pelvic floor - rescue needed

[Bo]

A common problem I believe - post natal pelvic floor - my really needs attention. i never remember to do the exercises, the rare occasion I remember I do too squeezes & then get distracted & therefore don't do them anyway.

Does anyone have any great tips, or has anyone tried the cones or whatever else is out there?
I don't want to spend a fortune. Where can you get them from? Are they any good?

All pelvic floor help without guilt needed please, thanks.

I did Pilates and thought it was excellent, although I did find it very hard at first. I found it really difficult to get the breathing and muscle contractions right. I kept getting it the wrong way round but I'm glad I persevered. I would strongly recommend Pilates for post-natal mums as it does have such a strong emphasis on a strong core - ie: tummy & back. However, you need to stick with it, results are not immediate.

Grizzler

What a relief to hear that someone has had a similar experience to my own! Every time I've asked a specialist (desperately seeking reassurance)'this is quite common isn't it?' they've looked at me with a mixture of pity and bemusement and said 'erm, no, we've never actually come across this before'.

However, am now down to one mini Tena Lady a day as opposed to 10 thick telephone directory sized ones and so am considering selling my shares in the company now! Have gone back to chuckling at their adverts...it's amazing how quickly complacency sets back in!

Anyway, what I wanted to know is, has it got progressively worse with each birth, as I'm on my first and am really worried that I won't be able to have anymore unless I'm willing to go through months of all this again?

I would also be interested in an answer to Bee100s question - does it get worse? Although I am generally not too bad I've been suffering from a particularly bad cough all week and so have been struggling.

Bee and Bozza -
Funnily enough, I was absolutely fine after my son was born and was exercising pretty quickly again afterwards without so much as a hint of leakage. It was after my daughter hauled herself into the world just over two years later that all the trouble started. My muscles just gave up the ghost after her birth, and I'd leak steadily throughout the day - not just under stress. Like you, Bee, the consultant I saw at the Chelsea and Westminster said I was a pretty unusual case, especially since I was only 35, and most women don't experience real problems with incontinence until their muscles get further softened by the hormonal swings of menopause. Anyway, the tests I had to have would make you cry with laughter (weeing into an electronic loo to measure my 'flow', weeing while my consultant squatted below to see where I was leaking from, having my bladder filled with blue dye and then weeing blue wee etc), but the end result was that nothing was going to fix me other than an op.
They don't actually know (or won't say) why I ended up in the state that I did, and a degree of damage may have been caused by the ventouse delivery, but some women also apparently have a genetic predisposition to weak collagen. In fact my consultant said that when he opened me up he found that the collagen in my pelvic area was spongy and had lost a lot of its elasticity. If you have this predisposition it can be like 'a ticking time bomb' which can go off at any minute resulting in incontinence, I was told.
So... in my case, it didn't actually get worse after I'd had my first child, since I hadn't had a problem at all previously. Pelvic floors do inevitably take a battering during pregnancy and birth, though, so all women should exercise them as much as possible both before and after to stave off the likelihood of becoming a Tena Lady devotee later in life.
I've been told that If I were to have a third baby I'd run a high risk of having to have another operation because even though I'd have to have a caesarian, the weight of the baby's head pressing on my pelvic floor during the pregnancy would probably stretch the muscles beyond their capacity again. I've also been advised that I may become incontinent again when I hit menopause - so I guess that answers the question about things getting worse as you get older.
This is probably more information than you ever wanted to hear, but incontinence is such a no-no subject for most people that it's a relief to have found a place where I can rant about it

Grizzler

No, not more than I wanted to hear - have had to discuss it with so many specialists/doctors/people who are completely incompetant and need ME to explain condition to THEM (harumph!!!) that have been completely desensitised to the horrors of incontinence! Lucky you, getting to 35 before the onset though - I'm only 25 and have been told that the operation would not last my lifetime and so I have to wait until I'm older as any subsequent child would ruin their handywork and so will only go ahead with it once I have had my lot, but even then they say that I may be too young for it (apparently it will limit my ability to carry heavy things - am not sure why this is a major point of concern for them as I am not a weightlifter and will quite happily leave any furniture manouvering to husband, but ho hum!. Did your incontinence start in pregnancy (mine did as stress incontinence and then straight after the birth it was just buggered beyond belief)??? I don't know about you, but it completely ruined the first couple of months with my dd, very upsetting as if it wasn't for that it probably would have been the most wonderful time ever, but as it was I was just utterly shocked and devastated. Glad to hear that you are much better now though. (sorry for numerous spelling mistakes!)

