Caroline’s Story
I had an uncomplicated pregnancy until approximately 28 weeks when my OB noticed that my fundal height did not match my due date. She ordered a growth ultrasound which showed that my daughter was measuring in the 20th percentile. This triggered some anxiety for me as I had a previous miscarriage requiring a D&C at 11 weeks. My OB reassured me that my daughter was likely fine but just on the smaller side since I am on the smaller side. Another growth ultrasound was ordered 4 weeks later showing that my daughter was now measuring in the 12th percentile. I was very concerned at that time and wanted to know if another growth ultrasound would need to be ordered at my next appointment. The provider seeing me that day was not my typical provider and told me that everything was fine and I may deliver my daughter prior to needing to order another ultrasound. Due to scheduling errors, I again saw a different OB who told me my fundal height was only measuring behind because my daughter had “dropped.” I told him I was worried because she has been measuring small on previous growth ultrasounds but he dismissed my worries.
I spent the whole next two weeks worrying about my daughter. Pregnancy is often depicted as a carefree and joyful time. This is definitely not how I felt-every time I did not feel my daughter moving for a few minutes, I became concerned. It was finally time to see my usual OB again and she immediately became concerned when measuring my fundal height and asked me to go for an ultrasound immediately. My heart was racing and I was by myself because my husband had a job interview. The ultrasound technician could not tell me the baby's measurements and said I would have to wait to speak with my OB. It felt like an eternity before I was back in an exam room speaking to my OB. She told me that my daughter was measuring in the 2nd percentile as my placenta had stopped functioning and I would need to be induced that day.
Immediately I was sent down to the maternity ward. I had been wanting to speak with my OB regarding my birth plan for weeks and had brought it with me to this appointment as well as my previous three appointments – however there was never enough time to discuss this. My OB just quickly came down and said that they would be starting pitocin soon and that she was on call overnight. I remember not really even being able to process everything that was happening. I was trying to reach my husband to let him know he needed to come to the hospital. My appointment had also been in the middle of my clinic day which meant I still had loose ends to tie up so I was trying to reach my supervisor to make sure my patients were taken care of. Hence when my OB stopped by to say they were starting pitocin soon, I did not even think to ask her to speak to me regarding my birth plan, which would have included converting to a C-section if an episiotomy or other special interventions would be needed.
When my husband arrived, I did finally feel some excitement about being able to meet my daughter soon. The pitocin was started and my contractions progressed quickly so I asked for an epidural. Nine hours after the pitocin was started it was time to begin pushing. This was when the comedy of errors that led to my injury started. My left stirrup was broken and kept falling down while I was pushing. Two kind labor and delivery nurses were talking me through when to push because I did not get the urge due to the epidural. After an hour of pushing, my daughter was not progressing and her heart rate started decelerating so the OB was called.
My OB arrived and was immediately mad at the nurses because I had been bleeding heavily and she was not notified of this. She told me that I had to try to get my daughter out in the next two pushes or she would have to use forceps to deliver my daughter. I was trying so hard not to cry because I was so scared that I would not be able to deliver my daughter safely. I also felt like a failure because despite my daughter being so small, I could not even manage to get her out. Despite the epidural, I could still feel the pressure of the forceps but immediately after that I could hear my daughter screaming. It was such a relief as the whole NICU team was crowding the room for her arrival.
My daughter was placed on my chest and I felt so much love for her. While processing my emotions, my OB informed me that I had sustained a 3rd degree tear and had a placental abruption. I had no idea what it meant at the time and was more worried about my daughter as the doctors were evaluating her. Her blood sugar and temperature were low so she required a heated bed and glucose checks every two hours. I probably felt the same way most first time mothers do…having this overwhelming feeling of love and just wanting to stare at your baby non stop but at the same time being terrified of them because you have no clue what you are doing. I slept maybe four hours during our 3 day hospital stay as I could not get comfortable and I refused to take pain medication because I wanted to make sure I could constantly monitor my daughter to make sure she was doing well.
When being discharged from the hospital the nurse told me I had sustained a second degree tear and I was not supplied with any appropriate instructions for how to care for a 3rd degree tear. Also, no one ever looked at my stitches while I was in the hospital. The pediatrician also told us that my daughter's bilirubin was a few points from her needing to be admitted for light therapy so we would need to follow up in two days. I was excited to be discharged and going back to the comforts of home but also anxious because I felt like I was not equipped to take care of my daughter. The whole time during our hospital stay I could not get my daughter to latch and sitting up to breastfeed was horribly painful. I felt like such a failure as a mother due my placenta not functioning, my inability to birth my daughter without help, and now seemingly not being able to breastfeed.
