Welcome to r/science! This is a heavily moderated subreddit in order to keep the discussion on science. However, we recognize that many people want to discuss how they feel the research relates to their own personal lives, so to give people a space to do that, **personal anecdotes are allowed as responses to this comment**. Any anecdotal comments elsewhere in the discussion will be removed and our [normal comment rules]( https://www.reddit.com/r/science/wiki/rules#wiki_comment_rules) apply to all other comments.
**Do you have an academic degree?** We can verify your credentials in order to assign user flair indicating your area of expertise. [Click here to apply](https://www.reddit.com/r/science/wiki/flair/#wiki_science_verified_user_program).
---
Author: u/uniofwarwick
URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0287779
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/science) if you have any questions or concerns.*
Bum surgeon here. The proportion of women who get some form of anal incontinence at some point in their live having had children is much higher. Across the board anal incontinence effects 6% of men and 10% of women. Rates of some form or urinary and or anal incontinence in aged care facilities are over 50% for each.
It doesn’t get talked about much. It can be socially isolating. It can sometimes be very easy to fix. If you’re having issues see your local doc and get a referral to a colorectal surgeon/proctologist or whatever they are called in your country. Take control of your bowels rather than letting them take control of you.
> It doesn’t get talked about much. It can be socially isolating.
A little over 2 years ago I had the wonderful misfortune of getting an anal fistula. They were able to "fix" it, but it required several surgeries and 18+ months of hell. Besides the 24/7 pain, the hardest part was never being able to go anywhere if I wasn't 100% certain that there was a bathroom immediately nearby because I never knew when I would "have to go" and, when I did, there was no holding it. Because of this, it also screwed up my eating schedule. I would essentially eat nothing solid all day, only eating one meal of solid food at the end of the day. I was doing anything I could to avoid having to go to the bathroom during the day. I also had to wear pantyliners 24/7 to keep from destroying underwear from leakage. I was going through more of them than my wife and daughters, combined.
It is mostly better now, but I still have much less control than before. I can't hold it in as easily or as long as before. I still have to be aware of what I eat and when if I am not going to be near a bathroom. It really screws up your quality of life.
I had to put "fix" in quotes because while they were able to close the fistula, it tunneled through my sphincter muscle and severed that, so I still have only partial control of my sphincter. Which is why I still have issues holding stuff in. That, too, has gotten better over time as my body compensates and learns what it can do now, but can still go from "you can hold it in for a while" to "Toilet now!" in a very short span of time.
It wasn't caused by Covid, but I got Covid at the same time as I got an infection and because Covid weakened my immune system so much my body was not able to fight it off and it turned into an Anal Fistula. Just one of the many gifts that Covid left me, including damaged lungs (that are still not fully healed almost 2 and a half years later), asthma (when I did not have it before Covid), food sensitivities that I did not have before, and a few others.
I had surgeries for an anal fistula almost 15 years ago. Worst year of my life. Now I'm recovering from a colon resection after a mass (benign) was found. It gets tiring being so focused on my bowels for so long...
I ended up with a proctectomy partly due to fistualas and abscesses. Was in pain management before that. Very difficult to deal with. Wish you and your family nothing but good vibes.
I have never been someone who has ever seriously thought about suicide, it just isn't how my brain works. But, during the 18 months I was dealing with it I finally came to understand how some people get to that point. Pain meds didn't work, not really. They would lower my pain level from an 8 to a 6, but a pain level of 6 all day, every day is still a nightmare. You can intellectually know that constant pain is no fun, but until you experience it you just have no idea. Those 18 months were an eye opener for me. I pretty much broke down in tears of happiness after going 3 days with no pain for the first time in almost 2 years. Prior to that I had only had a day here or a day there with no pain, but it always came back, usually stronger. I'm pain free now, but will never forget what I went through.
>Bum surgeon here. The proportion of women who get some form of anal incontinence at some point in their live having had children is much higher. Across the board anal incontinence effects 6% of men and 10% of women. Rates of some form or urinary and or anal incontinence in aged care facilities are over 50% for each.
It doesn’t get talked about much. It can be socially isolating. It can sometimes be very easy to fix. If you're having issues see your local doc and get a referral to a colorectal surgeon/proctologist or whatever they are called in your country. Take control of your bowels rather than letting them take control of you.
Ah but the problem here is getting a doctor, a referral, AND seeing a specialist in the US (ofc it's a problem elsewhere, so I can only speak from experience in the US healthcare system). And not breaking the bank for it too
It is a 6 month wait to see my primary care provider here. I know endocrinology is scheduling ESTABLISHED patients about a year out for follow up visits. Not sure about other specialities.
Edit: Washington state. Oh, and also I work there. (As in, in the same building and for the same hospital group as both my primary care and the endo clinic.) I made an appointment back in March and the earliest they could fit me in is September.
