“You just had a baby. Of course you’re in pain,” a doctor informed me three days after giving birth. In the midst of the hazy confusion of taking care of a very tiny human, I had managed to make an appointment for what I was certain was the worst UTI of my life.
“This isn’t normal,” I insisted. “I’m bleeding from where I pee.”
“You’re bleeding from your vagina.» He didn’t even look. «You just had a baby.” This old-man doctor with a grizzled beard and unkind eyes seemed more confident in his statement the second time he said it, his words and expression informing me he thought my complaints were unwarranted and, frankly, taking up his precious time.
Because my UTI had come on so suddenly, I was forced to see the first doctor available. But I had been shuffled through various physicians in the system throughout my pregnancy so I didn’t even have a regular ob-gyn I could ask for advice.
“I know the difference between my urethra and vagina,” I said. “If I’m wrong then I’ve been putting tampons, not to mention other things, in the wrong hole for 20 years.” The doctor didn’t think I was funny, and when he tested my urine, at my insistence, he discovered what I knew would be there — a nasty UTI, likely caused by the catheter inserted when I was given an epidural. One in 3 new moms report having urinary or bowel problems after giving birth, according to a 2013 survey by the nonprofit Childbirth Connection.
I’ve had both.
I was in one of the best medical systems in one of the most progressive cities in America and I have top-notch health insurance. But I would soon discover, on my own and through discussions with other women, that this lack of postpartum care is too often the norm in the United States, a country where more women die due to pregnancy-related complications than any other developed nation and where childbirth injuries can go undiagnosed for years.
I’ve spoken to many women about their own postpartum horror stories — untreated cracked ribs and pelvic bones, persistent incontinence, spinal fluid leakage leading to throbbing headaches, uterine infections, and swollen labias that make sitting impossible. The common thread was that doctors initially waved away these concerns when the women informed them they knew something wasn’t right with their bodies — until they forcefully advocated for themselves.
I assumed, incorrectly, that the doctors would let me know what to expect and how to take care of myself.
Before I was released from the hospital, about 36 hours after giving birth, no one talked to me about the many symptoms I might experience when I went home, including the possibility of a UTI. This was my first baby. I didn’t know what to ask for. I assumed, incorrectly, that the doctors would let me know what to expect and how to take care of myself. We didn’t talk about hemorrhoids, contractions while breastfeeding that would cause my uterus and vagina to ache constantly, or bleeding nipples due to breastfeeding. These are all common postpartum symptoms, according to a study out of UNC Chapel Hill, the 4th Trimester Project, which for two years has been tracking the care new moms get in the United States. The study found that around half of new moms are still in pain weeks after giving birth.
The one thing I was told about my postpartum care was to call a doctor if I had blood clots the size of golf balls, a possible sign of postpartum hemorrhaging, either in the toilet when I peed or on the giant maxi-pads that would become my new must-have accessory.
How big was a golf ball again? It’s been a while since I’ve been out on the links, what with the pregnancy and all. Everything else — blood clots smaller than golf balls, pus, throbbing pain, burning, itching — I was led to believe was par for the course.
The only time my injuries were discussed was immediately after the actual childbirth, while my legs were still paralyzed from my epidural.
The only time my injuries were discussed was immediately after the actual childbirth, while my legs were still paralyzed from my epidural and I had my purple, wailing newborn on my chest rooting around for a nipple he had never even met. That’s when the doctor explained I had a first-degree tear. She stitched it up and never mentioned it again. I didn’t know even what she meant until I Googled it a day later and learned that, in terms of birth injuries, I’d won the tearing Olympics. A first-degree tear means only the skin around my vagina was ripped apart, compared with a second-degree tear, which penetrates the muscles; or a third degree tear, which extends into the anal sphincter.
No one examined my stitches before I left the hospital, a situation familiar to many new moms I spoke to. “Shouldn’t someone look at my vagina?” I asked my husband. I felt a little ridiculous asking someone to check. Someone would look if there was a problem, wouldn’t they? I considered using the old makeup-compact-between-my-legs trick, the one I’d used to check out my labia for the first time when I was 14, but when I felt the swollen, bleeding tissue with my fingers, I was too scared to look.
