ELCS & vaginal laxity

[Magicmoo]

Hi, had a natural birth with extended pushing phase for DS1. Midwife put me in a really weird birth position - lying on left side with one leg in the air FOR TWO HOURS. I lost track of time (as you do in labour) and did not realise that pushing for an extended period was so bad for you.
Anyway, all this resulted in intense pain for 2 months afterwards (ligament strain) and slightly bulgier vaginal tissue on one side (connective tissue laxity) although the actual pelvic floor muscle has reconditioned okay. Back wall is fine, just front wall affected. No incontinence. 2 minor stiches. Glute muscles on left switched off for 21 months and it took about 6 physios, including a world expert to switch them back on! Still feels weird at times.
My question is...obviously I am thinking ELCS next time, what will this do to my pelvic floor? If anyone has had laxity/prolapse issues and a section would be great to hear from you. Thanks x

i dont know a huge amount but i think the pregnancy puts as much strain on pelvic floor as the actual birth, especially if abig baby.

I had elcs and have had no problems in that area. But then I had no problems in that area before IYSWIM.

Just wondering (not wanting to hijack thread magicmoo, and hopefully it's relevant) -

I often see it said on this board that pregnancy is what gives you pelvic floor strain, or pelvic floor problems - not VB.

Is that true, and could someone link to any reputable research/evidence for me?

I'm open to all reliable info, it's just... common sense tells me that VB must have some impact on pelvic floor muscles, and pelvic floor organs? In addition to pregnancy? Surely?

(I'm in the same position as lucybrad - no pelvic floor issues after ELCS, but none during pregnancy either.)

Barkfox - part of my discussion with my obs when requesting ELCS was my fear of pelvic floor damage with VB - he seemed to think it was a valid concern and I got my ELCS. (I had no problems in that area and hadn't had a previous VB)

Yes, Chynah. And I do appreciate that pregnancy can put a big strain on the pelvic floor, and may well give some women problems as a result...

It's just the idea that VB doesn't add to that I doubt. After all, one reason why ELCS's are sometimes carried out for DC's no. 2 and onwards is because of previous pelvic floor damage - if it was the case that a VB made no difference, then that wouldn't be an issue. IYSWIM.

Agree totally - I have never had a VB (both mine ELCS) and have absolutely no problems in that area at all - despite running throughout both pregnancies. Most of my friends who had VBs do have some problems even if only minor. I could just be lucky I guess!

With DC1 I had pelvic floor damamge and ongoing bladder incontinence issues after 6 hour second stage then emergency high rotational forceps.

My elcs with DC2 was to help prevent that worsening. My physio said the second pregnancy would do some damage - the hormones relaxing ligaments and the sheer weight of a bump on all those areas - but that a vaginal birth would also give the pelvic floor a HUGE stretch to get the head through and that an elcs would avoid that.

Obviously there are other risks with an elcs, and I weighed them carefully (I was very fearful that DC2 would be stuck as badly as DC1 and felt an elcs was safer for DC2 as well) but I am really glad I took the option my consultant willingly gave for my own health too.

Thanks for the comments everyone. I reckon that the chat the medics give you about the pregnancy itself contributing to pelvic floor damage is not the case or at the very least exaggerated. Women are designed to carry babies they are not designed to be pushing for 2 hours. Pregnancy doesn't stretch the connective tissue, the only thing that can do that is pushing i.e. when constipated or something or vaginal birth with pushing. There is so much bias against ELCS. I just want to have a baby and be able to walk!!!!
Through my research on pelvic floor I also reckon any strain on it during pregnancy is as much to do with how your abs work as anything i.e. if you are working your core or transverse abs properly then the bump is supported and everything is orientated up the way. If you have an oblique dominating pattern (tend to be quite tight under the ribs, hunched posture) then you are adding extra weight to the bump and pushing much more on the bladder. Switching my abs around has made a major difference to general wellbeing and posture and so many things. www.Dianelee.ca has a good section on her website if anyone interested in this.

lovethesea did you notice any further change after DS2? thanks

Things seem fine and unchanged really - pelvic floor weak on one side and very weak on the side it was cut through (episiotomy that tore), and I have almost no sensation of the muscle still, but no worse than before the second pregnancy.

My bladder coped fine with the surgery. I was warned it might be a month or two until it calmed down - I get urge incontinence - but once the catheter came out it worked normally. I still have a weakness there but it's manageable and miles better than I ever imagined.

I healed fast and almost pain free from the elcs and 5 months on it seems a lifetime ago, and a happy memory. 5 months after DC1 I was still attending outpatient appts with consultants, uro-gynae clinics, physio, was unable to have sex due to pain and had awful incontinence at times.

Very reassuring lovethesea thank you. i think I've pretty much decided on ELCS. If all the stuff with DS1 hadn't happened then I would defo go for vaginal but with an existing weakness I don't want to make things any worse. People seem to have an argument that if you've got a weakness in one place why have an ELCS and make a weakness in 2 places, but as my pal says, it's better than double the weakness in one place!!!
One wee question - do you abs feel significantly weaker after the ELCS? From what I have heard you can build the strength back up again if you're into pilates and stuff. Is this right? I don't think they actually cut through the rectus muscle anyway they pull it apart. thanking you

I never had very strong abs before the pregnancy, I was a healthy weight but not toned. I imagine it would be a mix of how committed you could be to exercises and genetic luck. I know it is really important to get the timing right and not try and do too much too soon, and to have someone who specialises in postnatal pilates to advise if possible to avoid worsening the abdominal separation.

I am building up my fitness again but with two under two I do a fair bit of awkward lifting which isn't great for me.

I also followed the line of thinking that my abs had had no surgery before and would therefore heal better than my vagina and perineum which were wrecked by the forceps last time. I feared a repeat stuck baby and assisted delivery would leave me doubly incontinent - a scenario the elcs reduced in risk. I don't mind a squishy small tummy from two pregnancies and an elcs, far better than a colostomy bag which is not unheard of postnatally.

Magicmoo - I did post natal pilates after my first ELCS but not after my second. Definitely think my abs felt better after first than they did after second but that could just be because it was my second or the old two under two thing.

Hello everybody, I also suffer from vaginal laxity after three childbirths. I found out on the internet a treatment called MonaLisa Touch, a laser therapy that tightens the walls of the vagina...it seems that this treatment can help feeling better also during sexual intercourse. I'm going to test it soon!

@ Amyplus, have you tried it? I will soon! I just made my appointment for the MonaLisaTouch treatment. My mother's best friend tried it for her menopause's symptoms and felt great after it, but Ii read on the web that it also works for postpartum's!