Postpartum prolapse

[Stilltobeseen]

So I'm 4 weeks postpartum with my second baby. First birth I had a forcep and episiotomy delivery but recovery was fine and I got my fitness back, worked out majority of my second pregnancy etc. 2nd birth was ridiculously fast, 8lb baby, all natural ended up with a 3rd degree tear that needed sutured in theatre.
Since the swelling etc has went down and my stitches seem to be dissolved externally anyway I've noticed internally a bulge and that my insides feel like they are going to fall out. I felt OK until I caught this wretched cold which has me coughing constantly nonstop and I feel making whatever is going on in there worse. I'm trying to clench before I cough to minimise the pressure, I'm also doing my pelvic floor exercises etc and do have a pelvic floor physio appointment in a few weeks.
I'm freaking out though. Has anyone got any experience of a prolapse postpartum that resolved itself etc? I'm not sure what's normal and what's not because I never had this the first time, I think because I had assistance so the pushing stage wasn't overly terrible or long. This time it went so fast, 6cm, my waters broke and I needed to push almost instantly and then he was out within 15 minutes so a lot of trauma happened down there including a pp haemorrhage.
I'm feeling really down about it and worried what this means for my future.

I’m so sorry, that sounds really tough. No one here can tell you what the future holds. A good women’s health physio will be able to advise - they can assess what kind of prolapse it is (eg cystocele or rectocele) and then work with you to find what exercises/visualisations work best to use those muscles (and also relax them, as counterintuitive as it might sound). 4 months postpartum is still fairly early and obviously your prolapse has worsened because of your coughing. It will improve again when your cough resolves and when you have had good pelvic floor advice. Good luck x

@Stilltobeseen just wondered how you are now? I am 3weeks pp and had a similar birth and possible prolapse. Still waiting to see physio to diagnose. Thanks

@Honeycomb245
Hey, so I'm now 6 months postpartum. I was assessed by a women's physio and she could tell that I had a rectocele but didn't think it was anything too severe. I have however noticed that the symptoms (pelvic heaviness, stuck tampon feeling, lower back pain) gets worse around my period and then gets better after it's over which is common. I'm learning what makes it worse/better and just trying to cope with it. For a rectocele they give you advice on how to use the toilet properly (squatty potty etc), to avoid constipation and how to assist yourself manually to complete a full 'elimination' so to speak which is what a lot of people with a rectocele struggle with. Thankfully I've been ok in that department thus far. You also have to tailor your workouts to fit. The old advice was pretty bleak on what you could do and not do with a prolapse in general/depending on its severity. Advice is much better now and I would highly recommend a women's health physio to go over everything with you properly. They also checked my pelvic floor and I found I actually had an issue with relaxing it as opposed to it's strength, I was also not performing kegels correctly even though I was SURE I had been. Nope. I also have one side weaker than the other.

That's a lot of info and it's not even everything to know but a professional doing an assessment on you if you're first step.
Oh and I've just stopped breastfeeding about a month ago and was told that it can take up to 6 months after that for hormones to balance out, and quite often women see improvements when they stop BF. Can't say I've seen much difference yet but still early days.

Biggest thing I'm trying to do is come to terms with it. I may never run again (like treadmill/5k) because it may make my symptoms worse. I likely won't lift super heavy weights again at least not without LOTS of physio, maybe a pessary but patience and accepting other exercise exists helps. But lots of women do! It's so individual.

@Stilltobeseen thanks for replying. I'm glad to hear you're doing better. Sounds like recovery is slow, but positive that it's moving in the right direction.

I have physio in 5 weeks time, so just practicing kegels until I can get more specific advice. I am keen to make sure I'm doing the exercises correctly. Were you ever reviewed again to check for improvement with the prolapse? Or have you just been happy with the improvement with symtpoms and left it at that?

@Honeycomb245 I have to make another appointment to see where I'm at as I missed my last one due to illness.
You're still so early postpartum though so be kind to yourself in the interim

Hi there. Just thought I would share my prolapse story. Bit long! My son is now 18 but was a large baby (in proportion to me) and the birth was long and tricky. Left me with a vaginal prolapse which was uncomfortable and embarrassing but you just carry on don't you? Life is busy and it's amazing what you can put up with. Was referred to a continence clinic after the birth of my second child and spent many years doing pelvic floor exercises with a machine and without. None of it worked. Couldn't use tampons anymore as the prolapse pushed them back out.
Joined a gym to improve my fitness, loved exercise for the first time in my life, high impact classes and weight's but oh boy, made my prolapse 10 times worse.
Menopause at 44... after 5 years of no periods, went onto HRT and had some bleeding so was referred to gynae clinic to double check nothing sinister. Was just a cyst but whilst I was being examined, my (brilliant) consultant mentioned my awful prolapse and said that prolapse repair was her specialty and would I consider surgery to fix it? It would include a vaginal hysterectomy to do the job properly so a lot to take in. I've never had elective surgery before so was nervous!
I said yes and after 2 years on an NHS waiting list, I had a vaginal hysterectomy and perineorrhaphy about 8 weeks ago and I'm so happy. Healed quickly and the difference to quality of life is amazing, no more rushing to the loo for a start. 'Shelf life' of this kind of repair is 20-30 years.
Whilst I was on the waiting list, I tried a pessary but my prolapse was so bad, it just pushed it out after 2 days!
I am still not 'allowed' to do high impact sport or lift weights though, it will undo the surgery quickly. I am going to try Pilates, Yoga etc which is encouraged and safe. I also have to do pelvic floor exercises still and I use the NHS Squeezy app for that.
OP, you are very early days post partum but I just wanted to flag up this option and make you aware of it for the future because for 14 years, it never crossed my mind to have surgery. No one ever mentioned it, even when they couldn't do my smears because they couldn't find my cervix anymore ( prolapse blocking it). Even when it was obvious that pelvic floor exercises weren't working.
Of course I was also post menopause so a hysterectomy seemed reasonable to me. No more chance of children anyway.
I was lucky that I saw an excellent female gynaecology consultant that day for that cyst appointment and she is an absolute advocate for women's gynaecological health and quality of life post childbirth. She did my surgery too.
I also think that now my kids are older, I have more time to look after myself and I took the time off work for the surgery, I make sure I do the pelvic floor exercises and I will do the Pilates. When your kids are young, you tend to put your needs last and you have no time for anything else!
Sending best wishes OP.x

Thank you for sharing @BettyBlue50 something I've noticed is the lack of conversation on the topic and how little women really know (especially those going through pregnancy and childbirth). It never even occurred to me, I was so concerned with tearing that prolapse wasn't even something I thought about. Thankfully at the moment mine isn't too severe but what I have learned is how common it is!
It's also common apparently to be asymptomatic and have no idea you have a prolapse until menopause. Honestly the education I've had since this occurred has been vast and it makes me sad people don't talk about it more.
For reference I'm actually a theatre nurse and have assisted in prolapse surgeries, pessary insertions etc and it STILL didn't occur to me that it could happen to me. Wild how little time and money is put into women's health research and education.

Hi op hope you're doing well.
Can i just ask does your prolapse feel lumpy? I'm having similar issues but can't get far with doctor google.

@Doyouknowdanieltiger mine doesn't but I have heard that it can, particularly a rectocele. YouTube has some really great information on it as well.