina and asked to be checked. The next day the midwife came to my home and found a hole between my vagina and rectum and referred me to a surgeon in Calgary Alberta.

4 weeks post partum I met Dr. Birch who diagnosed a missed 4th degree tear with a 1cm fistula and skin bridge.

At my 6 week post partum check up my midwife asked me if I had resumed sex to which I replied “No I can’t considering my circumstances” and she told me I can’t ignore my husband’s needs and get wrapped up in baby, side note this apalled me and still apals me to today! She didn’t offer to inspect my perineum and told me that the tear would have happened no matter what we did.

I went to pelvic floor physiotherapy 4 months post partum and I have found that it has not help in any way.

I am now 22 years old and 2 years post partum and still unrepaired. They don’t want to repair me until my family is complete so we got pregnant (I’m 13 weeks) despite my pain and discomfort during sex. The pregnancy has increased my incontinence and pain. I have restarted physio though I am hitting barriers with some ptsd and anxiety. We are looking into EMDR treatments as I have been feeling so sad and angry and guilty over the last 2 years.

I am still incontinent to flatulence and fecal matter, some days I poop in front of strangers or sleep in the bathtub due to diarrhea. I have numbness in my butt checks and regularly have stabbing pains itching aching and tingling in my nonexistent perineum which I manage with my tens machine. I can no longer enjoy certain foods or exercises or anything that increases stress or reduces the number of bathrooms near me. I have also recently found out that my sphincter has atrophied and is not responding to stimuli and if it is repaired the likely hood that it will work again is very low. I have been asking my surgeon about a colostomy to help me cope with the symptoms and give me more freedom in my life. We are also beginning to start litigation against the midwives in order to cover the costs of being off work and child care and supplies. I have started a gofundme account to help pay for my lawsuit.

The other side of my story is this has shown me how strong me and my fiance are. We are working together to get through all of this hell together and he is so understanding despite how much I put him through. I have also found new resilience and I refuse to let this completely destroy my life, I still work and go to school and take care of my son despite all of the barriers I hit. I find that the barriers make me want to push past them and I refuse to be limited by a mistake that someone else made, I won’t lay down and sulk, I will fight and move forward as much as I can. Does that mean it doesn’t effect me? not at all! I have days where I have to pull myself out of bed, pack a diaper, cry for hours and struggle with thoughts of self injury to get my repair sooner. But does that stop me from living my life? never

My story is one of sadness, pain, disappointment, despair and anger, but it is also a story of strength, resilience, love and inspiration.

*Jade ~ Canada

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