It was so joyous coming home and introducing my daughter to her two goldendoodle sisters, who could not have been more excited for the new addition to our family. Now at home, I was determined to figure out breastfeeding and make sure my daughter ate well and got plenty of sunlight to get her bilirubin down. Things did not go according to plan…I had not had a bowel movement the first 3 days at the hospital and the first night at home the urge came on with a fury. I was barely able to rush to the bathroom in time and I experienced the worst pain of my life. I was certain that this was due to constipation but it turned out I was having diarrhea. When I went to wipe after using the peri bottle, there was blood coming from my rectum and it felt like there was a mass. I became concerned but tried to brush it off as I wanted to take care of my daughter. I again attempted breastfeeding her but the pain was excruciating and I again felt the sudden urge to go to the bathroom. Like before, I just barely made it time and it was so painful. I just could not get clean no matter how often I used my peri bottle so I decided to get in the shower which still did not get things completely clean.
I spent the next three days rushing to the bathroom and showering. I felt so low because I was relying on my husband to take care of my daughter and my dreams of breastfeeding were quickly fading. In addition to the pain and trouble latching, my milk was not coming in. We saw our pediatrician to recheck my daughter's bilirubin levels. They were one point below when she would require hospitalization for light therapy. The pediatrician was kind enough to offer us a recheck two days later on a Sunday to see if we could get her levels down. I really did not want my daughter to be hospitalized so a lot of time was spent sitting uncomfortably with her on my lap trying to ensure she received enough indirect sunlight. My anxiety level was at an all time high and I was sleeping maybe 2-3 hours everyday. I was worried about my daughter, crying a lot about not being able to breastfeed, and worried about the pain and bleeding I was experiencing as well as the fecal urgency.
We went back to the pediatrician to recheck my daughter's bilirubin levels. I was so uncomfortable that I could not bear the thought of sitting down. While waiting for my daughter, I called my OB's office because my pain was worsening everyday and it was becoming unbearable. The nurse brushed me off and told me this was normal. The good news of the day was that my daughter's bilirubin had trended down and she would not need to be admitted to the hospital. The pediatrician was also very reassuring that my daughter would be perfectly fine with formula instead of breastmilk, which helped me feel a little better.
The next day my pain was even worse and I was still bleeding from the rectal area so I called my OB's office again and told them I was getting concerned and may stitches had ruptured because I was bleeding not just from the vagina and I felt this mass/heaviness at the anal opening. The nurse told me not to worry and that stitches do not rupture. Being a surgical physician assistant, I knew this was not true and I asked to be evaluated but was told that I was fine and did not need to be evaluated. I felt very poorly the next day and then started with shaking chills. A friend was over visiting and said this was probably due to hormones but I knew something was wrong so I went to measure my temperature which turned out to be 102.4. I began to panic and once again called my OB's office and they finally made an appointment with my OB for the next day. I felt a sense of relief knowing that I would be evaluated.
As I pulled into the parking garage of the hospital where I delivered my daughter, my heart started to race uncontrollably. I figured it was just anxiety about the upcoming appointment. My OB took a quick look and felt my uterus and decided I had an infection of my perineum and possibly a mild case of endometritis (an infection of the uterus). She quickly prescribed some antibiotics and rushed out of the room. I didn't even receive a follow up appointment for a recheck or have time to ask if my fecal urgency was normal. As odd as it sounds I was relieved to have been diagnosed with an infection because a part of me was scared that nothing would be wrong and my OB would be mad that I made an appointment for no reason.
I started the antibiotics and the fevers subsided, however, the antibiotics caused diarrhea and sometimes I was not making it to the bathroom on time. I felt so embarrassed and just constantly felt unclean and gross. I spoke to my husband about my worries but he did not know what to do other than suggest I talk to some of my friends to see if anyone had experienced something similar. Most of my friends had c-sections and could not relate so I felt very alone. I began delving into google searches on 3rd degree tears and some sources said it was normal to experience some fecal incontinence early in recovery. Temporarily, I felt reassured but I still felt so ashamed and embarrassed. I was scared to leave the house -this was not what I had envisioned. During pregnancy I dreamt of the walks I would take with my daughter while on maternity leave but with my level of pain and the incontinence, I couldn't even imagine going on a stroll with her.