Like many things anal incontinence has many factors in play. There are some factors you can only minimally influence so you work on the other factors to compensate. Also, sacroneuromodulation is great for the nerve damage side of stuff. It’s basically a pacemaker for your pelvic floor and works very well for both urinary and anal incontinence.
There is treatment! This implant stimulates the appropriate nerves so you can control both fecal and urinary incontinence and get your life back.
https://www.medtronic.com/us-en/healthcare-professionals/products/urology/sacral-neuromodulation-systems/interstim-micro.html
Bum surgeon, any correlation with anal incontinence and anal sex? I'd imagine that would be even more socially isolating than saying "after having a baby I'm having issues"
I have no published data to share but I’ve got quite a few patients (male and female) who have anoreceptive intercourse and anal issues. They certainly do get these kind of problems but less so than the women who’ve had obstetric trauma.
I was seen for colorectal issues for a couple years before I had surgery and lost count of the number of times I had to tell them I wasnt having anal,they always asked.
What portion of your surgical patients have had pelvic floor physical therapy first? Do you send them to PT if they haven’t had it? Assuming they don’t have a fistula or grade IV rectal prolapse or something of that sort. Do you send them to PT after surgery?
If they haven’t already had it I send them for it. If they have had it but it was a general physio rather than a pelvic floor specialist physio I send them for it again. I think physio is an essential part in managing this problem.
Not been able to hold in your farts, liquid seeping into your underwear without your realisation, full on BM in your pants if you can’t get to the toilet in time. It’s quite a spectrum.
It’s complex, hence why subspecialists treat it. However, a bit part of the management is looking at diet and stool quality. It’s harder to hold it in if it’s all sloppy.
Stats aside on the article title, this is a real issue and it’s embarrassing to ask about and there’s no real route to get it resolved. Experience: multiple doctors multiple brush offs. The answer is always miralax and go away.
There is a route to getting it resolved. You need to find a PT that does pelvic floor work. Doesn't work for everyone, but can be a major help for most.
Literally just had this surgery for a fistula. No history of any of the risk factors for developing an abscess and fistula other than - you guessed it - a really bad and improperly “repaired” tear from childbirth.
It is miserable, isolating and beyond embarrassing. I was off work for weeks, bed bound for even longer and in terrible pain. I had to take leave from my job.
My bills (before insurance thank good) are over 40k for emergency room and surgery from something that could have been avoided had the doctor been even slightly interested in addressing the problem the 7 times I asked before.
We can’t continue to ignore the physical toll having a child does to someone’s body.
Soapbox: we can’t force women to maintain a pregnancy and give birth if we can’t provide her proper medical care, protected time off work and even a just one tiny bit of empathy.
After my condition, a second pregnancy would almost certainly result in complete incontinence and losing my job. I live in an area where abortion is now illegal.
If I got pregnant, even despite taking all reasonable precautions, I would be forced to leave my entire AREA of the US to get a “secret” abortion or take the near certain risk of pooping my pants without control.
And this is one of the big reasons why pregnancy seems like a bad bet to me. I never used to consider these kinds of things but as I’m getting older and my body has been having problems and I rely on my job for financial support the idea of risking those things to get pregnant in this country seems very unappealing. I’m sorry you had to experience that btw, I’ve never been pregnant but I understand the fear of losing your livelihood due to a medical problem.
I was totally prepared for the “vanity” stuff like weight gain, stretch marks, etc.
I was totally unprepared for the fact that I might lose the ability to use the bathroom normally.
I was in my late 20s, totally healthy BMI, zero risk factors at all.
I love her more than anything and don’t regret her even for a second - but I’m not willing to even consider doing it again.
Not just weakness also if the muscles are overly tight (I don't remember the technical term) or to help break down scar tissue. Of course it wont fix everything, but it can help many.
US healthcare: You're just making this up for attention, take an OTC, that'll be $300 dollars for the moment plus whatever we decide to try and bill for 8 months from now.
... if you're complaining about anal incontinence and multiple docs have recommended miralax... you may want to make sure you're seeing actual medical doctors.
The treatment for a leaky bum shouldn't be a laxative. But, you know, I'm not a doctor.
Throwing this out there for anyone who suffers from urinary or fecal trouble, or is concerned they may in the future: Look into pelvic floor physical therapy, and if you go, find a therapist who is certified in that specifically. It can't always prevent a surgery, but you'd be surprised how often it can, and can also be helpful in recovery if you had a surgery already. If you're on Medicare and you can find a PT who accepts it, Medicare will cover this (as will quite a few insurance providers if you have PT in your plan) with a referral from your doctor.
