The physical and emotional trauma that a mother may experience during childbirth is a taboo subject that has left many women suffering in silence. Safe Baby Healthy Child believes that it is time for open and frequent discussion of this vital topic. We are pleased to bring you the expertise of guest authors Kimberly Johnson and Ellen Heed, two health care revolutionaries at the forefront of helping women heal after the momentous experience that is childbirth.
As many as 80% of women experience pelvic pain after having a baby.
If you’ve been experiencing pain ”down there” since you gave birth, you are not alone. As many as 80% of women experience pelvic pain after having a baby!
Many people assume that only women who have episiotomies or tearing during birth are those that experience pelvic pain. But even women who have births that go very smoothly can have pelvic floor challenges post-birth. The same is true for those that have a Cesarean section. Many months of a baby pressing on the pelvic floor can seriously impact its tone and function.
Symptoms that women may experience post-birth are pinchy or burning sensations during sex, air coming in and out of the vagina when bending forward or leaking when sneezing. Sadly, most women don’t know to correlate these symptoms to pelvic floor damage and instead make significant changes to their lives to accommodate these embarrassing, confusing and painful symptoms. We have worked with women who only go to yoga classes with loud music so that if their body involuntarily makes a noise from a “vagina fart”, no one will hear it. Other women avoid sex or certain positions during sex because penetration causes major discomfort. Other women wear pads all the time just in case they leak. For many, these temporary adjustments become permanent and end up impacting their lives and those around them much more than they realize.
Why Getting Help is Challenging
There are many reasons why women put up with these symptoms. They may think they’re just temporary and somehow their body will heal on its own. Often, they are so focused on their baby and keeping their household and partnership together that their own health is put on the back burner; they only seek help when their problem becomes so painful it can no longer be ignored.
Another reason women don’t get help is that these issues are not part of our cultural consciousness. Most women we have talked to have never heard of pelvic floor damage, they do not think help is available for their problem, or they admit that they’re too embarrassed to discuss their symptoms. This may be due to several factors: sexual shame and stigma, women’s bodies being the “other” in medical teachings and relegating a whole host of post-partum problems to mental health issues rather than acknowledging that their pain could be from birth injury or birth trauma.
Women who do find help from their doctors often end up going from doctor to doctor, each one telling them that their symptoms are “normal.” While these symptoms may be common, they are definitely not normal. It’s a double whammy. Women are already concerned about being seen as melodramatic or needy and may be reluctant to reach out for help or second opinions. Then, when they do advocate for themselves, many are subjected to dismissiveness, given misinformation and left with no hope for treatment. Women receive the message that they must just deal with these uncomfortable symptoms that many had no idea were even potential outcomes of birth.
For example, we have worked with women who had organ prolapses. Their doctor diagnoses the prolapse and tells them to come back in a year without any direction on how to heal. If it is not better in a year, they will do surgery. We have also worked with women who can see their organs from their vaginal opening but when they go to their doctor for an assessment, they are told they don’t have a prolapse. These are just a couple of examples of how taking the conventional route often leaves many women feeling confused, if not abandoned and broken, with nowhere to turn to get adequate help.
Honor Your Intuition
Birth injury and birth trauma may not be part of the mainstream conversation or understood by mainstream medicine, but they should be. We encourage every woman to honor her intuition when she knows something is “just not right” and continue seeking out the help she needs. Ideally, all women would have support for postural re-education and pelvic floor rehabilitation post-partum. This is not a pipe dream. In France, a physical therapist specializing in birth rehabilitation is sent to a new mom’s house for the first six weeks post-partum. Can you imagine how wonderful to treat birth as the momentous physical event that it is and provide all women some support to recover in the most optimal way possible?
While this is not the case in the United States, the good news is that there is help for all of these pelvic floor symptoms. With the right combination of scar tissue remediation, muscle activation and release through movement and somatic experiencing, almost all women can regain full function of their pelvic floor non-surgically.
The Trifecta of Birth Healing
Scar tissue remediation, intelligent movement and somatic experiencing are the trifecta for birth healing.
