A group of mothers, personal trainers, and physiotherapists have joined together to try to address New Zealand’s lack of post-birth care. Here’s why.

In the year ending March 2020, 59,238 people gave birth. Many of them (more than you’d think) will suffer from urinary incontinence and vaginal prolapse. When you give birth you roll the dice – it’s estimated one in three births will end in loss of urinary control with the prevalence of urinary incontinence even higher in adult Māori women at 47%. It’s estimated at least half of women who’ve had more than one child have some degree of vaginal prolapse.

In order to bring what they believe are serious issues around post-birth care into the open, a group of mothers and health professionals from across the country have started a petition calling for all birthing people in New Zealand to have a free pelvic floor check by a qualified pelvic health physiotherapist during pregnancy, free postnatal pelvic floor checks during the first two years after giving birth, and education in birthing and antenatal classes on pelvic floor dysfunction, wound care, and how to correctly perform Kegel exercises. It’s also requesting more funding for Continence New Zealand to employ nurses and increased DHB funding for pelvic health physiotherapists and birth trauma treatment funding from ACC.

One of the authors of the petition, Kirsty Watt, experienced the lack of post-birth care first hand after the birth of her child. “The care that we receive as women is shit and that’s putting it politely,” she says.

“I had no idea what a pelvic floor physiotherapist even was when I was pregnant. After the birth of my first child seven years ago I was given a pamphlet about pelvic floor health from the physiotherapist at the hospital and that was the last time it was mentioned. I had an amazing midwife, no intervention, no stitches, just a weak pelvic floor. I was told I could go back to exercise, without any form of a check-up. I was going to a boot camp, targeted at mums, but was jumping and running and basically ignoring the fact I had to take a leak after every jump squat. It got worse as time went on.”

Watt became a personal trainer and she said just ten minutes was spent on “women’s bodies” and pelvic floor exercises during the course. During the birth of her second child, she suffered a severe injury to her tailbone.

“He came accidentally in our kitchen, I literally didn’t have to push. The issues came later. I couldn’t sit properly for about 15 months. I was never offered physiotherapy and I was never referred to the hospital by my GP. I asked if my pelvic floor was alright and she said it was fine.”

Over the coming weeks, Watt developed urge incontinence which causes a sudden, overwhelming urge to urinate. Two years later she began seeing a physiotherapist. Watt was diagnosed with a hypertonic pelvic floor which meant her pelvic floor struggled to relax which meant it was always “switched on”.

“But I was also leaking, which was confusing as I thought my pelvic floor was weak, but without a proper assessment you just don’t know,” she says.

Watt, who’s doing much better now, wants to see a change in how post-birth care is delivered. “The system doesn’t work. From the way we are managed post-birth from our GPs and DHB to the education that we don’t receive, no one seems to ask any continence issues. And we’re generally told to just do Kegels, but there’s no diagnosis or checks to see if you’re doing them correctly or if you are in fact overdoing it. Women need help.”

Personal trainer Jess Baker supports the petition. She runs a free online group called SLAM which is an acronym for “strong like a mother”. She says there are gaps in knowledge for many personal trainers and gyms who might be causing further damage to mothers because they don’t understand pelvic health.

“There’s a real battle in our industry to put the women front and centre. There’s a need right now to cut through the bullshit that feeds a mother’s mind to ‘snap back’ and ‘lose the baby fat’,” says Baker. “There are many programmes, trainers and gyms that have no knowledge of pelvic health, but they’ll target mothers because it’s easy money whilst feeding into their insecurities. But at what cost to the mum? We’ve seen mothers losing bowel control while in the line for school pick up, her uterus descending down and out of her vaginal opening because she was pushed to keep going [at] CrossFit class, or spending $4,500 on physio treatments because she was advised at six weeks by her GP to get back into running, with no pelvic floor checks, and now when she fast walks she wets herself.”

The petition comes at a time when many are speaking out about the treatment of women before and after birth. Writer and influencer Emily Holdaway often talks about pelvic health with her followers on Facebook and Instagram. She’s spoken openly about her vaginal prolapse and her road to recovery.

“We don’t really know if it was my cervix, a bladder prolapse, a rectal prolapse, or a combination of all three,” she wrote at the time.”But I didn’t care. It was a prolapse and I felt like my body was breaking down. Plus we were six weeks deep into life [with two babies]. I cried a lot. I felt yucky. Gross. I felt broken. I felt like the birth I had been looking forward to, that I was so pumped for, so ready for, had instead shattered me.”

With the help of a physiotherapist she recovered from her prolapse but she continues to share her story in the hopes that it might help others.