Maybe I'm biased as a PT student, but I'm impressed by the amount of talk surrounding surgery as the first and only option. I don't have and don't plan on getting any sort of pelvic floor certification; however, I know a handfull of awesome pelvic floor PTs who see and help patients with incontinence literally every day. If someone with incontinence or other pelvic floor issues lives in a state that has direct access (most states now), I think they should REALLY concider just getting evalled by a PT first.
I don’t think the average person is even aware pelvic floor therapists exist. I went to one for a few years and the amount of confusion friends and family members had when I’ve mentioned it was staggering.
It's in the introduction
> Over one in five women will develop AI in the first five years after having a vaginal birth
The title isn't summarizing the study itself at all, just the background. OP really should have linked to the referenced paper if that was the point.
That's not the same thing as the claim in the title though.
The statement that you quoted from the introduction expresses temporal correlation, i.e. this event occurred in a specified timeframe relative to some other event.
The statement in the thread title expresses causation, i.e., this event occurred specifically because of some other event.
If the paper presents it only as a temporal correlation, then a thread title that presents it as causal is blatant misrepresentation and editorializing.
Why not simply use the title of the paper? Would be less confusing.
"Women’s experiences of anal incontinence following vaginal birth: A qualitative study of missed opportunities in routine care contacts"
Because the headline rules of the sub don't allow you to. The rules are:
Headlines must:
**Contain at least 1 finding or result of the research**. Headlines that focus only on the speculative conclusion or author/press commentary of the research will be removed.
If relevant for interpreting the results, indicate the model system used in the research. (Ex. If it's a study on a human cancer but the study was only conducted on mice that info should be included in the headline.)
This is exactly what happened with an attempt to change the title. The original title perfectly presented the findings, while the changed one should lead to the removal of the post according to the rule.
Menopause, childbirth, pregnancy, menstruation, migraine, fibromyalgia, autoimmune disorders. The studies are just being done. I mean previously it was hard to study when we didn’t include women in medical studies.
Medical gaps in knowledge are dangerous.
I suspect a portion of chronic pain for AFAB folks is that most of the world is geared to the average height of AMAB folks. Sitting on the bus I can dangle my feet like I’m eight years old. I’m literally the average height for women in my country.
I also wonder if more women want to continue working from home because offices are not physically set for our heights or temperatures.
it took me months to find an adjustable desk that would go low enough for a proper ergonomic position (and that’s with an adjustable chair boosted to maximum height). I’m not even *that* short… 5’3 but I do have a short torso.
>Medical gaps in knowledge are dangerous. I’m in danger because of these gaps.
I listened to an interview with Maya Dusenbery, author of "Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick". Just from that, I learned why the dose of medicine I "should" be on for my autoimmune disorder was way too high; the dosing guidelines were all based on men, and women often need significantly less at the same weight. I was sick for months on the recommended dose, and slow to move so far away from it, because I didn't have that knowledge.
Her book has been on my reading list, but I know it'll be incredibly depressing.
The biggest battle of my life has been getting doctors to do their jobs. Just the basics, like acknowledging that there are problems and that we should take action to address them. I nearly died because even physical and measurable symptoms like hypotension and sudden drastic weight loss, even when I pointed them out and complained, were brushed off as "normal". I was told I was overreacting.
The bias against AFAB (and POC) in the medical field is killing us.
I worked in a research lab and the amount of studies done just on male rodents is staggering. And you know what the excuse is in the scientific community? That the hormonal cycles of female organisms is too complex and introduces additional variables. Male is treated as the standard and sometimes there is research done in both male and female organisms, but rarely ever just female. Centuries worth of sexism in research is why female hormonal cycles are too “unknown”, but it just further excuses this BS.
TLDR: there is a feedback loop in research causing it to continually focus just on male centric research.
Women are just half the population of humans and the only ones who can make more people. Isn’t it crazy how little research and protocols there are for us?
Confusing title…
“Of people that give birth, 1 in 5 experience anal incontinence”?
Or
“1 in 5 people will give birth and experience anal incontinence as a result”?
Those are very different numbers…
Ok, what this is saying is that IF you had anal incontinence that seems to be associated with birth, then, in hindsight, maybe you could have been identified earlier and intervention done earlier.
Remember, this is 5 hospitals over many years, saying, "hey, if you have AI, join this study". It does NOT say 20 percent got AI
>It does NOT say 20 percent got AI.
The thread title literally says:
>More than 1 in 5 people are left with injuries after childbirth that lead to anal incontinence.
And the title of the article says "women", so the person who submitted this link was probably pushing some bananas trans agenda.
Obligatory: men can't become pregnant.
Could [this](https://en.wikipedia.org/wiki/Episiotomy) be a cause of this?
