Former Made in Chelsea star Ashley James has revealed she will undergo surgery after suffering from urinary and faecal incontinence for nearly six years.
The 39-year-old television presenter was left with chronic incontinence after being stitched up incorrectly following a missed third-degree tear during the traumatic birth of her son Alfie in 2021.
James shares five-year-old Alfie and three-year-old daughter Ada with her partner Tommy Andrews. She spoke publicly about her medical condition during an appearance on ITV daytime show This Morning on Wednesday.
A third-degree perineal tear is a severe injury during childbirth that extends through the vaginal wall and perineal muscles into the anal sphincter. When left untreated or improperly repaired, the tissue trauma can disrupt normal muscle function and cause long-term involuntary bowel and bladder leakage.
Explaining the hidden toll of double incontinence to presenters Cat Deeley and Ben Shephard, James said: "When you experience something like incontinence, you have to plan your days and evenings around this physical thing that nobody on the outside really sees but you know can happen."
"I try not to feel shame or embarrassment around it," she added. "The reason we are so shamed into silence, it doesn't help anybody, it doesn't help women. And it is something where you feel you're the only person going through it, or you're embarrassed."
Realisation and medical diagnosis
James admitted that it was only after consulting a private health physiotherapist that she came to understand her post-birth complications were not a normal part of recovery.
"I think because of so much secrecy and mystery around birth, I just assumed, in the 'mother and baby doing fine' that maybe everyone goes through this but no one talks about it because it's really embarrassing and humiliating," she told the hosts.
Pelvic floor physiotherapy is often recommended for postpartum women to rehabilitate weakened muscles, but severe tears frequently require corrective reconstructive surgery to restore anatomical function.
James confirmed she is now preparing for surgical intervention to resolve the issues. She stated: "For anyone that experiences incontinence, it's not something you have to put up with. And I will have to have surgery but it's just the trauma of it."
She added that she has her first appointment scheduled later this week to formally discuss the surgical procedure with specialists.
Paris trip and viral social media post
The decision follows a high-profile post over the weekend in which James raised awareness of birth injuries by sharing a photograph of herself wearing incontinence underwear with her 843,000 Instagram followers.
The broadcaster had traveled to Paris with her partner Tommy Andrews on the Eurostar high-speed rail service as a birthday treat to attend singer Celine Dion's concert residency. However, an unexpected problem arose when she misplaced her luggage on the train.
"Lots of you will know that since having Alf I’ve lived with various birth complications, and one of them is incontinence," James wrote in her social media message.
"Anyway, I managed to leave my wash bag on the Eurostar, which had my Tena pads in it, so there I was having to send Tommy out in Paris to buy me some more."
She explained that finding supplies proved challenging due to local street closures. "Half the Champs-Élysées was closed because of the Pope, but off he went, eventually returning not with pads, but Tena PANTS. Needs must."
"And honestly, no matter how glam I may look sometimes, there’s something very humbling about the reality of pulling on your Tena pants," she added.
Postpartum healthcare and breaking the stigma
James praised Andrews for his supportive attitude throughout her ongoing medical challenges, emphasizing that compassion from partners should be standard practice.
"I’m so grateful to have a partner who has never made me feel embarrassed about any of it, but also, that should be the bar," she stated.
"I have these birth injuries because I gave birth to our children, and so many of us live with birth injuries, with nowhere near enough postpartum care, while somehow being made to feel like the consequences are embarrassing or a failure on our part. They’re not. Our bodies go through huge, sometimes permanent sacrifices to bring children into the world, and we deserve support, not shame."
Since first rising to public attention on E4's reality series Made in Chelsea in 2012, James has developed a prominent career as a radio presenter, DJ, and advocate for body confidence and women's health issues.
She revealed that her online post prompted a flood of responses from women suffering in silence with similar maternal injuries. "My DMs were FULL of women saying 'me too', with so many of you saying it feels like a dirty secret, and actually all of your messages reminded me there really is no shame."
While preparing for her upcoming medical consultations, James confirmed she is continuing non-surgical therapies in the interim. "I’m still doing my pelvic floor training, still putting off the surgery, but in the meantime I’m not letting it stop me living my life."
Her message received overwhelming support from fans and television colleagues, who commended her for using her platform to candidly address postpartum health complications.