I tried to stay positive and tell myself that my body simply needed more time to heal. Then approximately 3-4 weeks postpartum this intense itching and pain started in my perineal area so I again made an appointment with my OB. I was so nervous going back to see her, what if something was horribly wrong or I never cleared the infection completely. Luckily I was diagnosed with a yeast infection which was easily treated. I did have time to ask about my incontinence issues and was told this is normal and would likely start to subside by 6 weeks to 6 months. I again felt partially reassured but deep down, I still had a feeling that something just was not right.
My anxiety was still at an all time high and likely the sleep deprivation that is so well known to all new moms was not helping the situation. I was still constantly worried about my daughter and whether she was eating enough, warm enough, and if I was putting her diaper on correctly. I spent hours reading about newborns and second guessing everything I was doing. This is embarrassing but I even googled how to put on a diaper correctly several times. I could not sleep when she was sleeping because I was terrified that she would roll over and suffocate or die of SIDS if I was not constantly watching her sleep. I was getting by on 2-3 hours of sleep everyday and just physically and mentally exhausted. I started withdrawing from friends because I was ashamed of my uncleanliness and I felt like a bad mom.
My husband became concerned because I started crying a lot everyday and prior to my daughter's arrival he had only seen me cry a handful of times. He knew I was not myself and we needed extra help so I called my parents, who live in Germany. My mom had been wanting to come but I had wanted to wait until Christmas for my parents to come over so we could all celebrate my daughter's first Christmas together. My mom booked the next available flight to come help. I was finally excited again. I could not wait for my mom to meet her first granddaughter and there was this huge sense of relief because there is nothing like your mom coming to help. My mom arrived and I was able to start sleeping longer stretches which was big help to my mental health and overall wellbeing.
It was time for my six week appointment and I was so nervous-my fecal urgency/incontinence had not yet improved and I was still in a lot of pain. My OB said some of the pain was secondary granulation tissue so she used silver nitrate on the areas and decided to wait on my pap smear until 2 weeks later. The areas treated with silver nitrate were very painful but luckily the pain subsided after a day. I felt optimistic that my pain would improve soon and I would be able to sit normally again. Unfortunately, this was not the case when I went back two weeks later to see my OB. She said she could not identify why I was having pain and that I likely just needed more time to heal. I again asked her about my incontinence issues and she said that it would take more time. I told her I was worried about returning to work in four weeks as I was an upper extremity orthopedic surgery physician assistant. She reassured me that the incontinence was not forever and would improve. She then performed an anal squeeze exam and there was absolutely no movement, I could see the panic in her face. She then prescribed pelvic floor physical therapy.
After seeing her panic stricken face, I knew something was definitely not right so at the suggestion of a friend, who is also a physician assistant, I made an appointment with a colorectal surgeon she recommended. I started doing so much research into my condition and what could be causing it, this is also how I stumbled across the facebook support group. I had finally found a group of women across the globe who were going through the same thing! I was so excited and could ask questions about what to expect from the appointment with the colorectal surgeons and what tests may be ordered.
My husband came with me to the appointment. I was nervous but also hopeful because I thought the surgeon could order testing to determine what was causing my symptoms. The surgeon was kind and performed a quick physical exam. She stated that my pain was being caused by an anal fissure and that I had a missed 4th degree tear. She recommended I start a cream, high fiber diet, and sitz baths to help heal the fissure. She recommended PFPT for the incontinence and did not order any additional testing such as an ultrasound or manometry. I held it together through the appointment, but as soon as we got to the elevators I started crying. My husband held me and felt my sadness but he remained optimistic that if I follow the recommendations of the surgeon, then things will be fine.
After this appointment is when everything started spiraling out of control. I looked up what can happen after a fourth degree tear and anal fissure which lead me down the road of colostomy bags, abscesses, and fistulas. I became so worried that my fissure would not heal and would develop into an abscess and then a fistula. I became extremely regimented in my diet and was counting grams of fiber all day to make sure I was getting enough. I also had to ensure a shower was always around so that I could get clean. I refused to leave the house for anything other than doctors appointments or going to the grocery store. When I would go out and see people running, eating any food they wanted, or just wearing leggings, I would start crying because those are all things I felt like I would never be able to do again.