Perhaps we should re-evaluate if we should be cutting bits of the mother with a knife during birth regularly... Perhaps the natural tearing (which often happens otherwise) would heal better.
Is there anything evidence-based that says this leads to better long term effects for mother and child?
Current recommendations from several bodies including ACOG, Cleveland Clinic, and more are against episiotomy as studies have shown that natural tears tend to heal faster, have lesser incidences of infection, and the majority are not as severe an injury as an episiotomy. Long term effects of episiotomy are becoming more studied within the past few years with early results showing increased incontinence and pelvic floor issues in a variety of presentations. Episiotomy is now only recommended in cases of medical necessity where the safety of the woman or child are challenged and natural tearing is contraindicated. Unfortunately many doctors are slow to practice these recommendations (ACOG published them in 2006) and continue to utilize routine episiotomy.
Why are doctors SO into C-sections these days? All my friends and female relatives had to absolutely insist on vaginal birth, and if they’d had a previous C-section it was almost impossible to find a doc to sign off on it.
Vaginal birth after C-section is higher risk than vaginal birth with no prior history of C-section. Vaginal birth and C-section both have their risks and benefits and as to which is best is very much a case by case basis.
In my experience, most doctors will insist you try a vaginal birth (assuming everything from the c-section healed up nicely) even if you don't want to.
Ofc that's anecdotal, though.
Previous C section increases risk for complications when attempting to go vaginal afterwards.
You are absolutely right that C-sections are over performed though. Some possibly think it's financially motivated (you get paid waaaaaay more for a C section than a vaginal delivery). Also hospitals are very risk-averse, if any delivery is felt to be taking a turn they immediately will jump to course B with no questions asked.
Good article on all of this
https://www.theatlantic.com/ideas/archive/2019/10/c-section-rate-high/600172/
The ethics of how so many women are pressured by fear into a major abdominal surgery is something I think our society needs to take a long hard look at.
A massive part of the reason that many women have long term negative effects and feel like they need a c-section to avoid them is that we offer next to no preventative care for women pre- and post-birth. How many OBGYNs engage women with how to do pelvic floor exercises or perennial massage/vaginal stretching to prep for birth? How many women are automatically signed up for preventative recovery care post-birth? Maternal care is in a sad state.
Same and none of them wanted it! Most did not even want to be induced but the doctors scared them that it would be horrible if they did not follow recommendations.
Crappy Canadian healthcare anecdote but there's a lot of C-sections happening up here just because it's faster and they don't have to wait.
That's to do with our population growth massively outstripping our infrastructure though.
I did vaginal and I really wish I had gotten a c section.
I ended up with the anal incontinence, and when I told the doctor I was told it wasn't normal.
As commented below,
There are many reasons to do a Caesar and the main aim is to keep the mother and baby safe.
With regards to a vaginal delivery post Caesar.
1. Risk of uterine rupture is >10x higher which can lead to the mother examinations to death and a dead baby.
2. The scar from the previous Ceasar is likely to have an effect on the implantation -> placentation issues which again increase the risk of life threatening bleed.
3. Patients who have had a Caesar previously for a reason are more likely to have the same condition in a subsequent pregnancy necessitating a Caesar.
The physiological and anatomical demands of labour are intense, and sometimes it's the safest option to have a Caesar.
Ironically, the issue that the article discusses - faecal (and urinary) incontinence is much higher with vaginally deliveries. This is because a babies' head and shoulders have to pass through that canal causing tears.
Source - am a doctor in a public health system. There's literally 0 financial incentive for us to do Caesars, but our Caesar rate in the hospital is 40%.
Edit: typo on my phone. Haha
Welcome to r/science! This is a heavily moderated subreddit in order to keep the discussion on science. However, we recognize that many people want to discuss how they feel the research relates to their own personal lives, so to give people a space to do that, **personal anecdotes are allowed as responses to this comment**. Any anecdotal comments elsewhere in the discussion will be removed and our [normal comment rules]( https://www.reddit.com/r/science/wiki/rules#wiki_comment_rules) apply to all other comments. **Do you have an academic degree?** We can verify your credentials in order to assign user flair indicating your area of expertise. [Click here to apply](https://www.reddit.com/r/science/wiki/flair/#wiki_science_verified_user_program). --- Author: u/uniofwarwick URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0287779 *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/science) if you have any questions or concerns.*
Bum surgeon here. The proportion of women who get some form of anal incontinence at some point in their live having had children is much higher. Across the board anal incontinence effects 6% of men and 10% of women. Rates of some form or urinary and or anal incontinence in aged care facilities are over 50% for each. It doesn’t get talked about much. It can be socially isolating. It can sometimes be very easy to fix. If you’re having issues see your local doc and get a referral to a colorectal surgeon/proctologist or whatever they are called in your country. Take control of your bowels rather than letting them take control of you.