“We’ve all heard the jokes about birth and vaginas. How they are ruined. Wrecked. Like watching your favourite pub burn down and all of that. And it really pisses me off.

“For a while it’s funny, and yeah I suppose it gets people talking about it, [but] it doesn’t help! … It normalises the idea that once you give birth your vagina will be ruined, you will pee when you sneeze and that’s your lot for the rest of your life and hard luck, deal with it, ‘insert ode to the vag here’. And that’s shit!”

Her advice for birthing people is simple. “If you think something is not right with your body after giving birth, please, see someone. It’s not shameful. Your GP, women’s health physio, midwife, has seen it all. The trampoline jokes, the sneeze peeing jokes, the busted vagina jokes. Yeah, they’re funny, but they don’t help. Getting help helps.”

But ensuring every birthing parent has access to help is a challenge. Physiotherapist Frances Tague says New Zealand is “massively lacking” in postnatal care compared to other countries around the world.

“A lot of people talk about France as the gold standard because women in France routinely get postnatal checks, not the baby. Everyone here gets their six-week check for the baby and I think the most that happens there for the woman is a conversation around whether there are any signs of dysfunction and if there aren’t, they’re literally told they can go back to anything and everything they used to do, which is just crazy,” says Tague. “In France, a woman has up to six fully funded appointments with a physiotherapist and every single woman has a vaginal examination and pelvic floor muscle training, often with instruments to measure strength or electric stimulation for women who struggle to initiate a pelvic floor reaction. And that’s just routine care.”

Tague says the most women here get in support is “advice and a leaflet”, and despite the frightening statistics, the issue just doesn’t seem to get political traction.

“Those of us who are trained in this area know that it’s hugely common,” she says. “Even the statistics around faecal incontinence – being unable to control your bowels – are massively high. It’s hugely distressing, life-changing stuff. It can cause women to be socially isolated [as] it’s something they feel afraid to talk about with their family.

“We’re not just talking about incontinence here, but postnatal pelvic pain, pain with intercourse [which are] all really common and none of them are dealt with routinely.”

Of course, many of us have theories as to why the topic of women’s health is ignored politically. This week, author Clementine Ford offered one suggestion, encouraging folks on her Instagram to consider what post-birth care would look like if cis men carried babies.

“You’d best believe there would be fully funded treatment centres in every town throughout this country to make sure they found a solution and ASAP,” she wrote.

“It simply would not be borne that fatherhood posed a natural end to men’s sexual function and enjoyment! So why is this loss of something many of us see as an essential core of ourselves just so casually dismissed as part and parcel of the supposedly more important experience of becoming a mother?”

In our RNZ podcast Conversations With My Immigrant Parents, immigrant whānau across New Zealand have frank conversations about ancestry, love, expectation, acceptance – and food. We asked immigrant kids to listen to the podcast and share with us their responses.

Last year, we had the immense privilege of making the first season of our podcast and video series Conversations With My Immigrant Parents, thanks to NZ on Air and RNZ’s Joint Innovation Fund. We travelled the length of the motu spending time with eight immigrant families, recording different generations in conversation with each other, getting ourselves (over)fed, and in all cases, not wanting to leave when our two days with them were up.

We made the podcast out of a motivation to connect more with our own immigrant whānau too, wanting to open up discussions that really hadn’t been given the time, from either generation. For Saraid, this came about from speaking more to her mum about the ways being half Sri Lankan has affected her life and her experience of whiteness in Aotearoa. For Julie, it came out of long held blocks in communication built across language barriers and internalised racism.

A lot of the desire to make the podcast also stemmed from seeing how thinly veiled the expression of white supremacy is in this country, historically and presently, but how reluctant as a nation we are to readily acknowledge and dismantle this. We wanted to offer nuanced stories and experiences of how the systemic marginalisation of migrants in Aotearoa hurts all of us, and how we can actively work against that.

Right now, we’re starting on our second season and looking for families to feature (applications close Jun 24 so please spread the word no matter where in Aotearoa you live!). We’re also thinking a lot about why we’re doing this and how to do it better, in relation always to the changing discourse around the world. Immigrant stories will always be important, and so will people of colour speaking out against a culture that systemically has never cared about us; we hope the series has offered new insights. But the best responses we’ve had to the series are from the people who see themselves or their whānau in the conversations. We made this for our communities because making something for and about people who get you without explanation is the best part of the job.

This is exactly why we asked eight kids of immigrants to respond to episodes featuring families from the same cultural background as theirs.