Bee - you're a baby! That's incredibly bad luck to start leaking at so tender an age. I felt cheated at 35, I must say, and am still incredibly pissed off about now having a very much less than perfect body. (I used to be very fit).
No, I was fine during both my pregnancies, and the incontinence appeared quite suddenly afterwards. It was an awful time (I'd already had a very stressful pregnancy for other reasons, which left me very emotionally battered), and I couldn't work out whether the leakage was normal, and would stop with time, or whether I really was buggered. The midwives who visited were next to no help at all - said I had a uterine infection instead - and it wasn't til I went to the doctor, just short of my 6 week check, that I really found out that things weren't meant to be that way.
Are you being treated by the NHS or privately? Luckily, I have medical insurance, and have been pretty much able to choose my treatment. My consultant gave me the options of having a temporary 'ring' inserted around my urethra to boost control, which may or may not have worked, of having just my prolapse repaired and a bit of support work done, which would be temporary, or of going the whole hog and having an operation called a colposuspension. I couldn't face the prospect of being fiddled about with over and over again, not knowing if the treatment was going to work - I just wanted the problem sorted, so opted for the colposuspension, which has about a 98 per cent success rate. I had a week in hospital then a six week convalescnece, but it was worth it.
Like you mention, it's not certain that my op will last indefinitely, but age wasn't ever mentioned to me as being a factor - as far as I understand it it's purely to do with how your body reacts to menopause, when the muscles soften up due to hormonal swings. Some get lucky and the op holds up, but some don't and have to have it again.
I was advised, however, that it wasn't the best idea in the world to have the colpo if I intended having another baby - although that said, my consultant told me that I shouldn't let it stop me if I really wanted to. The operation is only usually performed on people whose families are complete, purely I presume because you're obliged to have a casaerian with any future births if you've already had a colpo.
Agree with you about the hideous blight of incontinence and the associated shame/worry ruining the first weeks with the new arrival. Ih had my op when my daughter was only 10 weeks old, and couldn't lift her for four weeks afterwards, which was crucifying, but I simply couldn't live with the incontinence and had to get it sorted.
Not sure where the advice about lifting heavy weights hails from. I can assure you I haul my chunky 3 yr old boy around with no problems, as well as shifting furniture etc when the mood seizes me.
What treatment have you had so far? Did you also have a prolapse?

Grizzler - thanks for sharing your story. I feel a bit of a fraud. Both you and Bee are obviously suffering far more than I am. I had a 9lb 10oz baby with a head in the 95%ile. I am not that big (5' 4" and a size 10) and so despite not needing forceps/ventouse I had a pretty big episiotomy and was extremely battered after delivery. So much so that the midwife was unable to examine the stitches because I was too bruised and swollen.

Normally I am fine. However if I sneeze or cough I have to stop what I am doing, but DS down and really concentrate if I am to have a chance of holding it together. This is not often possible. Also I found when being sick I had absolutely no chance. I suppose I am concerned because my Mum having had 3 large babies in quick succession had the same op as Grizzler but menopausally (ie aged 50). So there is the genetic factor. I'm ashamed to say that I find it hard to discuss even with DH and keep wondering whether to see the doctor re referral for physio or to try to sort it out on my own but end up doing nothing.

Embarrassing, isn't it? My advice is to go the doctor and get yourself referred to a physio. Don't let the doctor fob you off with the old 'do your pelvic floor exercises' routine, since you've obviously got problems. The physio will be able to assess you properly (they've got various electronic devices they use) and will put you on a regime to help strengthen your pelvic floor again. After all, it's one thing doing pelvic floor exercises, and another entirely to do them properly and to do as many as you're supposed to. If you're seeing a physio, it will help you to get really stuck into improving things. (I have a friend in a similar situation to you who has been helped massively by physio). Also, if you intend having more children, the problem will only get worse if you don't do something about it now.
If the doctor seems uninterested, just make sure you cough lots and wee all over the surgery floor. Then you might get the attention you need. Good luck!

Thanks for the support Grizzler - it helps from someone who's been there. I'm afraid I've been burying my head in the sand. When I recover from the dodgy stomach inflicted on me by DS I will arrange to see the doctor. Maybe I will also discuss my other unmentionable side-effect of giving birth - the piles I have still got after 13 months...

Hello, I've had a horrid day. Am 40 weeks pregnant with second baby and desperate to go into labour and then today the midwife has diagnosed me with a vaginal prolapse, which hasn't really filled me with joy (especially having had a quick look on the net which just seems to talk about surgery, constipation and painful sex!) She rang me later having spoken to the obstetrician who seems to think it may sort itself out post delivery with the help of lots of pelvic floor exercises....... anyone else out there had the same thing? Any success with physio alone? Any info v welcome!!

No experience of this myself, just wanted to wish you luck with the labour and hope you recover quickly, it can't be easy for you. Will you get some help once no.2 arrives?

There was a thread about pelvic floor exercise cones recently. Maybe one of the websites mentioned there will say if they're suitable for helping a vaginal prolapse post delivery.

Thanks for your posts Batey and Soupdragon.... I'll have a look at the websites on the thread you mention. I'm being referred to a physio at the hospital so that should help and my mum will come and help once we have the baby. Just hate the feeling that my body is giving up / failing me, and after only 2 pregnancies!! DH is being v good - was feeling v down about it and distinctly unsexy (if you can imagine feeling more unsexy than you do at 40+ weeks!).He's been v reassuring and has reminded me that it's not life threatening to the baby or me at least plus it seems there's a good chance of recovery....... I'd love to hear from anyone that has experienced this. Is lifting ok? DS is nearly 2 and quite heavy - had the distinct feeling this morning when lifting him that it wasn't helping the symptoms, if you know what I mean!