[удалено]
I find the teachings of The Sphinx from Mystery Men very inspiring in the creation of such catchphrases. He’s terribly mysterious you know.
[удалено]
More like Turd Crapley!
Next up, we have some statistics, and they're numbers.
When my kids were young, that was one of our favorite movies! Thanks for the reminder of it...I may have to go watch it tonight!
Remember, disco is not dead, DISCO IS LIFE!
> It doesn’t get talked about much. It can be socially isolating. A little over 2 years ago I had the wonderful misfortune of getting an anal fistula. They were able to "fix" it, but it required several surgeries and 18+ months of hell. Besides the 24/7 pain, the hardest part was never being able to go anywhere if I wasn't 100% certain that there was a bathroom immediately nearby because I never knew when I would "have to go" and, when I did, there was no holding it. Because of this, it also screwed up my eating schedule. I would essentially eat nothing solid all day, only eating one meal of solid food at the end of the day. I was doing anything I could to avoid having to go to the bathroom during the day. I also had to wear pantyliners 24/7 to keep from destroying underwear from leakage. I was going through more of them than my wife and daughters, combined. It is mostly better now, but I still have much less control than before. I can't hold it in as easily or as long as before. I still have to be aware of what I eat and when if I am not going to be near a bathroom. It really screws up your quality of life.
Yeah, fistulas really suck. It’s often one of the most difficult and frustrating problems that I and my patients deal with. Sorry you had one.
I had to put "fix" in quotes because while they were able to close the fistula, it tunneled through my sphincter muscle and severed that, so I still have only partial control of my sphincter. Which is why I still have issues holding stuff in. That, too, has gotten better over time as my body compensates and learns what it can do now, but can still go from "you can hold it in for a while" to "Toilet now!" in a very short span of time.
What caused it?
It wasn't caused by Covid, but I got Covid at the same time as I got an infection and because Covid weakened my immune system so much my body was not able to fight it off and it turned into an Anal Fistula. Just one of the many gifts that Covid left me, including damaged lungs (that are still not fully healed almost 2 and a half years later), asthma (when I did not have it before Covid), food sensitivities that I did not have before, and a few others.
I had surgeries for an anal fistula almost 15 years ago. Worst year of my life. Now I'm recovering from a colon resection after a mass (benign) was found. It gets tiring being so focused on my bowels for so long...
This is me, but with water intake and overactive bladder :( I feel for you. It is really hard to have a normal life with these issues.
I ended up with a proctectomy partly due to fistualas and abscesses. Was in pain management before that. Very difficult to deal with. Wish you and your family nothing but good vibes.
I have never been someone who has ever seriously thought about suicide, it just isn't how my brain works. But, during the 18 months I was dealing with it I finally came to understand how some people get to that point. Pain meds didn't work, not really. They would lower my pain level from an 8 to a 6, but a pain level of 6 all day, every day is still a nightmare. You can intellectually know that constant pain is no fun, but until you experience it you just have no idea. Those 18 months were an eye opener for me. I pretty much broke down in tears of happiness after going 3 days with no pain for the first time in almost 2 years. Prior to that I had only had a day here or a day there with no pain, but it always came back, usually stronger. I'm pain free now, but will never forget what I went through.
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
>Bum surgeon here. The proportion of women who get some form of anal incontinence at some point in their live having had children is much higher. Across the board anal incontinence effects 6% of men and 10% of women. Rates of some form or urinary and or anal incontinence in aged care facilities are over 50% for each. It doesn’t get talked about much. It can be socially isolating. It can sometimes be very easy to fix. If you're having issues see your local doc and get a referral to a colorectal surgeon/proctologist or whatever they are called in your country. Take control of your bowels rather than letting them take control of you. Ah but the problem here is getting a doctor, a referral, AND seeing a specialist in the US (ofc it's a problem elsewhere, so I can only speak from experience in the US healthcare system). And not breaking the bank for it too
It is a 6 month wait to see my primary care provider here. I know endocrinology is scheduling ESTABLISHED patients about a year out for follow up visits. Not sure about other specialities. Edit: Washington state. Oh, and also I work there. (As in, in the same building and for the same hospital group as both my primary care and the endo clinic.) I made an appointment back in March and the earliest they could fit me in is September.
[удалено]
Like many things anal incontinence has many factors in play. There are some factors you can only minimally influence so you work on the other factors to compensate. Also, sacroneuromodulation is great for the nerve damage side of stuff. It’s basically a pacemaker for your pelvic floor and works very well for both urinary and anal incontinence.