Luciane Buchanan on episode 1: A Dress and a Cardigan for Mele

As I listen to Tongan immigrant Liliani and her daughter Kesaia talk, I notice the immediate lump in my throat. Familiar vowel sounds when Liliani speaks in broken English, rings in my mind of how my mother Losi, who’s also a Tongan immigrant from the 1960s, speaks. I feel a huge affinity to Kesaia, as her life experiences are almost identical to mine. My deep love for my mother and my Tongan culture is reflected in their conversation. As children of immigrants we share this evolved struggle. And it’s hard. But it’s a beautiful journey, something I wouldn’t change if I could.

One thing to know about Tongan people is that we have a hard ‘get on with life’ exterior, but we have the softest hearts. When we talk about our family, the flood gates open. I really felt this when listening to this intimate exchange between mother and daughter, as tears streamed down my face throughout the episode. I found comfort and I felt heard in this conversation.

Luciane Buchanan is a Tongan actor and writer.

James Roque on episode 2: Really Nice Potato Sacks

Look, I’m going to be upfront with you here: this episode made me cry in a queue at K-Mart. Not because it was sad, but because I felt like I was listening to a conversation my Filipino mother and I were having. I knew it would too, after the first thing Joseph’s mother Grace says is “you underestimate us”.

I’ve underestimated my migrant parents most of my life growing up in NZ. Not in the usual way that all teens think their parents will never understand them, but a much more insidious underestimation that a lot of migrant children do. “They won’t get me cause they’re FOBs,” I used to think. Now that I reflect back it was just another way for me to erase myself in order to assimilate into white New Zealand.

I remember a few years ago my family were playing the game Cranium on holiday. It was a heated game and my girlfriend and I were teamed up with my parents. We were in the last round and in order to win the game my dad had to spell an incredibly long English word backwards. “We’re screwed now,” I thought subconsciously. My sisters had the same doubt. Then, my dad got up, took a breath and without skipping a beat spelt the entire word backwards. My sisters and I were shook. “You didn’t think I could do it, did you?” my dad said, a cheeky grin on his face, my mum clinging on his arm like a hype man. It wasn’t ‘til recently that I realised that that story was symbolic of how much we underestimated them emotionally too.

Nowadays I try not to underestimate my parents anymore. The more I do the more I see how beautifully empathetic, nuanced and kind they are. I’m glad to have them in my life and look back with shame at how I used to see them.

James Roque is a Filipino comedian and one third of comedy group Frickin’ Dangerous Bro.

Brynley Stent on episode 3: Argumentative is an English Concept

Because of the racist, hierarchical society I’ve been brought up in, when I hear the word ‘immigrant’ my mind imagines a person of colour. This has been so ingrained in me that I’ve never really thought of my Oma, and the rest of my Dutch relatives as immigrants. But of course they are.

Listening to the Blaha-Brethouwer family talk so frankly about their cultural identities made me think deeper about how I identify culturally. I’ve always been proud of my Dutch heritage – I used to do Dutch folk dancing as a child (complete with traditional garb and clogs) and therefore have a stronger link to my Dutch side of the family – the other side, culturally, are “just Pākeha”. I think Julie makes a thought-provoking point when she talks about Pākehā pride (not white power just to be very clear), where if we all knew a little bit more about the intricacies of our white culture, i.e where exactly we hail from, we might be able to see beyond white being the default.

Hearing the Blaha-Brethouwer kids talk about speaking multiple languages, and wanting to represent their heritage, it made me feel sad that I never got to learn Dutch. My Oma got pulled into that “it’s easier to speak English” system that I feel many immigrants feel obliged to do when they arrive in New Zealand. I’ve been working on my Dutch on Duolingo and one day I hope to turn up to her house and surprise her by saying, “Goedemorgen, hoe gaat het!” – but only when I’m feeling a little more confident. Last time I tried to say it on the phone to her she went, “What? Speak English!”

Brynley Stent is a performer and writer of Dutch heritage.

Tayyaba Khan on episode 4: It Was Clearly a Joke

If you’re expecting a 13-year-old Pakistani boy talking about the traditional food his mother cooks him or his refusal to wear the shalwar kameez of her choice… this is not that.

Aliyaan is mature, well beyond his age. He and his mum Masooma give the audience a glimpse into the significant impact Islamophobia has had on their lives, and the changing nature of conversations over generations with immigrant parents.

“We hope it’s not a Muslim who has done it” is representative of many Muslims in Aotearoa as the events of March 15th were unfolding. This episode is a window into the excessive expression of being grateful to New Zealand from a self-flagellating faith community who has been made to question their standing since 9/11. The episode challenges whether we have collectively made it harder to speak up about the impact of the Christchurch terror attack.

