On my first day at Women’s Health, I wet myself. And not in the ‘fun’ way either (although they are a hilarious bunch). No, I mean that my bladder gave way while I was making tea. Reader, there’s nothing quite like disappearing from your desk for 40 minutes while you try to rinse and dry out your knickers to really impress your new boss.
I suffer with post-partum incontinence, a condition resulting from the birth of my daughter in 2021. The birth wasn’t traumatic, but it was fast and caused my pelvic floor muscles to weaken and my bladder to prolapse, partially descending into my vagina.
My case is mild, but it’s left me dealing with urinary incontinence on a daily basis. It came as a shock – no one warned me of this risk before the birth. If I’d known what I’d be living with now, I’d have insisted on a caesarean.
Incontinence isn’t a mental health condition, but it’s the bedfellow of many well-known symptoms. The constant paranoia that you stink of piss, for example. The anxiety that you’re going to get ‘caught out’ when you leave the house. The depressing thought that you might well have to live like this forever – feelings I deal with every day, woven together in my own miserable personal tapestry.
But its impact on my day-to-day life isn’t just limited to always being armed with a spare pair of knickers and an excessive amount of pads. It’s the insidious effect it has on your body image. Due to the stress it puts on your pelvic floor, any weighted or high-intensity exercise is out. Even yoga can cause leakage if you lift your legs too enthusiastically.
The most rigorous activity I’ve been able to do since my daughter’s birth is a brisk walk; a reality that’s made it harder to shift my baby weight, and my confidence has plummeted. Looking in the mirror often leaves me feeling disgusted.
I know this doesn’t adhere to the popular feminist narrative. That one of ‘self-compassion’ and ‘kindness’; the one that tells you to celebrate your body for what it has achieved (read: bringing a baby into the world) rather than berating it for how it looks. But it’s incredibly patronising to hear this, not to mention frustrating – how I feel about my body isn’t simply about aesthetics.
On a fundamental level, I feel as though my body has let me down. Yes, it gave me my amazing daughter, but it broke in the process, and I have to live with the consequences of that malfunctioning every day. Is it any wonder I don’t feel the love?
While I know that plenty of women are dealing with this, no one ever shares their experience, so I’m left feeling dirty and alone. One in three mothers in the UK suffer with urinary incontinence after childbirth, according to the National Childbirth Trust. Not to mention the number of women affected during the menopause; it’s thought that 40% of women over the age of 50 experience pelvic organ prolapse.
But the reality of under-reporting means that these figures could be even higher. Shame means it’s rarely discussed, and if it is, it’s whispered, wrapped up in more palatable, comedic packaging or normalised as a ‘little oops moment’. To be clear, there’s nothing ‘normal’ about it.
As for treatment, I’ve hit a stalemate. I’d heard enough stories from friends to know that, as a first-time mother, I’d need to advocate for myself during the birth. But I didn’t expect the gaslighting to continue throughout my post-partum recovery.
I was told the incontinence was ‘to be expected’, that it would improve after three months, after I stopped breastfeeding, after I stuck with those pelvic floor exercises for just a little longer. The truth is that sexism within the NHS is pervasive. Do I think we’d be expected to live with this if it were a problem affecting men? Absolutely not.
The reality is that I will need surgical intervention to fix the issue, but the NHS won’t intervene until I’ve ‘completed my family’ – something I’ve been terrified to do as pregnancy will only serve to make the incontinence worse.
In the meantime, I’ve been referred for physio, which has made zero difference – it turns out that it’s not just that my pelvic floor is weak, but my urethra is damaged, something no amount of Kegel exercises will fix. Like so many women, I’m being told to wait. For now, the future is looking… damp.
INCONTINENCE AND MENTAL HEALTH
The expert view: Dr Sula Windgassen is a psychologist and researcher specialising in chronic health conditions
How might incontinence affect mental health?
Incontinence can lead to feelings of shame and embarrassment, which often results in people avoiding certain activities. In doing so, people can feel like their identity has fundamentally changed. Women can worry about incontinence being untreatable, and a lot of anxiety comes from not knowing the best way to deal with symptoms and whether they can be tackled.
How does stigma make it harder to deal with?
The societal taboo of talking about these things can increase anxiety and a sense of isolation. When you feel unable to talk about your vulnerabilities, it increases the burden. Over time, this can leave people feeling really low. There can also be a lot of dismissal that happens in healthcare consultations that feeds into feelings of isolation and shame.
How can you support a friend going through it?
Create a non-judgemental space for them to express how they feel and what they’re worried about. There’s no need to try to problem-solve. Good humour can be a wonderful antidote to shame and embarrassment. Supporting your friend to feel comfortable doing things that they have withdrawn from can make a big difference in making them feel more like themselves.
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