Would you have an elective cs if you thought you had the beginnings of a prolapse?

[violentviolet]

Sorry this is all tmi. I had an examination by my gp a few months back after saying I was suffering from some incontinence problems. While she was down there I asked if it all looked ok as the pushing stage of having my first dc had been pretty fast and furious.

I do realise it's not going to be exactly the same after birth but it feels and looks as if the inner walls are bulging in on themselves slightly and the cervix is lower than before which makes sex painful sometimes.

Anyway she bvriefly had a look and said "you're a bit saggy down there but it's to be expected" (lovely!) But the thought persists that it might be the start of a prolapse. My mum had one although I don't know any details at all. I'm worried that it will get worse after any subsequent vaginal births, as will my slight incontinence.

I have been wondering whether it would be safer all round to ask for an elective cs for the next one as I only want one more dc. Any thoughts or experience of this?

I have a prolapse (discovered it when 5 months pregnant with DTs). I went on to have them both naturally and was told it wouldn't be a problem.

I was terrified when I first noticed it that it would mean a c-section but it was fine and it didn't get any worse pushing two more babies out!

Thanks for responding, glad it worked out ok for you! - any other experiences, anyone?

bump

bumping for you VV

I've got a vaginal prolapse and have been told that it won't stop me having a homebirth this time round - didn't sound like it would affect the birth at all.

just had my prolapse repaired after the homebirth of my 4th child. I could feel immediately after she was born that it had come down much further and all the pelvic floor exercises in the world didnt' move it back!
I wouldnt' change the fact I had a home, vaginal birth tbh as the recovery from vaginal repair (IMO) was a lot easier than C/S.

I had a bladder and bowel prolapse followig the birth of dd1. A year of physio sorted it out but now a month after dd2's arrival it has all fallen down again

Get referred to your local hospital to be seen by the maternity physio's - I found them to be brilliant.

There is some research by a chap called Chi (not quite sure how his name is spelt) who states that a quarter of women following birth have a degree of vaginal laxity and prolapse.

Having a c section is not recommended with mild prolapses. Infact the strain and pressure of pregnancy usually causes a lot of the damage.

I had a bladder and bowel prolapse followig the birth of dd1. A year of physio sorted it out but now a month after dd2's arrival it has all fallen down again

Get referred to your local hospital to be seen by the maternity physio's - I found them to be brilliant.

There is some research by a chap called Chi (not quite sure how his name is spelt) who states that a quarter of women following birth have a degree of vaginal laxity and prolapse.

Having a c section is not recommended with mild prolapses. Infact the strain and pressure of pregnancy usually causes a lot of the damage.

I don't know much about this topic, but I would ask my GP to get a referral to a consultant?!

No.

Vaginal, bladder and uterine prolapses have a number of contributory causes. These include but are not limited to:
-Excessive straining related to long labours/big babies/instrumental deliveries/chronic constipation and chronic coughs (in heavy smokers)
-Increased body mass index
-An inherent tendency of the tissues to lose their elasticity with increasing age!

If you are starting to have problems with significant prolapse then good physiotherapy advice with regular pelvic floor exercises will go a long way to helping mild cases. If you are only in your 30's / 40's and your prolapse is moderate to severe before the delivery the long term likelihood is that you will require some form of pelvic surgery at some stage. I think most gynaecologists would be of the opinion that such women should where possible complete their families and then consider definitive surgical repair(65-75% success rates). Women with an inherent weakness in their tissue elasticity are more likely to have recurrent problems despite surgery and repeat procedures then tend to offer lower success rates (40-55% success rates!).
Elective CSections have been quoted as a means of reducing the strain on the pelvic floor resulting from labour but in themselves they are not without risks and this should always be bourne in mind. I believe there is evidence that just the effects of carrying a pregnancy to term and the associated effects can worsen the pelvic floor without even going through labour.
We do normally advocate CSection for women who have already had pelvic floor repair surgery and then fall pregnant as a means to try and aintain integrity of the repair. I dont think most Consultants within the NHS would offer an el.CSection purely on the grounds of it being a preventative measure though!