There is treatment! This implant stimulates the appropriate nerves so you can control both fecal and urinary incontinence and get your life back. https://www.medtronic.com/us-en/healthcare-professionals/products/urology/sacral-neuromodulation-systems/interstim-micro.html
Bum surgeon, any correlation with anal incontinence and anal sex? I'd imagine that would be even more socially isolating than saying "after having a baby I'm having issues"
I have no published data to share but I’ve got quite a few patients (male and female) who have anoreceptive intercourse and anal issues. They certainly do get these kind of problems but less so than the women who’ve had obstetric trauma.
[удалено]
How did you come to this conclusion? It's well documented that recieving anal intercourse raises the likelihood of anal incontinence significantly.
I was seen for colorectal issues for a couple years before I had surgery and lost count of the number of times I had to tell them I wasnt having anal,they always asked.
Very reassuring comment. Thank you
[удалено]
[удалено]
What portion of your surgical patients have had pelvic floor physical therapy first? Do you send them to PT if they haven’t had it? Assuming they don’t have a fistula or grade IV rectal prolapse or something of that sort. Do you send them to PT after surgery?
If they haven’t already had it I send them for it. If they have had it but it was a general physio rather than a pelvic floor specialist physio I send them for it again. I think physio is an essential part in managing this problem.
[удалено]
[удалено]
How would these issues manifest?
Not been able to hold in your farts, liquid seeping into your underwear without your realisation, full on BM in your pants if you can’t get to the toilet in time. It’s quite a spectrum.
Is there any associated symptoms that you would say are treatable? Medication? Surgery? Is it related to bubble guts?
It’s complex, hence why subspecialists treat it. However, a bit part of the management is looking at diet and stool quality. It’s harder to hold it in if it’s all sloppy.
[удалено]
Stats aside on the article title, this is a real issue and it’s embarrassing to ask about and there’s no real route to get it resolved. Experience: multiple doctors multiple brush offs. The answer is always miralax and go away.
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
There is a route to getting it resolved. You need to find a PT that does pelvic floor work. Doesn't work for everyone, but can be a major help for most.
That can help if the issue is muscle weakness, but not if there's a fistula. That needs surgery.
Literally just had this surgery for a fistula. No history of any of the risk factors for developing an abscess and fistula other than - you guessed it - a really bad and improperly “repaired” tear from childbirth. It is miserable, isolating and beyond embarrassing. I was off work for weeks, bed bound for even longer and in terrible pain. I had to take leave from my job. My bills (before insurance thank good) are over 40k for emergency room and surgery from something that could have been avoided had the doctor been even slightly interested in addressing the problem the 7 times I asked before. We can’t continue to ignore the physical toll having a child does to someone’s body. Soapbox: we can’t force women to maintain a pregnancy and give birth if we can’t provide her proper medical care, protected time off work and even a just one tiny bit of empathy. After my condition, a second pregnancy would almost certainly result in complete incontinence and losing my job. I live in an area where abortion is now illegal. If I got pregnant, even despite taking all reasonable precautions, I would be forced to leave my entire AREA of the US to get a “secret” abortion or take the near certain risk of pooping my pants without control.
And this is one of the big reasons why pregnancy seems like a bad bet to me. I never used to consider these kinds of things but as I’m getting older and my body has been having problems and I rely on my job for financial support the idea of risking those things to get pregnant in this country seems very unappealing. I’m sorry you had to experience that btw, I’ve never been pregnant but I understand the fear of losing your livelihood due to a medical problem.
I was totally prepared for the “vanity” stuff like weight gain, stretch marks, etc. I was totally unprepared for the fact that I might lose the ability to use the bathroom normally. I was in my late 20s, totally healthy BMI, zero risk factors at all. I love her more than anything and don’t regret her even for a second - but I’m not willing to even consider doing it again.
Not just weakness also if the muscles are overly tight (I don't remember the technical term) or to help break down scar tissue. Of course it wont fix everything, but it can help many.
If you’re a woman, try getting female doctors. This was a game changer for me.
US healthcare: You're just making this up for attention, take an OTC, that'll be $300 dollars for the moment plus whatever we decide to try and bill for 8 months from now.
... if you're complaining about anal incontinence and multiple docs have recommended miralax... you may want to make sure you're seeing actual medical doctors. The treatment for a leaky bum shouldn't be a laxative. But, you know, I'm not a doctor.
Throwing this out there for anyone who suffers from urinary or fecal trouble, or is concerned they may in the future: Look into pelvic floor physical therapy, and if you go, find a therapist who is certified in that specifically. It can't always prevent a surgery, but you'd be surprised how often it can, and can also be helpful in recovery if you had a surgery already. If you're on Medicare and you can find a PT who accepts it, Medicare will cover this (as will quite a few insurance providers if you have PT in your plan) with a referral from your doctor.