I started crying multiple times a day everyday and could not get myself together. I became obsessed with searching for answers and fixes for my problem. All this reading brought more fears…as I was reading about women's failed surgeries or how they were doing fine until menopause but then needed a colostomy bag. I began having trouble bonding with my baby as my thoughts about my horrible future were all consuming. I could not escape my reality because some symptom or simply running to the bathroom would remind me that I was broken. My husband became very concerned about my symptoms and knew this wasn't just baby blues. He made an emergency appointment for me with a psychiatrist. The psychiatrist diagnosed me with postpartum depression and anxiety. He suggested I start medication immediately and was very concerned about my lack of sleep and the fact that I was hardly eating because I was scared to have a bowel movement that I could not control. I was hesitant to start medication and tried to tell him that this was situational and once I have my symptoms under control, my mental health will improve. He agreed but recommended I start medication anyway to help until that time because in his opinion I was suffering from severe depression and needed extra help to treat it. He also recommended therapy.
I started the antidepressant Zoloft and started to feel better the next day. I even had the courage to call my employer and ask for two additional weeks of leave, which were granted. My husband and mother were optimistic that this was going to be what would help me through this tough time. Day three of Zoloft brought diarrhea in the middle of me changing my daughter. I did not even realize what was happening until my underwear was soaked. I called my husband to take my daughter off the changing table so I could take a shower and get clean. I could not stop crying because on top of the embarrassment that I felt, I also felt that I could not do anything right at the moment…starting this medication was supposed to help me and not send me spiraling downward.
There were several days of this until I decided to stop the medication and try something else. I was scared of recurring diarrhea and everything felt so raw after the days of GI upset. My fissure became so painful that I could not sleep and I became worried that it was developing into an abscess. On top of this my husband was returning to work and my mother was leaving. I had no clue how I would care for my daughter by myself. I felt like I was not a good enough mother to take care of her on my own and I was so depressed that even getting out of bed was taking everything in me. The future of colostomy bags, pain, and constant embarrassment was taking over my mind and I could think of nothing else. This lead to me contemplating suicide. I felt like my husband and daughter would be better off without me as a burden and they both deserved so much better than what I could offer them. I verbalized this to my husband and he called my psychiatrist who recommended he take me to the ER for hospitalization.
The ER doctor quickly came in and asked if I had ingested anything and I said no and that was the extent of our interaction. The nurse then drew labs and we spent 10 hours waiting in the ER for a psychiatric bed to open up. Once a bed opened up, I was taken up in a wheelchair and my husband wanted to come up too but they told him he would have to ride in a different elevator. I had not said goodbye to him because I did not realize that I would not see him again prior to being admitted to the psychiatric unit. My phone was taken from me and a basic intact was obtained where I was told I would not see my husband again until visiting hours the next day. There was a patient in the hall yelling for help the whole time at the top of her lungs. I was told that she would be my roommate during the stay. I told the nurse that she had to call my husband and that I could not stay there, that it would make things worse. She asked me when the last time I slept was and I told her 36 hours ago. She told me that they would help me get some sleep and I could try to go home in the morning.
My time in the psychiatric unit was not helpful. There was no therapist to talk to and the psychiatrist spent very little time talking to me and did not seem to care why I was there. I missed my husband, daughter, and home so much. I just felt like they were trying to medicate me to unawareness. I asked the psychiatrist if I could go home because I felt better and missed my family. She agreed and I was counting the hours until my husband could come pick me up. I was so excited to be with my family again and also having access to a bathroom and a shower whenever required.
My experience in the hospital led me to look into maternal mental health and maternal health in general. I was astounded to learn that suicide is the number one killer of moms in the first year postpartum. When I saw my OB at my 4 weeks postpartum, I told her my struggles with anxiety and she prescribed me an antidepressant. I never started the antidepressant because I did not want to be medicated at that time. She never checked with me to see if it was working or how I was doing despite me telling her I felt completely hopeless. I also learned that the United States is the developed nation with the highest maternal morbidity and mortality rate. I started to wonder how we can accept this as a nation and why it is not standard of care to screen a woman for postpartum depression when that is her greatest risk factor of death. Then I started thinking about how can I change this. I contacted a nonprofit focused on ensuring all women have access to maternal mental health and asked if they would add a branch to focus on birth trauma and severe maternal birth injuries as this predisposes women to developing postpartum depression and anxiety. They responded that they are interested in this but did not have the funding to add this to their organization currently.
