Many women get flashbacks to their childbirth – the first reedy cry that pierces the air or a newborn’s curling lips and tiny, feather breaths. The emotional battle between exhaustion and love. The smell of blood on the walls.
My flashbacks were different. They were rambling, visceral fragments not of my delivery but of what happened immediately after. The moments on a warm ordinary July morning when I realised that my body felt broken. I couldn’t focus on the memories of a hot newborn on my chest – I could only feel the shock of standing in my first puddle.
They were always the same: saggy, no-longer-pregnant me staring, bewildered, into a mirror helpfully installed (by a sadist) in the shower room off the labour ward. A familiar, overtired face stared back, young and glowing like a fierce new moon, and as ugly and bitter and old as time. My black eyes flinching at the stretch-marked, ruined belly – and the river of pee and blood flowing down from the gap between my legs.
Suddenly, I was 30 and incontinent. I felt surprised and stupid at this unfair change, which began with my body and poured into each corner of my world. I felt my life had ended. I also felt, in no particular order: scared, upset, embarrassed, itchy, lost, dirty, shocked, broken, sticky, unsexy and really fucking angry and ashamed. I wasn't someone who couldn’t do star jumps any more or found “buggy fit” stretching – instead I was a patient with barely any bladder control at all.
Incontinence is one of the last – steadfast – medical taboos left to smash. Perhaps because leaking is often linked to pregnancy, childbirth or menopause, it's filed away with other bullshit women have to put up with, like ageing, mansplaining or Donald Trump. We've reached a point where we can talk openly about tampons, but this frequently curable condition, which has a devastating effect on quality of life, remains a stigma, despite affecting one in three women.
The NHS estimates up to six million people in the UK suffer from some form of incontinence, and campaigning charity the National Childbirth Trust found almost half of women who give birth experience it. Nobody wants to be a statistic, but for something so common the degree of upset and embarrassment is huge. Part of the problem is that we make light of it. Like many taboos, incontinence breaks out in the half-light of humour and metaphor. It's no surprise that we talk about pissing ourselves laughing. Leaking is a shared joke about the dangers of a trampoline, ladies of a certain age or a film so funny “a little bit of wee came out”. But it wasn't funny to find myself an embodiment of embarrassment and no restraint. It was rank.
Overjoyed though I was at my son, I was outraged and distressed. It was hard to articulate that – especially as I felt cowed into a corner. Would complaining suggest I wasn’t grateful enough that my son was alive and I was, too? Wasn’t a little bit of damage just the price I should pay at being blessed enough to have a child of my own? Shouldn’t I put up and shut up? Doctors didn’t agree. Over the next 10 years, the men and women I saw acknowledged my bad luck and lamented how few women seek help.
My beautiful son, peach cheeks on his old pope's face, came at one hell of a price: a second-degree tear (normal), a prolapse (hmm), pelvic-floor damage (hang on) and poor urinary control. Not to mention the trauma.
I didn't want anyone, ever, to see the mess I was in. But, I needed someone, or something, to remind me that I was still a human
In that post-birth shower room, I remember two things most of all: one, wishing I hadn't tried to clean my shredded fanny with mint Original Source shower gel, and, two, wondering what the fuck had become of me. If I concentrate, I can smell the meaty air and eucalyptus. I hear my voice telling the midwife outside, “I'm fine.” I wasn’t. I didn't want anyone, ever, to see the mess I was in. But I needed someone or something to remind me that I was still human.
Those first few days and weeks of getting used to my new body were a brew of shock, exhaustion, old wives' tales and humiliation. I mistakenly believed wet pants were something women just dealt with. A few Kegels were all any girl needed to make her muff whole again. Instead, at my six-week post-birth check, I met a consultant, who said with a sigh, “This was your first baby? Don't worry, there's a lot we can do these days.”
She fast-tracked me to physio to relearn control and tighten up enough to stop my prolapse bulging into my vagina wall. But what rocked me more was the surreal scene. My son gurgling in his pram with his educational squishy books, as I lay half-naked on a hospital bed, privates on display in the August sun. This doctor's pity echoed through the depressing vocab. Severity, stress, urgency, voids, anus, bedroom, leaking – I yearned for a reset button. The sympathy made me shiver on the paper sheet.
My healthcare workers were all so committed to de-stigmatising incontinence that they sometimes missed the heartache. “What's the worst that could happen?” asked one, kindly, when I looked aghast at her latest instruction, that I train myself not to run to the loo.
“I piss all over the carpet in front of my boss?” I nearly shouted back. “My husband has to wipe up another puddle from the kitchen floor? I die of a panic attack in public?”
