Ten Months Later, This New Mom Finally Feels ‘Normal’
A personal account of one woman’s health journey amid the complexities of postpartum recovery in America.
Of the many, many unknown consequences brought about by the current global pandemic, one glaring flaw we’ve seen exacerbated has been the pre-existing weaknesses within America’s healthcare system. This is especially the case when it comes to women’s health, and one area in particular where the country falls short is postpartum care and education.
Tiffany Lorena Walker, 26, recalls her 10-month long postpartum recovery that was both physically painful and mentally taxing. When Tiffany found out that she was pregnant, she began to do all she could to prepare for a smooth pregnancy, labor and delivery. Although her first trimester was difficult — she was nauseous and always tired — everything improved as her pregnancy progressed and by the time she was six months pregnant, she was strong enough to drive a 16-foot moving truck across the country to join her military husband at his new post in California.
On July 25, 2019 Tiffany delivered a baby boy after twenty-one hours of labor.
“When my son was born, his arm was up with his thumb sticking out. His umbilical cord was wrapped around twice,” Tiffany explained.
While this position may have prevented the cord from strangling her son, the placement of her son’s arm upon delivery caused injury to Tiffany’s perineum, which required stitching. The perineum is the tissue between the vaginal opening and the anal opening. It is designed to stretch, but more than 90 percent of women who deliver their first child vaginally will tear.
The Painful Reality
After giving birth, Tiffany soon realized how little she knew about women’s health. She shared a conversation she had with some of her female family members about this subject.
“We talked about how much you don’t know about being a woman and childbirth. There’s so much that doesn’t get taught to us in sex ed classes,” Tiffany said. “People talk about the sex part of it and not about the sex organs.”
Sara Reardon, Physical Therapist and owner of NOLA Pelvic Health and creator of the popular website and social media platforms, @The.Vagina.Whisperer is known to be vocal about the lack of emphasis and education around women’s health. Notably, in 2019 Sara did a TedTalk called, Rethinking Postpartum Care which has more than 20K views. According to Sara, beginning conversations with young women in the teens about menstrual cycles, anatomy, pregnancy, and birth should start as soon as puberty hits.
“I’m a medical provider and a mom. I’ve seen the lack of awareness, education and resources we have to address this part of your body,” said Sara. “You have a baby, you go home and that’s it. Why aren’t we educating people about this before there are problems? Why are we not giving them resources earlier?”
Building a sense of autonomy at a young age, could impact how comfortable women are advocating for their bodies as adults.
While at home, Tiffany did her best to advocate for her body. She diligently followed hospital recommendations to support her body’s healing process. She applied witch hazel pads to the affected area, used pain relieving spray and ice packs to ease the discomfort, and patiently waited for the six-week benchmark — the recommended time for new moms to have their first and only postpartum check up.
In the U.S., a woman will typically go from weekly visits with their OBGYN in their third trimester (10–14 total visits during their pregnancy with most visits focused on the baby and not the mother) to one appointment with their OBGYN after a gap of six weeks post-delivery. At this six-week appointment, new moms are often cleared to resume normal activities, including being sexually active.
When Tiffany’s appointment came, she knew something was not right.
“The doctor basically told me that I still had an ‘open wound’” Tiffany explained.
The recommendation was cauterize the area with silver nitrate to speed up the healing process. Silver nitrate is a chemical agent commonly used to destroy unwanted tissue.
“[The doctor] said if we do the cauterization now you will heal in a matter of days versus weeks. That’s the only reason why I agreed to it.”
Tiffany describes the pain from the cauterization as worse than labor contractions. When she left the doctor’s office, she called her mom.
“I told my mom, I’m not having any more kids. She was all concerned and was like ‘why what’s going on?” That’s one of the worst things I have had to do, and I have a high pain tolerance. I don’t want to go through this again.”
A month passed. Tiffany’s condition had not improved and it was difficult to manage the responsibilities of being a new mother while living with constant discomfort.
“It burned to pee. It hurt to sit down. It hurt to shower. It hurt to take long or wide steps. I couldn’t squat down. I couldn’t bend over. I didn’t even try to be intimate.”
Among first-time mothers, an estimated 17–36% of women report painful sex at six months after birth, according to one study. Furthermore, in most cases women who experience pain or discomfort during their postpartum recovery do not report it to a health professional.
Postpartum Care in America
For Tiffany, when the promise of a recovery within days turned into weeks without improvement, she did not reach back out to her gynecologist with an update. Instead, she actually decided to opt-out of her follow-up appointment for fear of another painful experience.
“I was traumatized by the pain of the cauterization. It hurt to even look at the area. I wasn’t getting cauterized again. I told myself you’re going to heal on your own,” Tiffany remembered. Believing that her body just needed a bit longer to recover, she began to piece together her own postpartum plan.