While I started to think about how to enact change in our current system, I began seeing a therapist and took a genetic test to see which antidepressant would work best for me. I started a new medication and weekly counseling and PFPT. I started making some progress toward controlling my anxiety and managing my depression. Around the time of my hospitalization I also started with increased vulvar and vaginal pain/irritation. Most providers brushed me off and told me it was dermatitis. I had to undergo a vulvar biopsy and was then referred to a vulvar specialist who diagnosed me with desquamative inflammatory vaginitis and started treatment. It was such a relief to finally have an answer to the etiology pain and starting a treatment plan. Prior to seeing this vulvar specialist, I had given up on myself but she told me that the symptoms I was experiencing were not in my head and I should advocate for myself and also ask for testing for what was causing my fecal incontinence. Her reassurance and support made such a big difference in my medical care and my state of mind because finally someone was acknowledging that my symptoms were bothersome and I was not crazy.
I had seen several urogynecologists and a colorectal surgeon prior to seeing the vulvar specialist, who had all told me there was nothing to do for my symptoms. They would tell me to work on a high fiber diet and do PFPT. I would tell them that my symptoms were not improving and I would like to find out what is going on with my body. They would tell me that they did not want to order an ultrasound or manometry because there was nothing to do and surgery would not help me or might worsen my symptoms. One provider even told me that I should just be happy that I wasn't having to wear a diaper all the time and that she would not suggest fixing my rectocele until it was protruding out of my vagina and I was having to push it back in. I was astounded at the lack of compassion especially from female providers. Being a healthcare provider myself, my trust in the medical community plummeted and I was unsure if I wanted to continue a career in medicine.
The decision was made for me because I was due to return to work as an upper extremity surgical physician assistant 4 months postpartum. I felt that there was no way I could return to the operating room and rush out in the middle of a surgery or have an accident in a busy clinic. Could you imagine seeing a healthcare provider and they poop themselves?! Work agreed to extend my leave if a medical provider would provide a letter. I called my providers and none of them would extend my medical leave. Apart from the embarrassment of a potential accident, I was not able to sit or walk comfortably yet. Also in order to heal my fissure I was supposed to be taking 3-4 sitz baths a day and apply a cream three times a day for 6 weeks. How could I do that during a work day? None of my providers would extend my medical leave and I lost my job.
This job loss compounded the identity crisis I was having. Any new mother faces an identity crisis when their newborn comes home but my body was destroyed, I constantly felt unclean and disgusting, and now I had no purpose. This was not the maternity leave or life I had pictured prior to my birth and all of my plans and hopes were taken from me because my OB decided to use forceps instead of offering me a C-section and then did not repair my tear correctly. I did not even feel like a woman anymore, my husband and I had not been intimate since before my daughter was born and I couldn't envision that changing anytime soon. This was not the life a previously healthy 33 year old should be living so I decided to contact law groups to see if they would take my case. I felt guilty about this at first because I felt like I was violating the medical community that I used to be a part of, but then I realized that I would never be ok treating a patient the way that I was treated. Most of the law groups would not consider my case as they had conflicts of interest because my OB works for one the largest OB/Gyn groups in the area. The other law groups felt that the damage I sustained was not significant enough or that standard of care was not violated. I was once again astounded that no identifying or treating a laceration correctly which led to devastating outcomes, was not considered violating standard of care. Or that the fact that my medical records stated that my OB discussed the risks and benefits of a c-section versus vaginal delivery and risks/benefits/alternatives to forceps delivery with me when this in fact did not happen, was not an issue that anyone cared about.
All of these infringements on what seemed like basics of medical care and consent, ignited a passion in me to bring about change. Now to figure out how to do this. I was also spending hours on the FB support groups looking for women who had had success because I refused to accept that the rest of my life would be like this. I was coming across a lot of women asking the same questions or looking for resources. I myself had searched so hard and long for specialized resources on 3rd or 4th degree tears in the United States but nothing existed except for the FB support groups. Then I thought to myself, why not start something like this, it is what I would want just coming out of an injury and even now still.