To adequately address pelvic floor pain and dysfunction, a combination of tools is needed. One of these tools is scar tissue remediation. Internal scar tissue is rarely considered or addressed as part of pelvic pain. Scar tissue is a natural part of the body’s healing process that develops whenever there is an injury to a tissue. It can result from C-sections, tears or episiotomies. But pelvic pain that arises after childbirth can also originate from pre-existing tissue damage from falls (slipping on ice and landing on the tailbone or falling crotch-down on a balance beam or bicycle), muscle tears and even rough sex. The spread of scar tissue affects free range of movement, blood circulation, and lymph drainage within the body, meaning that scar tissue can block blood flow to certain areas, making those areas very tight, which can cause other areas to also be pulled taut. Scar tissue remediation involves hands-on and hands-in work to melt scar tissue away and bring new life back to once stagnant tissues. While it can be intimidating and scary to receive genital touch, especially since it is so unusual outside of a sexual or medical context, it is at this level of awareness that healing usually happens.
Muscle activation and release can take place through hands-on work like massage, or through intelligent movement like targeted Yoga, Pilates and Gyrotonic. These intelligent movement methods bring added circulation to boggy tissues and increase lymphatic drainage. These movement methods also target the relationship between the pelvic floor and core muscles, which can be lost during pregnancy and childbirth.
Another tool is Somatic Experiencing (SE). SE is a trauma resolution therapy that brings the body to the forefront of the healing process. While many forms of therapy involve talking and processing emotions, somatic experiencing focuses on becoming aware of the sensations felt in the body. If the physical symptoms the woman is feeling are related to a highly charged and traumatic birth, working with a somatic experiencing practitioner is essential to allow the nervous system to recalibrate and accept new physical patterning.
Working from the understanding that wild animals do not experience trauma because their nervous systems complete their natural cycles of fight, flight, freeze or collapse, the somatic experiencing therapist guides the client to gently allow for the completion of nervous system cycles that may have been truncated through anesthesia, social shame, early conditioning or jarring interventions. The process feels a bit like talk therapy mixed with guided meditation and light touch.
Surgery is rarely the cure-all that we want it to be.
Many women inquire about surgery as a quick fix. But, surgery should be the very last resort. We see too many women undergo operations and end up in even more pain and confusion, especially if they have chosen surgery under duress or from a place of desperation. We have seen many cases where surgery has actually resulted in creating more scar tissue. To maximize the efficacy of surgery while minimizing any potential additional trauma, it is imperative that the nervous system be as regulated as possible. If women make the decision to have surgery from a disregulated place (confused, desperate, highly anxious), they risk compounding the trauma and symptoms they are already experiencing. Surgery is rarely the cure-all that we want it to be.
Scar tissue remediation, intelligent movement and somatic experiencing are the trifecta for birth healing. Because injury impacts many levels of our being, we have rarely seen women heal completely without using all three of these tools. There is no use in attending only to the body if there is an injury to the mind or psyche. And there is no use in tending only to the mind if there is a physical injury! Healing needs to address all of these areas.
Who Can Help?
Women do not need to suffer and wait while they feel their organs are falling out, have no libido and feel broken or damaged. So who can help? There are professionals well-versed in these issues that are qualified to help women traverse this intimate territory. It is imperative to find a professional that is competent. Equally important is a feeling of trust.
There is no reason to suffer in silence, especially when something as important as the ability to experience pleasure and move with ease in the world is at stake.
Practitioners Who Remediate Scar Tissue
Pelvic Floor Physical Therapist
One of the best practitioners to start with is a holistic pelvic floor physical therapist. Make sure that they will do actual hands-on, hands-in work. Usually pilates-type movement re-education and breathing exercises are not enough to really affect change in the pelvic tissue if that is where some of the damage occurred. If you are experiencing pelvic pain, you will need someone to actually work inside your vagina and possibly anus to remediate the scar tissue.
Tami Lynn Kent, MSPT trains professionals who are already licensed to touch the pelvic floor to practice somatic experiencing. She is also the author of “Wild Feminine”, an extremely practical and beautiful book on the wisdom of our organs and what we can learn by listening to them.