Moments where Aliyaan reminds us he is of a generation who will hold their footing in this country and speak out make me thankful. Masooma and Aliyaan’s conversation is one of friendship between a mother and her son, even when times aren’t friendly to them.

Tayyaba Khan is a Pakistani social justice activist and founder of the Khadija Leadership Network.

Hye Ji Lee on episode 5: Actually I’m Korean

Navigating motherhood and womanhood in an environment where one is Othered is a narrative we don’t often stop to think about. The conversation between The conversation between 어머님 김수남씨 Sue and 따님 문보경씨 Bokyong reminded me of the immense capacity of migrant mothers.

I grasped glimpses of the challenges my own mother must have faced, and like Sue, how she just got on with it. Got on with it for me, for us, the kids of migrants, so that we could live a life that was better than theirs.

Listening to the conversation I felt the vulnerable and precious space that is the interpersonal relationship between a mother and daughter. My heart ached, and I missed my mum. The giants among us are often the ones that raised us.

Hye Ji Lee (Erica) was born in Korea. She researches and teaches in the sociology department at Te Whare Wānanga o Tāmaki Makaurau.

Ashleigh Williams on episode 6: The Best Street in Birkdale

From Tammy’s dad moving over and working to set things up for them, to hearing Tammy talk about one of their racist experiences, there is something so special about hearing the voices of people from your home and crying because you’ve experienced the exact same things.

My dad left school at the age of 15 to work and support his family growing up, then years later left his home in South Africa to work and support us before we moved over. My first year living in New Zealand, at the age of nine I was told that my school did not allow black people and that I should go home. Listening to this episode I resonated with the stories.

I thought deeply about my family and our own journey here. I thought about how similar our experiences were at the beginning. I thought about my family at home, our time in NZ, and how much work there is to do here still around racism. It hasn’t only made me cry, it’s made me smile and laugh, it’s made me angry, and it has also made me think.

Ashleigh Williams is a South Africa-born actor and creative based in Tāmaki Makaurau

Sarita So responds to episode 7: Sucking on Chicken Feet

Listening to this episode made me think how fortunate I feel to know my culture and speak my language. In a way that might not be as fluent as I would like, but where I have a different way of thought, a distinct sense of humour, an insight into another world. The ability to communicate – I’ve luckily always seen it as my superpower.

It makes me sad for those who haven’t had this opportunity, or people who have lost it or had it beaten out of them. I think of the many experiences within a collective trauma and how different they can be. Even between a generation how much can be lost, what is lost in translation? Will my children and my parents be able to communicate?

I hear through the episode possible misunderstandings between the family members, the wanting to make sense of how their lives have unfolded, and the desire now to connect. This is why I hold on so tight to my relationship with family, history, trauma and the beauty of where I came from.

I’ve never needed convincing, I’ve always loved my culture and have celebrated it but listening to this reminds me that there’s always something to be lost, and that there’s always more to learn, especially from the ones you love.

Sarita So is a Cambodian writer, performer, and co-founder of Wellingtonian company I Ken So Productions.

Batanai Mashingaidze on episode 8: Nothing Other than Beauty and Hope

I know that sacrifices needed to be made in order for me and my siblings’ lives to look the way they do, but hearing the Muzondiwa family made me think back to the first few years of being here in New Zealand.

My family are also from Zimbabwe. My mother raised us as a single parent and I can only imagine how hard that must’ve been for her, being here alone with three kids, knowing there wasn’t anyone coming to help any time soon.

Hearing Nyembezi talk to her experience of being alone and not being able to eat anything reminded me of the memories I have of Mama making these beautiful meals for us out of nothing, meals she often wouldn’t eat with us. She would say she wasn’t hungry and I wonder if like Nyembezi, the worry of what family back home in Zim would be eating was too much for her to stomach.

My generation may not ever know how hard it was for our parents. We all get told the “basic” version of the story but there are things that she doesn’t talk about at all. I want to know all that information, but I’m also not sure which questions to ask… How did you get through all by yourself? What would you say on the phone when back home asked how it was going? What happened when you told Gogo that you were leaving? Do you still desire to go back home? Most importantly, MAMA, WHY ARE YOU SUCH A BOSS!!!!!!!

I appreciate and cherish everything my mother has done for me and my siblings. The first thing I did after listening to the podcast was to message her telling her how much.

Batanai Mashingaidze is a Zimbabwean actor hailing from Pōneke and currently based in Tāmaki.

Register your interest in being featured in season 2 of Conversations With My Immigrant Parents here.