Alarming figures show that one in four women who give birth will end in loss of urinary or bowel control. Photo / 123rf
Alarming figures show that one in four women who give birth will end in loss of urinary or bowel control. Photo / 123rf
A Kiwi mum suffered in silence, unable to return to work for 14 years until she had physio and was able live a normal, pain-free life.
Another woman was unable to have sex with her husband for eight years after giving birth because it was too painful, before she discovered her suffering was treatable.
These are just two of the thousands of disturbing stories pelvic health physiotherapy specialist Melissa Davidson has heard in her 30-year career.
"It's a very rare day if I don't have someone burst into tears because for so long they thought their suffering was normal, that's what they'd been told, they had no idea they could get help. It's a taboo subject so no one talks about it."
Davidson is part of a national movement calling for better rehabilitation care for New Zealand women after birth.
Alarming figures show that one in four women who give birth will end in loss of urinary or bowel control. For Māori women it's 47 per cent.
It's caused by a prolapse which happens when the pelvic muscles and tissues are weak or damaged and can no longer support these organs. Depending on the severity of the prolapse, it can mean women are forced to avoid high-intensity exercise like running or jumping. They can be left unable to pick up more than 10kg of weight, may find it too painful to have sex and have to deal with unnecessary pain.
A petition started in early June has gathered more than 27,000 signatures from women across the country.
They are asking for:
• All New Zealand women to have access to free pelvic floor checks by a specialised physiotherapist for up to two years after giving birth.
• Better education on pelvic floor dysfunction, wound care management plans for birth-related surgical procedures, and how to correctly perform pelvic floor exercises before and after birth.
• All women suffering pelvic floor dysfunction or post-birth urinary incontinence to have access to up to 10 sessions with a pelvic floor physiotherapist, covered by ACC.
&bulll; More funding for district health boards to employ more pelvic health physiotherapists.
Davidson said it was an issue that affected nearly half of New Zealand's population but, because it hasn't been talked about, those affected carry on thinking it's normal.
"It's not normal, it's common and it can be treated," she said.
"It is not fair that so many women suffering from pelvic floor dysfunction or urinary incontinence can not access physio because ACC won't cover it, yet if you injure your back it's covered."
Pelvic health physiotherapy specialist Melissa Davidson has helped thousands of women in her 30 year career. Photo / Supplied
Though Davidson has treated tens of thousands of New Zealanders, she said there were many who couldn't afford treatment and missed out.
She charges $250 for an initial appointment and then $125 for a follow-up. Normally, women need about five sessions but each case varied.
"Whether they get ACC coverage depends on how hard they and the physio fight to get it for them, which ACC case manager they get, where they live in the country. There are so many inequalities and it's totally unacceptable."
ACC's chief clinical officer, Dr John Robson, said the public health system routinely helped women recover from "the rigours of childbirth".
"ACC provides support for those who suffer injuries that are not considered a normal part of the birthing process."
He said ACC covered all injuries that met the requirements of the treatment injury legislation and this included injuries suffered by women who have had a c-section, and those who have had vaginal births.
Robson cited the Accident Compensation Act 2001 which said ACC could only cover perennial tears that were a result of treatment or the failure to provide clinically indicated treatment.
Advocates, including Davidson, said the problem was it was a fight for each woman and there was no funding for that fight so many women gave up.
In other countries such as France, all women recovering from childbirth are entitled to 10-20 rehabilitation sessions with a pelvic health physiotherapist.
One of the authors of the petition, Kirsty Watt, said she wrote a letter to Minister of Women Julie Anne Genter asking for her support.
She was advised Genter's office was looking into it but was yet to get a response.
The minister told the Herald on Sunday she would make pelvic health a high priority and she intended to progress improving access to after-birth care.
"I'm committed to doing all we can to support our māmā and pēpī," she said.
"I wholeheartedly support the goal of all women having access to preventative care to protect their pelvic health, and access to healthcare professionals they need after birth or carrying a baby."
Juanie's story
Mum-of-two Juanie Odendaal is one of thousands of New Zealand women suffering in silence. Photo / Supplied.
Juanie Odendaal can no longer run or practise karate like she used to.
If she wants to jump on the trampoline with her daughter, she'll wet herself.
Before giving birth, the 29-year-old was an educational psychologist, which she loved, and worked with high-energy kids with behavioural issues which sometimes involved picking them up to restrain them.
Now, she says she has no choice but to find an office job.
The mum-of-two suffers from severe prolapse and urinary incontinence after childbirth - which was left undiagnosed for nearly a year.
"I kept getting told there was nothing wrong with me, it was normal to feel this way after childbirth."
It took three doctors and months of waiting for her to finally get a diagnosis but still she can't get treatment.
She has been denied ACC coverage for physio because there was no "failure in treatment"; her injury was a result of childbirth.
"It's no one's fault I've got this injury but that doesn't mean I don't deserve help."
Odendaal said she couldn't afford regular physio sessions because it would mean choosing between providing for her two children and helping herself.
"The system is broken and it is putting the responsibility on women to 'get back their health' so they can work and earn and raise their families, while at the same time, making the goal unattainable for the most marginalised.
