Did you know that 1 in 3 women can experience symptoms of a prolapse after childbirth?
It is surprisingly common and yet it is a condition that we don’t often talk about or prepare for. So how do you know if you have a prolapse after birth?
In this blog we will explain what a prolapse is, why they can happen, what the symptoms are and what you should do if you think you have one.
What is a prolapse?
Pelvic organ prolapse happens when the organs that move downwards towards the vagina.
There are a few different types of pelvic organ prolapse and it is not unusual to have more than one type of prolapse at the same time. The most common type of prolapse experienced by individuals is a front vaginal wall prolapse. This prolapse is when the bladder and sometimes the urethra (the tube that our wee comes from) moves downward and pushes against the front wall of the vagina. Another common type of prolapse is a back vaginal wall prolapse which involves the rectum pushing downward into the back wall of the vagina. The uterus (womb) can also move downwards after childbirth, and this is called a uterine prolapse.
Why do they happen?
A prolapse tends to occur when the pelvic floor and ligaments supporting the pelvic organs are stretched, but under long term pressure or are not working as well as they should.
It is often not just one thing that will result a prolapse but a mix of the following:
- Genetics (family history of prolapse, hypermobility, or connective tissue disorder)
- Constipation
- Pregnancy
- Childbirth
- Aging
- Being overweight
- Recurrent heavy lifting without training
- Chronic cough
When we are pregnant, our pelvic floor and ligaments are required to work harder as we grow and carry a baby. We also have hormonal changes that allow our bodies to stretch and adapt to grow another human.
Many women can suffer from constipation in pregnancy and after childbirth. When we are constipated, the increased intra-abdominal pressure can cause the pelvic floor and ligaments to be strained and stretched. Regularly struggling and straining to empty your bowels can increase the likelihood of a prolapse or make a current prolapse worse.
The most obvious change can occur after childbirth itself, especially if you deliver vaginally with the help of forceps. The vagina and pelvic floor are designed to stretch for child birth and will recoil as you recover and heal from childbirth. This recoil will happen gradually over the first few months after birth. It is during this time you may start to really notice pelvic organ prolapse symptoms.
How do I know if I have a prolapse?
A prolapse isn’t always easy to identify due to there being a lot of changes to your body after childbirth.
Here are some common symptoms:
- Vaginal heaviness
A common symptom of a prolapse after childbirth is a feeling that your pelvic organs are falling out. You may be able to see or feel a bulge at the entrance to the vagina. Or you may feel fullness or heaviness in the vagina that worsens if you have been on your feet, lifting a lot or straining to go to the toilet.
- Bladder issues
A front vaginal wall prolapse tends to produce symptoms relating to the bladder. This can include problems with needing to go more often or more urgently to the toilet to wee. You may find you are struggling to fully empty your bladder. Incontinence can be another symptom of a prolapse but this can occur without a prolapse.
- Bowel issues
A back wall vaginal prolapse tends to produce bowel symptoms. It may be difficult to fully emptying your bowel and you may find you need to use your fingers to press around the vagina or anus in order to fully empty your bowel. Other bowel related symptoms include bowel or wind leakage and sudden urges to empty your bowels which come on without warning.
- Pain or discomfort
Some may notice discomfort and pain when reintroducing sexual intercourse or using a tampon. They may notice a feeling that there is an obstruction in the vagina. Some may notice a heaviness, pain or discomfort in the back or the tummy.
What should I do if I think I have a prolapse?
All of these symptoms can be an indication that you may have a prolapse. However, they can also occur due to other reasons including swelling, healing and injury to the bladder or bowel. If you have just given birth and are feeling these symptoms, please know that your body will not feel like this forever. You should expect that prolapse symptoms will improve gradually over the first few weeks postnatally. However, it is important to speak to your midwife or GP if you think you have a prolapse or are getting any of these symptoms. Especially if you are concerned, if things aren’t improving or if something doesn’t feel right. They will be able to guide, support you and refer you on to health professionals such as specialist pelvic health physiotherapists. In some areas you may be able to refer directly to a pelvic health physiotherapist for assessment and support.
In the next blog we will talk through the treatment for a prolapse after child birth and what you can do to improve symptoms if you have a prolapse.
Useful links
Risk factors for Pregnancy and childbirth
Guide for women on pelvic organ prolapse
Information on pelvic organ prolapse
Urinary Incontinence and pelvic organ prolapse in women management
Author
Suzanne Vernazza – Know your Floors