Separated at Birth

This weekend, before my husband left for a four day road trip, I wrote the letter I’d been dreading. I put it off for months because of all of the emotions wrapped up in it and my need to be constructive. I dreaded writing it because I thought it would take me all day to get down on paper what I wanted to convey to the midwives who helped me get my son into this world. It took me about 2.5 hours.

I’m going to post it here because I hope it can help someone else — a midwife or mommy. First I want to make absolutely clear that I have no reason to believe that my separated pelvis is in any way related to where I delivered my son or is in anyway a reflection of the quality of care I received. I love the birth center and I would recommend a birth center delivery to any woman with a healthy pregnancy who feels like that is a good environment for her and her family.

The primary benefits to the birth center environment for me were:

• My husband and I got to know my care team and felt really comfortable with them.
• They respected and appreciated that we wanted our son to enter the world naturally and that we wanted him to be alert when he arrived.
• That natural environment meant I was able to eat, drink, move and wear what I was comfortable with.
• They coached me through every minute of that process and allowed my husband to be an active participant in it.
• I was really concerned about having an episiotomy. I wanted to avoid this and did everything I was advised to do before labor (daily massage from 36 weeks and primrose oil). I did not have an episiotomy. (Ironic? Maybe.)

The letter follows. It will be enclosed with a card, a family picture and a picture of my son.

Happy holidays to you all!

I am writing because I want to share some things with you in hopes of helping you as practitioners and helping other women and families in the future. Please know that [my husband] and I would not change anything about our birth experience and I’m so glad you were a part of our lives. I have recommended birth centers to friends and will continue to.

As you know, my pelvis separated during labor/delivery on Jan. 22, 2012. Because the pain did not get better, and instead began to get worse in May, I saw a doctor at [the local orthopedic clinic] in July. ([Our son] was 5.5 months old at the time.) I had an x-ray on July 12, 2012 that revealed a diastasis at my symphysis pubis of 13 mm. I was referred to Dr. John Sojka at KU Medical Center because I was told no one locally could help me.

On Aug. 24, after we could move from our third-floor apartment to a ground-level place, I had a surgery to repair my pelvis. [Our son] was seven months and two days old when a titanium plate and six titanium locking screws were used to permanently stabilize my pelvis. Surgery meant almost 10 weeks of no weight-bearing and another eight weeks of physical therapy, which finishes Dec. 20. I had to re-learn to walk with a normal stride after compensating with an extremely short one for so long. Therapy also helped me to wake up the abdominal muscles that hadn’t properly worked for months. While we had planned to have only one child, we were told any future pregnancies would be considered high risk and would require a c-section delivery.

I was told that the binder I wore every day until sometime in May or June and often until surgery probably did shrink the gap. But it wasn’t enough on its own. I know that is extremely rare (especially when there are no signs of pelvic instability during pregnancy), but I was in pain every day for the first seven months of my son’s life. I want to do everything possible to prevent another woman, another family, from experiencing the same.

The farther away from the experience I get, the more I realize how much it hurt and how difficult everything really was. I will begin seeing a therapist this week in hopes of untangling the pain of those early months from the joy of my son’s birth and early life.
I’m asking you to please encourage any woman in the future to seek an x-ray right away. In recent weeks, after beginning physical therapy, I began researching the condition and have found medical journal articles that suggest early physical therapy may make surgery unnecessary. By the time I got to KU Med it seemed the window for all non-surgical options had closed and I had no energy left to try to find anything else. I had to start weaning [our son] the day of surgery as well, so my relaxin levels could return to normal during healing. Earlier intervention might be able to sustain the breastfeeding relationship for another mother and child, too, based on some of the articles I have found.

Because I am a writer and because I was (and am) desperate for community in this, I started blogging in August. I have found other moms and organizations, primarily in the UK, who have helped me to learn more and to feel less alone. If you’re interested, I’m happy to share the articles and other resources I have found. I also would be glad to talk with you, or with other expecting/new moms about this any time.

[Our son, my husband] and I are just now learning what it’s like to be a whole, healthy family. The little guy still laughs when I carry him on the stairs. I think he recognizes that it’s new, different and exciting – for both of us. We are optimistic about 2013.

Happy New Year!