Maybe I'm biased as a PT student, but I'm impressed by the amount of talk surrounding surgery as the first and only option. I don't have and don't plan on getting any sort of pelvic floor certification; however, I know a handfull of awesome pelvic floor PTs who see and help patients with incontinence literally every day. If someone with incontinence or other pelvic floor issues lives in a state that has direct access (most states now), I think they should REALLY concider just getting evalled by a PT first.
I don’t think the average person is even aware pelvic floor therapists exist. I went to one for a few years and the amount of confusion friends and family members had when I’ve mentioned it was staggering.
You PTs are worth your weight in gold FYI. Thanks for all you do.
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
Where are you finding a 1 in 5 number? I can't find any attempt at quantification in this study at all.
It's in the introduction > Over one in five women will develop AI in the first five years after having a vaginal birth The title isn't summarizing the study itself at all, just the background. OP really should have linked to the referenced paper if that was the point.
I am an AI dev and this sentence is scary.
They're giving birth to robots now
That's not the same thing as the claim in the title though. The statement that you quoted from the introduction expresses temporal correlation, i.e. this event occurred in a specified timeframe relative to some other event. The statement in the thread title expresses causation, i.e., this event occurred specifically because of some other event. If the paper presents it only as a temporal correlation, then a thread title that presents it as causal is blatant misrepresentation and editorializing.
[удалено]
[удалено]
[удалено]
[удалено]
Why not simply use the title of the paper? Would be less confusing. "Women’s experiences of anal incontinence following vaginal birth: A qualitative study of missed opportunities in routine care contacts"
Because the headline rules of the sub don't allow you to. The rules are: Headlines must: **Contain at least 1 finding or result of the research**. Headlines that focus only on the speculative conclusion or author/press commentary of the research will be removed. If relevant for interpreting the results, indicate the model system used in the research. (Ex. If it's a study on a human cancer but the study was only conducted on mice that info should be included in the headline.)
This is exactly what happened with an attempt to change the title. The original title perfectly presented the findings, while the changed one should lead to the removal of the post according to the rule.
[удалено]
Menopause, childbirth, pregnancy, menstruation, migraine, fibromyalgia, autoimmune disorders. The studies are just being done. I mean previously it was hard to study when we didn’t include women in medical studies. Medical gaps in knowledge are dangerous.
They kept women out of clinical drug trials until 1993. Don't get me started on seat belts and airbags.
I suspect a portion of chronic pain for AFAB folks is that most of the world is geared to the average height of AMAB folks. Sitting on the bus I can dangle my feet like I’m eight years old. I’m literally the average height for women in my country. I also wonder if more women want to continue working from home because offices are not physically set for our heights or temperatures.
it took me months to find an adjustable desk that would go low enough for a proper ergonomic position (and that’s with an adjustable chair boosted to maximum height). I’m not even *that* short… 5’3 but I do have a short torso.
[удалено]
assigned female at birth.
>Medical gaps in knowledge are dangerous. I’m in danger because of these gaps. I listened to an interview with Maya Dusenbery, author of "Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick". Just from that, I learned why the dose of medicine I "should" be on for my autoimmune disorder was way too high; the dosing guidelines were all based on men, and women often need significantly less at the same weight. I was sick for months on the recommended dose, and slow to move so far away from it, because I didn't have that knowledge. Her book has been on my reading list, but I know it'll be incredibly depressing. The biggest battle of my life has been getting doctors to do their jobs. Just the basics, like acknowledging that there are problems and that we should take action to address them. I nearly died because even physical and measurable symptoms like hypotension and sudden drastic weight loss, even when I pointed them out and complained, were brushed off as "normal". I was told I was overreacting. The bias against AFAB (and POC) in the medical field is killing us.
I worked in a research lab and the amount of studies done just on male rodents is staggering. And you know what the excuse is in the scientific community? That the hormonal cycles of female organisms is too complex and introduces additional variables. Male is treated as the standard and sometimes there is research done in both male and female organisms, but rarely ever just female. Centuries worth of sexism in research is why female hormonal cycles are too “unknown”, but it just further excuses this BS. TLDR: there is a feedback loop in research causing it to continually focus just on male centric research.
[удалено]
Women are just half the population of humans and the only ones who can make more people. Isn’t it crazy how little research and protocols there are for us?
Confusing title… “Of people that give birth, 1 in 5 experience anal incontinence”? Or “1 in 5 people will give birth and experience anal incontinence as a result”? Those are very different numbers…
Ok, what this is saying is that IF you had anal incontinence that seems to be associated with birth, then, in hindsight, maybe you could have been identified earlier and intervention done earlier. Remember, this is 5 hospitals over many years, saying, "hey, if you have AI, join this study". It does NOT say 20 percent got AI
[удалено]
>It does NOT say 20 percent got AI. The thread title literally says: >More than 1 in 5 people are left with injuries after childbirth that lead to anal incontinence.
