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Birth Stories

4th degree tear and ileostomy – Steffi’s story


Trigger Warning: This birth story discusses trauma, topics discussed include forceps delivery, emergency theatre and postpartum haemorrhage, and complications from a 4th degree tear. If you are seeking support for your birth trauma, you may wish to contact our Peer Support Service.


Here, Steffi recounts her story of recovery after a 4th degree tear and ileostomy. By sharing her birth experience that resulted in a serious birth injury, Steffi hopes she can help other women who have also been through birth trauma feel less alone.

On the 27th of April 2020, my daughter Ruby was born. She is the best thing in my life, but that day she was born was probably the worst – it was the start of a huge physical and emotional journey for me.

The month Ruby was born was when Adelaide was in the thick of Covid restrictions, I was restricted by whom I could have in the birthing suite with me and who could visit after. I had always wanted and planned for my Mum to be there supporting me, unfortunately I could only have one person and that was my amazing husband, Luke.

I laboured at home with my Mum from 3am that Monday morning and by 11am I had arrived in hospital, at 11.15am I had had my first examination and I was 7cm dilated, I thought “Amazing! I’m over halfway.”

I always intended on having an epidural, so after using the gas for about an hour, I was SCREAMING for one. Two attempts from the anaesthetist and I was numb by 1.30pm and by 3:30pm I was fully dilated. By 4pm I was starting to push… sounds like the perfect labour, right?

I pushed for over an hour when the atmosphere started to change, things became blurry for me. I remember a flock of people running into the room, one scanning my belly, my midwife along with two doctors at my feet, others standing in the background and a very scared looking Luke to my side.

At 5.50pm – Forceps were used, and an episiotomy was performed. Ruby was born.

Ruby was quickly put on my chest and then taken away almost instantly, there was blood, so much blood and within seconds I was wheeled up to theatre, crying out for my baby. 

It spent a total of five hours in surgery – 2.5 hours awake and 2.5 asleep. The obstetrics team, and a colorectal surgeon worked on putting me back together, and after a blood transfusion I was finally reunited with Luke who had cared for a very hungry Ruby while I was gone. I’d missed out on all those first moments our family dreamt of. Luke had called my parents and announced Ruby’s birth but couldn’t give any indication of when I’d be back from theatre or why I was there for so long. It makes me sick imagining how my mum and dad felt not knowing how I was.

During Ruby’s birth, I had endured a nasty 4th degree tear, an extension of my episiotomy, and a large amount of blood loss. I knew it was nasty, I could tell from the looks on the nurses faces when I asked them if they had seen this before. “Rare” is all I kept hearing.

That night I was so medicated that I hardly remember it at all, Luke was asked to leave the hospital for covid reasons, and I was left to care for Ruby with the help of an extremely busy ward of midwives overnight. I couldn’t move, so it was not the night I was expecting. 

Tuesday I was met first thing with both the obstetrics and colorectal team who told me I was going in to have another surgery that night. They told me in order for my body to heal without retearing, infection, and constant incontinence I was going to need an ileostomy. Medicated me had absolutely no idea what an ileostomy was.

So sure enough, that night I was taken away from Ruby and Luke again. My small intestine (ileum) was brought to the outside of my stomach, a bag was placed around it and from then I was “pooping in a bag.”

Wednesday was finally the day I came to terms with what was going on, until then I was in shock. Learning to be a Mum is hard enough and juggling a hormonal body which had internal and external stitches, literally holding my vagina and bottom together, while my intestines were hanging outside of my stomach leaking poop into a bag was debilitating. 

That day I had a meltdown, I couldn’t look at the bag, let alone touch it. Oh, and the pain, I don’t think I’ll ever forget the pain. 

That’s when my husband Luke stepped in, he said he would learn to change the bag, clean and handle the area until I felt ready. With that, we were allowed to go home a few days later, although the midwives and nurses had been amazing, I was a new mum and all I needed was my mum. I felt desperate to get home.

At home I was unable to walk unassisted for the first week, and I continued to have episodes of vomiting because of the pain. Mum stayed with us for months just to help out at night, help me shower and so much more. Luke took seven weeks off work to totally care for me and Ruby. I will always be so grateful for them but I also wish it never had to be that way. 

They stayed so strong for me, but I’ll never forget going to shower in the next room when they thought I couldn’t hear them, they would both break down and cry. I remember my sisters coming to see me for the first time after having Ruby; they looked at me while fighting back tears. It was cruel. I tried to make them laugh, to make them feel less sorry for me. All I wanted was for them to feel excited for their niece to finally be here. 

Breastfeeding was really the only thing I could do at the start, initially I couldn’t even stand long enough to change her nappy. I would sit in our rocking chair when Ruby was so little just wishing time away because of the pain and the unknown of what my life might eventually look like, it breaks my heart to think about now, I’d do anything to hold my tiny baby again. She was such a good, easy baby, it’s like she could sense I needed her just as much as she needed me. 

My surgeon was always hopeful my ileostomy was going to be temporary, but I didn’t know what to expect, after all I hadn’t expected this. 

Friends and family would visit, and I would be so paranoid my bag would leak, paranoid they might smell it or see it, I was constantly trying to hide my pain. I never told them exactly what had happened because I didn’t want them to look at me differently, worry about me, most of all I didn’t want to take away the first special moments they had meeting Ruby. one thing I regret so much was downplaying my situation, I wish I was more honest and open about it. 

Thankfully after three months of weekly appointments and healing I was able to have my reversal surgery. The reversal went well, but my body was exhausted. The day after my surgery was scary, I was in pain and my body was lacking a lot of nutrients due to the weight I lost while having the ileostomy. My body started to seize and contract, I was hyperventilating and couldn’t speak. The medical emergency team was called in. I remember waking up and seeing Luke standing at the end of my bed crying, he thought he was going to lose me that day. I had a few transfusions and was getting better day by day after that. 

Thankfully five days later my bowels began to work as normal, I had total control over them too which was such a relief. The recovery was long but soon enough there was more good days than bad. 

Today Ruby is 2.5 years old. I have fully recovered; I use my bowels without a stoma bag and that’s all I ever wanted. Nothing will be the same, but I’m okay with that. I have a fantastic OBGYN who will look after me with an elective caesarean should we decide to have another baby and I’m excited for that. I have regular colorectal check-ups which will keep me in check for my future. I go to the gym, I run, I chase my little Ruby and nephews around, I’m the mother I always knew I would be. 

Although I have always tried to remain positive, there has been tough times. What happened to me wasn’t fair, but I truly believe I handled the situation the way I did because of the support I had around me. I know not all women have support like I do, so my aim now is to reach as many others as I can who have suffered from birth trauma, so I can give my support to them. 

For my beautiful girl, I’d face that time again. I wouldn’t change what happened because it’s our story. 

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