We recently have had an influx of newly postpartum women experiencing pelvic organ prolapse. These women all have the same question, “why didn’t anyone tell me about this?” Some are here to set the record straight and get to the facts about postpartum pelvic organ prolapse. If you are experiencing a pelvic organ prolapse, you certainly are not alone. The International Urogynecological Association noted 29% of women 6-10 weeks postpartum experience some form of prolapse.

What is Pelvic Organ Prolapse?
The pelvic organs: bladder, urethra, uterus, vagina, rectum and anus, sit in a bowl that is our pelvis. Prolapse of these organs is the dropping or tipping down of one of these and most commonly, they tip into the vaginal canal. This can occur with the bladder tipping back on the vaginal wall or the rectum tipping forward on the vaginal wall, as well as the cervix and uterus dropping down into the vaginal canal. This creates a small bulge in the vaginal canal that some women can feel or visibly see if they were to examine themselves.

What are the symptoms?
Symptoms may vary depending on the organ that is prolapsed, however the most common symptoms we hear are a feeling of heaviness or pressure in the pelvic area or vagina. This pressure seems to worsen as the day goes on, or if you have been running around and on your feet for a significant amount of time. Other more common symptoms are:

• Visible bulge in the vaginal canal or protruding outside of the vagina
• Low back pain or ache in your low back that is not going away
• Pain with intercourse
• General feeling like something is falling out of the vagina
• Urinary issues such as bladder leakage, difficulty starting the stream, feeling like you are unable to empty all the way, or feeling like your always have to go
• Bowel issues such as constipation, difficulty evacuating the bowel movement, or a change in your ability to have a bowel movement
• Some spotting or bleeding from the vaginal canal

What causes this?
Pregnancy and childbirth are both risk factors for prolapse. We know pregnancy can put a lot of stress and strain on our pelvic floor muscles as the added pressure from our baby growing and uterus expanding. As well as a vaginal delivery can cause an increased stretch and added strain to the vaginal canal and pelvic floor muscles. Tearing during vaginal delivery can cause weakness in the pelvic floor as the muscles try to heal. Women who have had a c-section delivery are still at risk for pelvic organ prolapse due to pregnancy.

What can I do to fix this?

• Modifying your physical activity- early motherhood comes with a lot of new physical challenges, including lifting the car seat, the diaper bag, your newborn and/or toddler. It is important to learn proper lifting techniques to ensure you are not putting significant stress or strain on your pelvic floor muscles. We also want to make adjustments to your exercise routines, we know exercise has incredible benefits, so slight modifications to keep you exercising safely is our main goal.
• Avoiding constipation- hard bowel movements can put a lot of pressure on your pelvic floor muscles. Being constipated can cause pushing and straining to evacuate your bowels. By increasing your water and fiber intake, can assist in a healthier bowel routine and decrease the strain on the pelvic floor muscles.
• Finally, one of the best ways to help your prolapse is through pelvic floor physical therapy. Pelvic PT can help women strengthen their pelvic floor and learn how to appropriately modify their activities to safely and effectively help their prolapse symptoms.

Pelvic Organ Prolapses after childbirth can occur and you are not alone. Many women experience this and find great success with conservative symptom reduction through pelvic floor physical therapy. If you are experiencing any of the symptoms listed above or have concerns about your pelvic floor muscles after childbirth, give us a call at Legacy Physical Therapy 636-225-3649. We would be happy to answer any of your questions!

Want to read more about treatment for pelvic organ prolapse? Check out our free eBook Feeling Better And Getting Healthy When You Have Pelvic Organ Prolapse here. (https://legacytherapystl.com/pelvic-prolapse/)

Citations:
Vergeldt TF, Weemhoff M, IntHout J, Kluivers KB. Risk factors for pelvic organ prolapse and its recurrence: a systematic review. Int Urogynecol J. 2015;26(11):1559-1573. doi:10.1007/s00192-015-2695-8