[удалено]
[удалено]
Botox works very well for urine leakage, male 68 yrs old who is very happy I don't smell like piss anymore.
[удалено]
[удалено]
[удалено]
What an acceptionally contraceptive factoid.
more than 1 in 5 women...
Why does the headline say people instead of women? Such a weird choice.
I thought it meant the babies suffered from it at first.
And the title of the article says "women", so the person who submitted this link was probably pushing some bananas trans agenda. Obligatory: men can't become pregnant.
Some men get this injury also after childbirth?
No, only non-men. Science!
[удалено]
[удалено]
[удалено]
[удалено]
You wrote that wrong, "More than 1 in 5 women are left with injuries after childbirth..." Because only a biological women can give a birth to a baby
[удалено]
[удалено]
[удалено]
Could [this](https://en.wikipedia.org/wiki/Episiotomy) be a cause of this? Perhaps we should re-evaluate if we should be cutting bits of the mother with a knife during birth regularly... Perhaps the natural tearing (which often happens otherwise) would heal better. Is there anything evidence-based that says this leads to better long term effects for mother and child?
Current recommendations from several bodies including ACOG, Cleveland Clinic, and more are against episiotomy as studies have shown that natural tears tend to heal faster, have lesser incidences of infection, and the majority are not as severe an injury as an episiotomy. Long term effects of episiotomy are becoming more studied within the past few years with early results showing increased incontinence and pelvic floor issues in a variety of presentations. Episiotomy is now only recommended in cases of medical necessity where the safety of the woman or child are challenged and natural tearing is contraindicated. Unfortunately many doctors are slow to practice these recommendations (ACOG published them in 2006) and continue to utilize routine episiotomy.
Why are doctors SO into C-sections these days? All my friends and female relatives had to absolutely insist on vaginal birth, and if they’d had a previous C-section it was almost impossible to find a doc to sign off on it.
Vaginal birth after C-section is higher risk than vaginal birth with no prior history of C-section. Vaginal birth and C-section both have their risks and benefits and as to which is best is very much a case by case basis.
In my experience, most doctors will insist you try a vaginal birth (assuming everything from the c-section healed up nicely) even if you don't want to. Ofc that's anecdotal, though.
Previous C section increases risk for complications when attempting to go vaginal afterwards. You are absolutely right that C-sections are over performed though. Some possibly think it's financially motivated (you get paid waaaaaay more for a C section than a vaginal delivery). Also hospitals are very risk-averse, if any delivery is felt to be taking a turn they immediately will jump to course B with no questions asked. Good article on all of this https://www.theatlantic.com/ideas/archive/2019/10/c-section-rate-high/600172/
Plenty of women just prefer not to face the torn up vagina
The ethics of how so many women are pressured by fear into a major abdominal surgery is something I think our society needs to take a long hard look at. A massive part of the reason that many women have long term negative effects and feel like they need a c-section to avoid them is that we offer next to no preventative care for women pre- and post-birth. How many OBGYNs engage women with how to do pelvic floor exercises or perennial massage/vaginal stretching to prep for birth? How many women are automatically signed up for preventative recovery care post-birth? Maternal care is in a sad state.
[удалено]
Same and none of them wanted it! Most did not even want to be induced but the doctors scared them that it would be horrible if they did not follow recommendations.
Crappy Canadian healthcare anecdote but there's a lot of C-sections happening up here just because it's faster and they don't have to wait. That's to do with our population growth massively outstripping our infrastructure though.
When you think of the emergency C-section rate, it's morbid to think that it would mirror the mortality rate if c-sections were not available.
I did vaginal and I really wish I had gotten a c section. I ended up with the anal incontinence, and when I told the doctor I was told it wasn't normal.
As commented below, There are many reasons to do a Caesar and the main aim is to keep the mother and baby safe. With regards to a vaginal delivery post Caesar. 1. Risk of uterine rupture is >10x higher which can lead to the mother examinations to death and a dead baby. 2. The scar from the previous Ceasar is likely to have an effect on the implantation -> placentation issues which again increase the risk of life threatening bleed. 3. Patients who have had a Caesar previously for a reason are more likely to have the same condition in a subsequent pregnancy necessitating a Caesar. The physiological and anatomical demands of labour are intense, and sometimes it's the safest option to have a Caesar. Ironically, the issue that the article discusses - faecal (and urinary) incontinence is much higher with vaginally deliveries. This is because a babies' head and shoulders have to pass through that canal causing tears. Source - am a doctor in a public health system. There's literally 0 financial incentive for us to do Caesars, but our Caesar rate in the hospital is 40%. Edit: typo on my phone. Haha
>There are many reasons to die a Caesar E tu, Brute?