Pelvic floor issues after 1st - 2nd delivery?

[NuffingChora]

Hi all,

I had a fast labour with my 1st (sub 4 hours) but over half of that was pushing - certainly over two hours. Never seemed to be any question of a ventouse or forceps and DD arrived eventually. Tear-wise things were fairly minimal - small labial tear and a couple of grazes. For the first year or so I felt like I’d got away reasonably ok (though wasn’t hugely active due to challenging time with DD and probable PND) but weirdly AFTER stopping breastfeeding, pelvic floor seemed to just give up the ghost and despite ongoing input from specialist women’s physio and consistent pelvic floor exercises (which have been checked and I know doing right) - I just can’t seem to get anywhere near back to normal.

I was really fit and active before having DD - gym/running/spinning multiple times a week and lots of time spent outdoors dog walking and other activities. Well, I can do the walking... but everything else is f*cking hopeless and I’m really not dealing with it very well - feel like I’ve lost a massive part of my identity.

I’m now 7 weeks pregnant with baby number 2 and here I am facing another labour. Will be just over 3 years since the 1st.

So I wondered - has anyone who’s had good-going pelvic floor incompetence after their first that they haven’t managed to rectify - what did you do about your second? Another vaginal delivery and hope for the best? C-section?!

Maybe my expectations are too high and I should just suck this up - but I’m only in my late 20s and not sure I can face a life of not being able to do all the things I used to and potentially worsening symptoms in later life.

Thanks for any input!

Are you thinking about prolapse or incontinance? I had massive pelvic floor damage after baby 1 (my main pelvic floor muscles were torn off my bone during delivery) so have a prolapse. I decided on an ELCS for our second as just couldn't face pushing another baby out. Recovery was brilliant and seem to have (hopefully) avoided further damage. Symptoms are fluctuating right now (only 5 weeks postpartum) but definitely feeling much better than I did after my vaginal delivery.

Thanks for your reply! Mainly urinary incontinence. Couple of bowel related symptoms but not incontinence as such. Maternal family history of bowel incontinence after childbirth though in later life so that’s on my mind too. No prolapse.

What’s most frustrating is the objectively my issues are fairly minor - nothing hugely exciting to find when I’m examined - but subjectively my symptoms seem far worse than they should be given the above. So I’m worried about asking a obstetrician about mode of delivery as I would probably be considered to have got off pretty lightly in the grand scheme of things, but I cannot tolerate having these symptoms for the rest of my life, if not worse, and not being able to do any of the things I want to 😔

I have a bladder and bowel prolapse after first delivery (yay forceps) and won't be having any more.

When I had my debrief the consultant highly recommended a c section for next delivery if I was having one. However, there is also a risk anyway that the extra weight of pregnancy can increase the risk of prolapse on an already weakened pelvic floor. So I would strongly recommend you seek some physio throughout the pregnancy and try and do all you can to minimise further damage.

Obviously delivery method is personal preference. I would not feel comfortable pushing / bearing down again, but I've read many stories of women who have, and felt it didn't cause any further damage. Good luck x

Thanks @sar302, sorry to hear you had such a rough ride, hope things are better for you now.

Totally agree with you about the physio; will definitely be keeping this up and going back to see her again, my concern I guess is that months down the line I just don’t seem to be getting anywhere with it. Will be interesting to see how pregnancy affects things.

Would be great to hear from anyone who’s gone on to have a subsequent vaginal delivery, in terms of how it’s affected your symptoms?

Thank you! I had physio on the nhs from 4 months pp, til my son's first birthday - so 8 months worth. It was only really once I got to the end of that that I saw major improvements.

I'm now seeing a women's health physio who is also a trained in Pilates, and we're continuing to rebuild my pelvic floor and core through that. I have continued to see improvement. I still have symptoms, as I'm not able to empty my bladder properly, but it's very rare that I feel any day to day discomfort any more. It can unfortunately take a long time to see real improvements I believe.