There can be a lot of fear around pregnancy after being diagnosed with a pelvic organ prolapse, the worry that each pregnancy or delivery method is going to make your pelvic organ prolapse worse. Questions going through your head like
‘If I get pregnant again am I going to make my prolapse worse?’
‘If I get pregnant again, will I be able to recover like I did before?’
‘Will I still be able to love this child knowing what the pregnancy has done to my body’.
We can have some pretty dark thoughts when we have a birth injury, teamed with the hormonal fluctuations that occur post birth.
You may feel comfort knowing that MILLIONS of women get pregnant after being diagnosed with prolapse and are absolutely fine!!
There are so many things to consider when planning to have a baby again after a POP diagnosis. Although not all of it is fully in your control, you can still set up some parameters to help you feel confident going into pregnancy again. IF that is what you choose at the end of it all.
First and foremost, you should talk to your healthcare provider about your specific circumstances and what your risk factors (if any) may be. There is always support you can receive either from your OBGYN or pelvic health physiotherapist to help you make your decisions.
For myself, I gave birth vaginally to 3 babies (2014, 2018 and 2021). I was nervous about pregnancy only after my second baby. Although recovery was ok after my second, my third pregnancy threw a few wrenches in the works. An unplanned pregnancy teamed with a pandemic and Polyhydramnios a condition where tour body produces excess amniotic fluid send my brain racing. All things which were out of my control.
Here is what was in my control!
#1 See a pelvic health physiotherapist early on in your pregnancy. This way you can monitor your tissues and determine the best action plan for you. Sometimes it may be you need strength in you pelvic floor other times it may need releasing. The situation will change throughout the pregnancy as different hormones ebb and flow.
#2 Seek out the use of a pessary if you are well suited to using one. That can help take a little of the load off the pelvic floor and the particular organ(s) that is prolapsing. In Canada your OBGYN will be able to prescribe the use of a device and it can be covered under your health plan. OR you can see you pelvic health physiotherapist for recommendations too.
#3 Use your Breath wisely. When you are lifting something heavy (like if you have a toddler), breathe out when you lift. Also known as exhale with exertion. This way the pressure in your abdomen is being transferred away from your pelvic floor and supported. You may feel like you need to exhale through the full task rather than just with the lift and thats ok. Just ensure you are NOT breath holding.
#4 Stay hydrated! This couldn’t be more important for your pelvic health so listen up! Having a good poop and a healthy bladder has a direct effect on your POP. If you get constipated, that strain on your pelvic floor can make your symptoms worse. that along with an irritable bladder the tissues can get angry. So drink up, stay on top of your poop, use a stool to elevate your feet and ensure your diet is full of fibre!
#5 Well balanced exercise can help to keep those pesky symptoms at bay. Now don’t just run to kegles as the first port of call. A lot of the time the pelvic floor tone is high and needs to chill out. So ensure you are mastering the diaphragmatic breath rather than jumping straight for the kegels. The key to a healthy pelvic floor is maintaining strength while allowing length and softness. Support your pelvis with glute strengthening and lengthening in your programs and co-ordinate all your movements with that diaphragmatic breath.
At the end of the day, the choice to get pregnant again is yours. But with these tools in your pocket it should take a little of the pressure off the decision.