In the United States, many women find themselves in Tiffany’s shoes, having to design their own postpartum recovery plan. Women who utilize a doula during their pregnancy may secure an afterbirth support service. Others seek a lactation consultant to support them through breastfeeding. Few are aware of services like pelvic floor therapy or perinatal mental health therapy and the benefits they pose to new moms. Vaginal and cesarean births can cause significant stress to a woman’s body and can make them especially vulnerable to pelvic floor dysfunction. A woman’s pelvic floor contains muscles that support her womb (uterus), bladder, and bowel (colon), pelvic floor therapy can be used to restore their strength and function.
Outside of the US, a postpartum strategy is emphasized nearly as much as a birth plan, and the conversation begins before the baby is born. In France, new moms receive pelvic floor therapy as a standard covered by the government to add in their postnatal recovery. In China, they practice zuo yue zi, or “sitting the month,” a set of diet and lifestyle restrictions that prioritizes rest and recovery after giving birth.
When new mothers are experiencing physical and mental stress after giving birth, it impacts how they care for their children, how they engage in intimacy with their partners and even how they perform at their jobs.
Sara describes lack of quality postnatal care in America as a “human health” issue, but it is a problem that does not just impact women, but society as a whole. Furthermore, women who do not have childcare support, access to quality doctors or who might have to return to work quickly experience greater challenges after the baby arrives.
“People with higher economic status have resources like child care. People with a lower economic status may have to go back to work sooner, and cannot afford pelvic floor therapy in private practice,” said Sara. “We’d be ignorant to say that’s not the case.”
To bring attention to the discrepancies in women’s healthcare, particularly when it comes to women of color, Sara and her team at NOLA Pelvic Health hosted a two-part series for healthcare, wellness and medical professionals about race in our current healthcare system. They also offer both in-person and online support for moms to address everything from painful sex after birth to managing pelvic organ prolapse.
In the past couple of years, there has been somewhat of an effort to improve the state of postnatal care in The United States. In 2018, the American College of Obstetricians and Gynecologists published a report that recommends that women see their doctor three weeks after giving birth (as opposed to the standard six-week appointment). According to the report, “To optimize the health of women and infants, postpartum care should become an ongoing process, rather than a single encounter, with services and support tailored to each woman’s individual needs.”
A New Approach
In February 2020, when Tiffany’s son was 7 months old, she was not any closer to feeling completely recovered from giving birth. So, she set out to find a new OBGYN.
“At that point, it was getting ridiculous, I was dealing with it for almost a year,” Tiffany explained. “The [new] doctor told me that she thought she knew what was going on, and that it sounded like granulation tissue.”
This was the first time Tiffany had heard the term granulation tissue, which occurs when your body over heals and an excess of scar tissue is developed at the wound site. As a result, that affected area is susceptible to pain, inflammation and bleeding.
Tiffany’s doctor said it was the worst case she had seen. The options were cauterize again or remove the tissue surgically. Tiffany decided to try the cauterization again, feeling more optimistic now that she had a diagnosis. However, after two unsuccessful treatments, Tiffany realized she would have to move forward with surgery.
“[The doctor] had said that she had never taken anyone to surgery for this. I started crying…I still have a new baby and my husband is in the military about to go overseas,” Tiffany shared.
After signing a handwritten modified consent waiver specifically drafted for this procedure, Tiffany had the surgery on March 9, 2020. It was a quick procedure which required her to go fully under anesthesia. Tiffany’s sister-in-law took a few days off to help her while she recovered and cared for her baby, as her husband was already out of the country.
“For about a week it was hard for me to do just about anything and my baby was very mobile at that time, so it was definitely needed to have somebody who could follow him around,” Tiffany said.
By April, three weeks after the surgery and nine months after her son was born, Tiffany started to feel whole again. She also decided to share her experience in hopes that it might educate other women who might have had the same challenges during their postpartum recovery.
Today, Tiffany has returned to visit her doctor, but this time it’s for a good reason. After a lot of convincing she decided to have another baby, due March of 2021.
This time, Tiffany is more prepared and armed with both knowledge and a plan for both her pregnancy and postnatal recovery. “At least now I know what to expect,” she said.
Thanks so much for reading! As a new mother who also had a difficult postpartum recovery, I hope this article brings hope and awareness. Listed below are links to resources from organizations that educate and promote a healthy postpartum recovery.
Resources:
- The Postpartum Project is a consortium of doulas, lactation consultants, mental health clinicians, and obstetricians.
- Postpartum Support International (PSI) seeks to increase awareness among public and professional communities about the emotional changes that women experience during pregnancy and postpartum.
- Vaginal and Perineal Granulation By Emily McElrath, The Vagina Whisperer. March 4, 2020
- Black Mamas Matter Alliance is a Black women-led cross-sectoral alliance. We center Black mamas to advocate, drive research, build power, and shift culture for Black maternal health, rights, and justice.
- National Perinatal Association brings together people who are interested in perinatal care to share to listen and learn from each other.