Incontinence is brutal. There's an edge to intimate examinations of areas usually hidden by modesty and undergarments. Take my first meeting with a women's health physio. Her rubber-gloved Girl Guide salute was inside me before I'd had a chance to remember her name or come to terms with dropping my drawers in front of a complete stranger. I felt seasick as I tried to squeeze her cold fingers and simultaneously – because I am compliant – adhere to her other instruction: don't be embarrassed.
The conspiratorial hush was so strong that I briefly wondered: did everyone piss their trousers day and night?
She concluded the session by giving my pelvic floor a mark out of five. I scored minus three. I had both urge and stress incontinence. I wet myself if I ran, walked, coughed, laughed, shouted, stood up too fast, carried heavy things, got upset, got cross, got frightened or had sex. I begged her not to write the score down (she had to), then resolved to do everything I was told to make it better. Getting a new mark of zero out of five became my life goal.
As I saw more medics, I noticed that people kept talking to me about my body in ways that made me feel squeamish and stupid. Like most women, I could point to the clitoris on an anatomical diagram of lady parts, but my pelvic floor? I didn't know that from Adam's rib. My schoolgirl studies hadn't impressed on me how tantalisingly close the urinary and digestive systems are, nor the potential for collateral damage.
I wonder if ignorance fuels the shame and silence. What had happened to me was more than the occasional “oops” moment, but the conspiratorial hush was so strong that I briefly wondered: did everyone piss their trousers day and night? Was I just making a fuss?
Yes, I completely “voided” (the medical term for full bladder emptying) in my kitchen in front of my shocked, but resilient, husband. But other women couldn't stop their flow at all.
Maybe every mum changed her clothes as often as me. Or adopted a uniform: stretch leggings, long top, jumper (for tying around your waist). They were all black to disguise damp patches and make a last attempt at style.
Being toilet-trained is so fundamental to our idea of being a civilised grown-up that those of us who achieve continence early don't realise how far we've lucked out. When you start pissing yourself in public, but you’re too old to be that drunk at the student party and too young for a care home, what then?
That I, like most people, had consumed many unhelpful messages from the media about incontinence didn’t help. Continence-pad adverts show older women getting their groove back with odour-absorbent inserts, neglecting to talk about forceful spurts that make the whole bundle slip out of place and wodge itself halfway up your arse. I had a new sympathetic outrage for older women. And, despite my fem-roar, for incontinent men – they don't even get bins in their loos to throw their pads away.
I was a woman out of time. Loving friends could only give proxy commiserations. I'd joined the ranks of our mothers and grandmothers. Helpful amateurs told me to do my pelvic floors and take up Pilates. But they didn’t help with how to cope when I peed myself at a Christmas party or with how to feel sexy in a nappy. “My mum suffers like that,” people would say and I’d crumple into drunkenness or despair, and searching online for other (anonymous) birth-mangled sisters, also “too young” to deal with this.
I don't know why society doesn't treat something so common and blatantly grim with more seriousness and kindness
I toyed with speaking out about medical misogyny and a conspiracy of silence. Why did men get black Tena pads but women have to risk a whitish glow at the groin? I wanted to be honest and reach other women, but it's a hell of a job being the poster girl for a broken fanny, and I was busy.
When I met a male surgeon five years later, he was incredulous that I had put up with this for so long. Over the next decade, I had physiotherapy, bowel and bladder retraining, and bulking agent injections to improve my clenches. I also had another baby, used weights, bum tampons and underwent keyhole surgery to stitch my bladder into place. By luck, I avoided the controversial vaginal mesh and later had a pink silicone pessary the size of two Jaffa Cakes fitted to hold things in place.
But that was just the physical side. Research shows strong links between leaking and clinical depression and, mentally, I was definitely struggling. A stigmatising two-for-one leaving incontinent people even more marginalised, silenced, ridiculed and ignored. It's as if our shameful conditions, which lay bare everyone's fragile ideals of humanity, are contagious. In some countries, incontinent women are still ostracised from their communities. In the UK, we write about a serious health issue as if it is nothing more than farting in yoga.
Combatting this issue effectively would lead to less environmental pollution, less time off work and lost tax income, less social isolation, less care home and health costs for incontinence issues later in life. Especially when women getting better care for early incontinence problems would improve their lives, and everyone else's, I don't know why society doesn't treat something so common and blatantly grim with more seriousness and kindness.
But I do know this: I felt alone in my shame, but other women don't have to. And if we can smash the period and birth-injury stigma, we can speak up for the one in three, too. I’m starting the conversation here.