A list of medical professionals trained in pelvic rehabilitation may be found here.
Sexological bodywork is a relatively new field that trains somatic sex coaches to work with genital arousal and therapeutic concerns. Sexological bodyworkers are uniquely trained to work with scar tissue and post-birth issues. They have counseling skills as well as hands-on skills. The sessions have clear intentions that are co-created and may include talking, touch skills and genital work.
For a list of practitioners, visit the Association of Certified Sexological Bodyworkers.
Somatic Experiencing Therapists
Somatic Experiencing therapists are often marriage and family therapists, psychologists or psychotherapists but can also be any other health practitioner such as a social worker, physical therapist, bodyworker or physician. To become certified, the health professional must complete a three-year training course along with a clinical portion. Practitioners can be found in this directory.
Birth Story Medicine®, created by Pam England, birth pioneer and author of “Birthing from Within,” is also a very powerful tool to help women work through difficult emotions that may have been created during birth and understand the meanings that were made. The unique model “is an uplifting guided personal-growth process that brings insight, resolution and healing after a difficult or disappointing birth.” Sessions take place in person, via Skype or over the phone. See the Birthing From Within website which offers classes for expecting parents as well as training, workshops and retreats for birth professionals who want to teach “birthing from within.”
Every woman can benefit from pelvic floor work after childbirth even if there is no glaring overt trauma or injury. Also, there are ways that women can prepare for childbirth that help minimize tearing and pelvic pain afterwards, topics to be covered in future articles.
Birth is a radical event on many levels – physical, emotional, sexual, mental and spiritual. Pelvic pain and birth injury is real.
If you are experiencing this, give yourself the opportunity to heal in a supportive environment where you feel valued. There is no reason to suffer in silence, especially when something as important as the ability to experience pleasure and move with ease in the world is at stake. We urge every woman to advocate for herself and find the support she needs to return to a feeling of wholeness.
About the Authors
Kimberly Johnson is a birth doula, Certified Sexological Bodyworker and near-certified Somatic Experiencing Practitioner. She specializes in birth injury, birth trauma, post-partum recovery and sexual healing.
Before dedicating her life to helping women emerge through the childbirth and motherhood process more whole, she was a full-time yoga teacher, yoga teacher trainer and Structural Integration practitioner. She has taught classes and trained teachers in New York City, Boulder, San Diego, Brazil, Thailand and Malaysia since 1999.
Her own difficult post-partum healing process, where she experienced searing back and sacroiliac joint pain, incontinence, hemorrhoids and painful sex, led her to a path of exploring what she calls the black hole of women’s health: the post-partum period. Told she needed full pelvic floor reconstruction, she committed herself to healing holistically. Along the way she met Ellen Heed, who was conducting a research project on post-partum scar tissue remediation. In three sessions, the hemorrhoids reabsorbed, her abdominal wall knitted back together, and she returned to joyful pain-free sex. Already a bodyworker, she was determined to learn this work and to help as many women as possible navigate the post-birth process with far less suffering and far more support than she experienced. Founder of MagaMama.com, she is currently at work on a book about the physical, emotional, spiritual and sexual aspects of becoming a mother. For more about Kimberly, visit her website.
Ellen Heed loves her life teaching somatic professionals. She has had the opportunity to engage thousands of students around the globe since the year 2000. She has taught alongside Ana Forrest, Joseph Kramer, Hugh Milne, and Vincent Medici. She teaches in all kinds of environments including yoga studios and professional training programs internationally, as well as birthing centers, massage schools, and universities in the US. Her mission is to spread the word about scar tissue remediation, ancestral nutrition, and embodied mindfulness practices to everyone who desires vitality and radiance in their life. She has pioneered bold new approaches to healing sexual pain, and continues to influence the development of somatic sex education and professional practice worldwide. She maintains a holistic health consultation practice in Los Angeles, where she is completing her doctoral dissertation on the psychology of somatic sexual healing. Visit Ellen’s website for more information.