The nurses made an appointment for me to have my stitches checked out six weeks from delivery. A majority of women aren’t scheduled to see their care provider until six weeks after birth, in contrast to a newborn’s first doctor’s appointment, which is typically two or three days after bringing the baby home.
When I left the hospital, I knew how to swaddle, diaper, soothe, bathe, and burp my baby. I had no clue how to take care of my own body.
When I left the hospital, I knew how to swaddle, diaper, soothe, bathe, and burp my baby. I had no clue how to take care of my own body. No one even gave me instructions on how to keep the area around my stitches clean and free from infection.
I was given a squirt bottle that looked like it should contain an off-brand version of Gatorade and told to squirt it «down there» when I peed. It was unclear which part of «down there» was being referred to. This gave me the sense from the hospital staff that I shouldn’t be worrying about myself at all, that I should be focusing on caring for my infant.
“First-time mothers, especially, have so little sense of what degree of physical and emotional upheaval is to be expected and what’s cause for concern,” says author and researcher Lauren Brody, who wrote the book The Fifth Trimester and interviewed more than 700 American mothers about their physical, mental, and emotional health after giving birth. “Generally, women err on the side of dismissing our own needs.”
I cried every other day the first few weeks after my baby was born in July. The internet told me this was normal. It even has an adorable name, “the baby blues.” But my crying wasn’t the result of a hormone-induced depression or a subconscious fear about my radically altered life. I cried because I felt sharp pains every time I rolled over to get my baby from the bassinet and because I’m wasn’t yet physically capable of walking up and down my hallway to soothe him. Those pains made it difficult to care for my baby the way I wanted to and I felt like a bad mother. Sometimes the guilt outweighed the pain and I pushed myself to do it anyway, which wasn’t good for either of us.
Before I had our baby, my husband Nick and I attended free classes at our hospital on childbirth and taking care of a newborn. Each of them lasted the better part of a day and covered everything from newborn acne to the amount they will likely spit up in a given day (a lot).
«Fuck this thing!» No one in our house can Moby the baby. #mobywrapfail @mobywrap It looks like Charlie needs to learn to walk.
A post shared by Johanna Piazza (@jopiazzaauthor) on Aug 12, 2017 at 3:13pm PDT
The hospital didn’t offer me a single class, before or after the birth, on caring for my postpartum body. It would have been nice to have an hour of instruction on why and how my body would feel weird, and what would be worth worrying about.
“There is a lack of lay education about the normal physiological events that are going to take place in your body postpartum. It’s not drilled into you, like so much of the other prenatal information,” says Erica Chidi Cohen, a birth and postpartum doula, the co-founder of Loom, a reproductive wellness center in Los Angeles and the author of Nurture: A Modern Guide to Pregnancy, Birth, Early Motherhood. “No one tells women they might have postpartum bleeding for eight weeks, they might have uterine cramping for up to a month, excessive sweating, urinary incontinence, the high possibility of a UTI if you had an epidural.”
It’s complete bullshit that a new mom should have to rely on the internet, with its anecdotal and potentially misleading information, to scrutinize every new ache and pain. I’ve been lucky to get advice from a village of women, some I know well, and others near-strangers on social media who have given me advice on how to create ice packs from maxi-pads and baby diapers; why I should use olive oil as nipple cream; and to squirt lidocaine on Tucks pads like toothpaste, smush it around, and stick ’em where it hurts like a poultice. This is pure magic. Their help has been invaluable, but I should be getting advice and guidance from medical professionals. I’ve since reached out to friends who live across the country and are trained ob-gyns, and taken to weeding through the great morass of medical information on the internet.
Giving birth is painful. Recovering from giving birth is also painful. But there’s no reason that pain should be a mystery.
Jo Piazza is the author of the memoir How to Be Married and the novel Fitness Junkie.