When I was at school I used to run 800 metres and cross country, and enjoyed playing hockey and netball. When I was in my twenties I walked miles to and from work (sadly in court shoes which require them to be a size too small to stay on and a high degree of toe-tension to stop them slipping off your feet). I also started hiking in the hills around Birmingham, north Wales and Manchester in heavy leather hiking boots. When I was in my thirties I did some long distance walks including the Cumbrian Way, the Tongariro Crossing in NZ, two weeks trekking near the border of Thailand and Myanmar and my own Friend-to-Friend Walk from Manchester to Keswick via Sheffield. All these were done in solid and relatively heavy walking boots with a fixed mid-sole. This is meant to offer ‘support’ and protection, but in reality disabled my ankle joints and the joints across the ball of my feet. I am now sure that the weight and rigidness of these boots contributed to my pelvic problems during pregnancy and childbirth.
My ex-partner is a keen runner and in my late 30s I started to jog with him and enjoyed a few 5km Park Runs and the Manchester 10km and did a marvellous Barefoot Running Course with John Woodward near Ulverston in the South Lakes. His next one is coming up in September 2018. I felt free, energetic and graceful. https://www.naturalrunning.co.uk/courses/natural-running-course-one-day-course-2/
Then in 2009 I became pregnant aged 40 and my body changed overnight. I had months of nausea and sickness and unusual food cravings, and from month 7 I swapped those symptoms for SPD Symphysis Pubis Dysfunction.
Symphysis Pubis Dysfunction or SPD is a condition that is linked to the pelvis. This condition causes excessive movement of the Pubic symphysis, possibly because of a misalignment of the pelvis and may cause symptoms of pain and swelling. Symphysis Pubis Dysfunction is commonly associated with pregnancy and childbirth in women. (www.epainassist.com)
(In women?! Who else gets pregnant and gives birth to children!? Ed’s note.)
The SPD meant that every step was painful, it was as if the front of my pelvis had turned into a cheese grater.
Obviously I became more sedentary, my weight increased and the problem worsened. Some people casually call this joint at the front of the pelvis – the pubic bone as if it is one bone. The Symphysis Pubis is actually the front joint of the two wings of the ilium / pelvis. The two joints to the rear are called the sacroiliac joints where pelvis and spine connect. In preparation for birth a hormone called Relaxin helps soften the ligaments to ready the pelvis for the baby to pass through the birth canal as easily as possible. Unfortunately mine allowed my ligaments to soften too much causing the joints to become increasingly mobile and the pelvis unstable with the bones grinding together causing great pain and inflammation.
I was a trained Alexander Technique Eutokia Doula (non medical attendant to the mother during childbirth). I had had the great good fortunate and privilege of attending 4 births with friends at this point. I trusted my body and chose a wonderful midwife and Doula to accompany me during labour. For whatever reasons I find hard to put into words, poor communication is the most likely reason, they were not there during my labour. A second midwife came and attended me for the last 10 minutes.
During labour I got stuck in one position and my baby was trying to find his way out against an anterior lip (a fold of cervix) which blocked his way. When the midwife helped me walk a few steps from bathroom to bedroom, out he came! The Doula arrived to hear ‘its a baby boy!’.
I experienced a 2nd degree tear which needed stitches.
Second degree tear – perineal skin and muscles torn.
I lost almost a litre of blood, but the midwives knew I really didn’t want to go into hospital and kept close observations over the next few hours as I was deemed safe to stay home with my new baby.
The next steps in the days and weeks to follow were painful and bewildering. I didn’t recognise my body, the swollen and sore area around my stitches and perineum. I was heavy, sluggish, in pain and somewhat traumatised. I was also proud and delighted to be a mum and to look after and care for this darling boy. As I gradually began to regain some strength and became more mobile I felt as if something hard was always there. I was diagnosed with a pelvic organ prolapse.
Causes of pelvic organ prolapse (NHS):
Pelvic organ prolapse happens when the group of muscles and tissues that normally support the pelvic organs, called the pelvic floor, becomes weakened and can’t hold the organs in place firmly.
This meant that the network of muscles, ligaments, tissue and other organs which would normally support the bladder, womb and anus were damaged and these organs were falling into the womb.
I was offered physio initially which seemed to involve mostly Kegel exercises which seemed to tighten the surface muscles nearest the skin and stitches but didn’t substantially affect the larger muscle network deeper inside.
I was offered local hormones to try and redress the balance. These didn’t work for me.
I was offered a ring pessary, a support structure to be placed inside the vagina to provide scaffolding for the injured area. I declined. This treatment is usually used for elderly women with incontinence. This might have helped in the short term, but I wanted a more lasting wholistic solution.
I tried Pilates and Yoga which, if done gently enough, were helpful to get me moving again in a variety of ways with supervision and instruction. Into my second year after birthing, I had regular treatments of Osteopathy and Shiatsu.
And of course, throughout, I continued to work on myself using my Alexander Technique Directions as best I could.
My thinking was not often organised and disciplined due to on-going discomfort, trauma and lack of sleep. I was however, able to walk without pain and could carry my baby in a sling. The discomfort and heavy feeling continued. But I was slowly and gradually improving. I went swimming when I could and enjoyed the easier movements in the water.
… to be continued
Lucy Ascham is mum of a now 8 year old boy. She completed her first 5 km Park Run in mid August 2018.