I reached out on the Facebook support groups to see if any women were interested in helping me start a nonprofit to bring awareness, prevention, and support to women who had sustained severe obstetric lacerations. To my surprise several amazing women with a variety of backgrounds were interested in volunteering their time to make something like this happen. I quickly came to realize that I needed to learn as much as possible about how to form a successful nonprofit so I got to work. Really my work with starting The SOLACE Foundation is where my healing journey took a rapid path toward advancement. I was spending less time focusing on my injury because I was so busy working on starting a nonprofit. My fissure finally healed and I could start sitting and walking comfortably. My daughter at 6 months old was starting to become very interactive and this is when I really started bonding with her and feeling the deep love for her that I had felt initially when she was placed on my chest right after delivery. My husband was happy because the “old Caroline” was returning.
It was time to hold SOLACE's first meeting and I was so excited and also a little nervous because I had never done anything like this before. I started the meeting by having everyone introduce themselves and tell as much of their stories as they were comfortable with. Even though this was a Zoom Meeting, it was so powerful to be in a room with women who had been through a lot of the same experiences I had been. You could sense that we were all moved by coming together and felt stronger for it. We ended the meeting by sharing ideas on what we would like to accomplish and I felt strongly that with the help of these wonderful women, starting a nonprofit would be obtainable.
With this renewed sense of hope, I once again scoured the FB support groups for women who had had successful surgeries. I saw an old post where a woman stated that she had undergone successful surgery with a urogynecologist, Dr. Holly Richter, in my area. I messaged her and within a few minutes she called me. She told me that she had previously suffered from the same issues as I had. She said that Dr. Richter could not have been nicer or more understanding in her care and most importantly all of her symptoms had resolved after her surgery and she even went on to have another child via C-section. She told me she would have the surgery done a hundred times over and was very supportive in me seeking care with Dr. Richter.
I immediately emailed Dr. Richter detailing my symptoms and the testing and treatments I thought I might need. She emailed back within a few minutes saying she would be happy to help me and her nurse would call me to schedule an appointment. I immediately ran to tell my husband. I was excited that potentially a provider would take my concerns seriously and may know of something to improve my incontinence. I counted the days until my appointment but then also started getting worried about what would happen if she could not help me…I guess at least I would have a definite answer about whether there was anything to be done.
The big day finally arrived and I was immediately taken back for an ultrasound and manometry. My husband could not come back for testing and I was so anxious because this was the moment I would finally know what was going on and if my sphincter was intact. The testing was completed and I was asked to meet with Dr. Richter and my husband in her office. She told me that my external sphincter was not intact and would need to be repaired as months of PFPT did seem to help my symptoms. She also diagnosed me with a rectocele and an extremely short perineum and felt that I would benefit from having those repaired at the time of surgery as well. In addition, she found some sinus tracts and thought that those could be leading to my desquamative inflammatory vaginitis symptoms. She was very kind and hugged me. Surgery was scheduled for two weeks later.
Finally after months of not knowing how things would turnout, I had a sense of peace and calm. There was hope again for a normal life. Even though I had lost my job, I had found work through SOLACE that seemed so much more important and that could help so many more people than simply working in a clinical setting. I was truly enjoying all the extra time spent with my daughter and grateful that we did not have to send her to daycare when she was just 3 months old. I was seeing my friends again and most importantly they still loved me even after trying to push them away. My husband could not be happier that I was myself again.
Dr. Richter called me the day before surgery and reassured me that I would be in good hands and I went into surgery the next day with a sense of calm. I spent two days after surgery in bed but felt surprisingly good after this and started doing some light things around the house. I felt better than I had in months and my perineum finally felt supported again…things you never thought you would be excited about or say. My incontinence was also improved and I was so thankful that I had not given up but found a provider who would listen and take me seriously. I am still only three weeks into this healing journey but I could not be happier right now. I am so grateful for my husband, family, and friends who helped love and support me through this whole experience, I could not have accomplished what I did without them.
Thank you for bearing with me through my long story. I just want you to know that hope is out there. If you know something is wrong, don't give up and make sure you advocate for yourself. Let friends and family help you, this is an extremely stressful time and getting a little extra rest or help with chores can go a long way. There is no shame in seeking mental health or multiple medical opinions until you can find someone to truly listen to you and help you. While I still hate that my birth and postpartum experience were not remotely what I pictured, I am glad that my experience led me to create The SOLACE Foundation. I hope we can bring about change, prevent as many of these injuries as possible, and support women who have sustained these injuries.