The medical community asserts that nerve damage from childbirth is very rare (some believe the rate may be rising with the increased importance being put on vaginal births instead of c-sections, but we’ll leave that discussion for another time). So if so few people are affected by this health issue, why should we care? Why should we educate pregnant women about the issue? Why should we train those in obstetrics on how to avoid this damage? And why should we provide special care to women who suffer from it?
Firstly, studies say that rates of neurologic injury from childbirth is around 1%.[i] This percentage is certainly rare, but that does not mean a lot of people are not affected. There are approximately 131.4 million births every year.[ii] That means over 1.3 million women are affected by neurologic injuries from labor and delivery. In the United States alone, there are about 4 million births a year,[iii] resulting in approximately 40,000 women sustaining this injury. (It is understood that the number of births per year is greater than the number of women giving birth per year due to some women having multiples; therefore, the number of women affected is slightly less than 1% of the number of births in a year.)
Secondly, it is important to pay attention to this injury because its ramifications extend far beyond just the neuropathy. Just for a moment, put yourself in the shoes of these women…
After 40 weeks (give or take, of course) of pregnancy, you go in to labor. Of course you know there are risks. While nerve damage in your legs was never mentioned, you are well aware there are unknowns throughout labor and delivery. So you breathe through the contractions for however many hours as your cervix dilates. Maybe you get an epidural, maybe you don’t. Maybe you were able to have the child vaginally, after most likely pushing for multiple hours. Maybe labor resulted in an emergency c-section. Either way, you finally get to hold your baby. All is right in the world.
Then during the next day or two, the nurses ask you to stand up and go for a little walk. You say you can’t feel your foot, your knee, your whole leg. Maybe they believe you and start calling in specialists. Maybe they don’t and ask you to stand anyway. Wanting to trust the hospital staff, you try to stand and fall. Thank goodness you weren’t holding the baby (this time). Specialists come in and out – the anesthesiologist, the OBGYN, a neurologist, a physical therapist, an occupational therapist, and more. The anesthesiologist, if you had an epidural, immediately exclaims “not my fault!” Hopefully, the OB or neurologist are able to give you a diagnoses. But maybe not. Maybe no one has ever seen this before and hasn’t even been taught what it is. And you think you’re the only one to walk away (or not) from having a baby being unable to feel part or all of one or both of your legs. Maybe for days you aren’t allowed out of bed, for liability reasons of course, so you have to use a catheter or a bedpan for days, regardless of your pleading to just help you to the bathroom. Over the course of the next several days, you get outfitted with a wheel chair, walker or cane. You try to figure out how to use the bathroom or shower. Your whole body hurts from being bedridden.
Now comes the hard part.
You go home. How do you use a walker and hold a baby? You don’t. Hopefully you have some extra help – your spouse, your mother, a postpartum doula, a sibling, a friend. But maybe you don’t – you’re far from family, your spouse must work to pay the mounting medical bills, and money is tight. You might have a child at home already. Now you have to explain not only the new child to him/her but also why you’re using a wheelchair or walker. “No, no, the baby didn’t purposely hurt me… No, no, it’s not the baby’s fault… No, no, don’t hate the baby, I will be just fine.” But will you? When will you? The doctors said 3 weeks to 6 months, hopefully, you’ll be mostly recovered. What does that even mean?
Now the baby is crying. All s/he needs is a little bouncing. Not to worry, mommy is here. But you’re not. You can’t bounce. So you watch someone else pick up your child and rock them quietly to sleep. You’re so thankful someone is around to help, there are others that don’t have the help. And yet, you sit there helplessly, thinking, “That should be me. I’M her/his mother.”
Several weeks after giving birth, you have a few painful tests done to figure out just how bad the damage is. You know it won’t change anything, but you just have to do something, anything, to get this figured out. You’re told the extent of the damage and given a huge range as to when you might be better. You need time and physical therapy. But you don’t have time. You have a newborn to care for.
So now you’re focusing on feeding, changing, and burping the baby, all the while trying to schedule physical therapy. But wait, you can’t feel your leg and can’t drive, so how do you get there? You’re exhausted and told you need rest and sleep to allow your body to recover. “Sleep when the baby sleeps!” But that is the only chance you have to do your exercises. So you sit on the bed you’ve been stuck in for weeks, tightly hold on to that precious bundle, squeeze your eyes shut and just try to visualize your toes, your foot, your knee, your thigh moving again. “I think I can, I think I can, I think I can.”
Maybe during your recovery you fall. Hopefully not with your baby in your arms, but maybe so. Fingers crossed neither of you get hurt. Maybe you’re in horrible pain as the nerves start to regrow. Do you tough it out and be more miserable? Or do you take medicine and risk it getting through your breast milk to baby? You get mad that you can hardly take care of yourself, let alone a child. You feel like you’re missing out on so many of the joys of being a new mom. Sadness, hopelessness sets in: “The doctors said it would only be a few weeks and I should be getting better. It’s been months.”
But you must keep pushing forward. You don’t have an option. A little life depends on you. Thank goodness this little life is at least safe and okay. Thank goodness the injury happened to me instead.
You can finally wiggle your big toe. You start to sob. Maybe there is light at the end of the tunnel…
Doctors say that they prognoses for neuropathy from childbirth is good. On a more personal note, most women in our support group do mostly or completely recover. The time varies drastically from several weeks to several years. Yes things could be worse – nerve damage from labor and delivery is not life threatening to mother or child and people recover from it. So why should we care, when it affects such a small portion of the population? Because no mother should have to go through the above or similar scenario, especially when a little education and training could prevent many of these injuries.
So spread the word. Encourage your doctors and delivery staff to read about best practices to prevent nerve damage during delivery. If you’re pregnant, know how to advocate for yourself. And if you hear about a woman suffering from neuropathy from childbirth, ask her what you can do to help and send her this way for support, love, and encouragement.
[i] McDonald, Alison, et al. Obstetrical Nerve Injury. Spring 2008. http://www.mncyn.ca/wp-content/uploads/2013/08/volume31.pdf
[ii] World Birth and Death Rates. Ecology Global Network. http://www.ecology.com/birth-death-rates/
[iii] Births and Natality. National Center for Health Statistics. 31 March 2017. https://www.cdc.gov/nchs/fastats/births.htm
[iv] Image credit: © Design Pics / LJM Photo/Getty Images. https://www.verywell.com/physical-recovery-after-birth-2759446
[v] Image credit: Sleep Baby Sleep. http://violetsleepbabysleep.com/baby-wont-sleep-in-the-crib-or-bassinet-2/