Why is it that when I read anythink that says Pelvic Floor - I squeeze in, but didn't when I was pregnant - and can't get into a complete habit of doing it - I am considering the cones - I will let you know if I actually do - I could do with a workout since I have packed in the gym to save money!

Elderberry - I still have a mild prolapse from my last birth (3 days long - oh hell) and am now 23 weeks pregnant just 18 months on. I realised all was not right fairly early on - I felt I was walking around with a tampon half coming out. My GP said do the pelvic floors (I try to but am like everyone else, either forget or never finish 'a set' etc) and see how it went. It didn't get worse but it didn't get a whole lot better and as soon as I got pregnant, well... Anyway, I was refered to see a gynaecological physio who reasurred me that I was doing the pelvic floors right, just need to to do them. I have tried and tried but always forget! Am seriously considering buying one of the cone thingys - by the way, did anyone see the ad for the becontent thing that sponsored the Tip of the Day on Mumsnet about 2 days ago? Is it the same as the cones? Didn't look like a cone but involved holding weights inside. It said 'not for use during pregancy'. Is that because it is dangerous? Or just that your muscles and tendons are so loose during pregancy that it wouldn't work? Anyone know?
Great thread this.

Hi Cha
The symptoms you describe are similar to what I have been feeling and like you I've been told to keep doing the exercises and like you keep forgetting!! It's just not the first thing I think of - but I guess I am going to have to think of some way of building it into my daily routine, like brushing my teeth (maybe while brushing my teeth!) Perhaps we should have a mumsnet pelvic floor excercise group?!!!!!!

I had a look at the becontent site yesterday but I think it said somewhere not suitable for vaginal prolapse and not in pregnancy. I presume because things are already under pressure without giving it an extra workout? Also looked at a cleo discreet website mentioned below but found it a bit confusing - couldn't really figure out if it is suitable - so thought I would wait to see the physio and ask their opinion.

On one of the threads someone seemed to be saying that the gynae physios have some kind of electronic stimulus type thing which seemed to be along the lines of the cleo thingy. As I am now 4 days past my due date I expect I'll be having the baby before I get to see the physio!

Am a little daunted / worried that this will complicate things and would be glad to hear from anyone who has delivered with a prolapse. The midwife did say that in some cases an episiotomy may be recommended (eg if baby is pressing down hard against the prolapsed tissues) but that it is questionable (cutting into weakened tissues only creates more weakness). Also the obstetrician didn't seem to think this was necessary and that I should be able to deliver in a fairly "natural" way. I am booked in to the local midwife unit - no doctors on hand - hence my being a bit daunted!

Good luck with it all - I'm sure it will be fine. I think once we've delivered, then things can start getting sorted out. I'm definitely not having any more after this one and have an appointment to see the gynae 3 months after the birth where s/he's going to see if I need an op or whatever else there is out there. Got to be better than pelvic floor exercises anyway!
I think the thing is to try not to worry about the birth - there's nothing we can do about it anyway. Worrying certainly won't help things. Just try and 'enjoy' (ho ho) the birth - really hope it all goes well. Keep posting anyway, so as we know how it went and what you had!

Back again with a lovely healthy baby boy. He was delivered weighing 7lb 14oz on Sat morning after about an hour and a half in the birthing pool. We're really happy with the way everything went, no stitches required and no complications as a result of the prolapse. Now that he's been delivered everything seems to be getting better down there and I am doing lots of pelvic floor excercises so hoping that everything will right itself. The doctor seemed to think that if I work hard enough at it there is no reason to rule out a third baby if that's what we want.

Good luck with yours and let us know how things go! When are you due - mid September?

Message withdrawn

Congratulations! (odd to be posting congrats on a pelvic floor thread but never mind )

congrats elderberry!

Anything can happen - after my first baby my pelvic floor was all over the place and I had a lot of difficulty getting it back into shape, despite crunching away like mad both during pregnancy and after, yet after number 2 was born it seemed to sort itself out with minimal help from me. I've just bought a 'cones' thingy to try and get that last bit of fitness back.

Thanks for the congrats - am still in baby heaven - and foolishly looking at mumsnet at 11pm at night!!

Milch - how are you getting on with the cones thingy? Would be interested to know what you got / where from / if any good as I am not being as diligent as I should be with the pf excercises - thinking maybe if I got something like that I'd have more incentive to do it!

Bron - every little helps, I believe - do keep doing the exercises even if you can only manage a small "squeeze". Hope others can help you more.

Elderberry - confession time - I haven't tried them yet. 'Mental' block, I just don't look forward to stuffing things up in there, if you see what I mean. Also, you have to be standing up for up to 20 minutes with them inserted, and the only 20 minutes privacy I have is when both kids are napping at the same time - on which rare occasion I grab the chance of a lie-down myself! I need to motivate myself.