Prolapse and pregnant

[bloomety]

I am currently 12 weeks pregnant. I have a grade 1 bladder prolapse after a forceps birth with my son. I've not been given any advice by my midwife about how to avoid making it worse. Has anyone been in the same position?

I'm worrying about the birth. Should I go for caesarian to avoid making it worse? Avoid an epidural again (as thats what led to be nor being able to feel where to push and thus forceps)?

Sorry no advice but am in almost the exact same position. 14 weeks with uterine prolapse from previous birth- although my birth was "easy" with just gas and air. For various reasons I've not even seen (or spoken to) a midwife yet, and not sure what, if any advice I'll get.

I don't have a grade for my prolapse - it was looked at by a physio who just said it wasn't too bad/ was 'manageable', but that as I'd seen her first thing in the morning, ie, hadn't been on my feet all day, that it was just what she could see at the time. Mine also isn't reversible with pelvic floor exercises but they may help, so I'm cranking those up.

In the last week I've just started feeling it more and am trying not to pick up my toddler too much (impossible!), and even short walks are making it worse (really not good for my fitness levels).

All I've found from googling is people saying that doctors told them to come back when they were done having children, but not what to do while carrying a whole heavy baby inside you! Oh and a couple of scary articles about miscarriage that I'm just ignoring.

If I get any answers when I eventually see a midwife, I'll update you with what they say. The only thing keeping me positive is that it seems prolapses are very common, just not often talked about, and so there must be many many women going through pregnancies with existing prolapses.

Have you thought about seeing a private gynae physio? I did after my 1st and found it really helpful. I hadn't thought of it while pregnant, but having felt my prolapse a lot worse this last week, I might see about making an appointment with her again. So much more knowledgeable than a midwife or GP. My last appointment was somewhere between £50-£80.

Good luck with it.

I had my second by caesarean for this reason OP, and I’m so glad I did. They tried to fob me off and to tell me that the pregnancy can make prolapse worse regardless of birth, which is true, but vaginal birth is a big additional risk factor. There is a clear association between vaginal birth and prolapse.

Obviously there are downsides to a caesarean (especially if you want more children), but if your priority is preventing making your prolapse worse, as mine was, a caesarean is worth considering.

To minimise damage from the pregnancy, just do loads of pelvic floors. I used the Squeezy app 3 times a day. I felt ruined after my first birth but feel no different after my second,

@bloomety I have a bladder prolapse from my last birth? I'm currently pregnant and my midwife told me it would likely be a vaginal delivery but has referred me to a consultant to discuss it, however another midwife told me it's likely to be a c section. I can't find any information on this and it's really stressing me out. This is my last baby so happy either way I just don't want to cause more damage. TMI but when I push when going to the toilet my bladder pops out so surely a vaginal birth is going to cause a lot more damage?

@ChocBeforeCock where did you find all of your information on births with a prolapse?

@Lollol86 I know it's stressing me out too. No one seems to care. Yes I'd have thought pushing would cause more damage too, especially if your bladder is coming out already when pushing.

@bloomety the lack of knowledge, considering how common it is, is really frustrating xx

I know. I can't help but think if it was a problem men had then there would be a lot more support out there

@Lollol86

I’m quite lucky because my husband is a doctor and so was able to find and explain research papers to me. He is a surgeon and was also able to counter the consultant about the risks of surgery, which were basically made to sound as awful as possible but actually for me - a first caesarean, planned and low risk for surgical complications - they were relatively small (but still there and important to take seriously obviously, but not the 5x greater risk of dying that was given!)

I also had pelvic floor physio and she told me that a section won’t prevent prolapse but it will reduce the risks, which sounds sensible to me.

One of the downsides of a caesarean is that it can affect future pregnancies so if it’s your last birth that’s relevant. What do you prefer, birth wise? What I was told is having a prolapse doesn’t affect the chances of me safely delivering the baby, so they wouldn’t necessarily recommend a caesarean. However if your concern is your prolapse then you might prefer a caesarean because a safe delivery with a worsened prolapse isn’t a good outcome for you. Be aware that the consultant may try to push you into vaginal (they may not but mine did and from MN that seems to be common) so I would be clear about your preferences before going to the meeting. Be clear about the effect that the prolapse has on your life. I hope your trust allows a companion to this meeting?

An example of the kind of papers I read is below:

www.ncbi.nlm.nih.gov/pmc/articles/PMC3877300/

(I just read the abstract!)

@bloomety

I know. I can't help but think if it was a problem men had then there would be a lot more support out there

YES!!!

@ChocBeforeCock Thank you for explaining further. Well I would prefer a c-section to minimise any further prolapse problems, however, I know that it will leave me bed bound for days and I may get an infection. I just don't know if it's the easy option as I might be left worse off after the birth and have to care for a 3 year old and a newborn then.

I don't want any more children so thats not a concern.

With my son's birth, I was induced with the drip and the midwife turned it up every half an hour. The pain was so bad I had to have an epidural. With the epidural, I couldn't feel where I was pushing, yet I was pushing as hard as I could for a long time. They said babies heart rate was going down, so then it was forceps to get him out. I don't know if it was the forceps or the pushing that caused the prolapse. Either way, I'd prefer this time to have a natural birth with gas and air. I'd hope that childbirth without induction would be bearable to me so that I wouldn't end up down the epidural path again and thus further damage. I don't know that though. Maybe it would still be unbearable for me. That's why I can't figure out whether to go vaginal again and hope I manage without an epidural, or go straight for c-section.

Also @ChocBeforeCock, have you considered surgery? My GP said I couldn't get it until I had all my children. Although, form what I have read, it's not worked for a lot of people.

I was recommended this podcast about prolapse and childbirth whymumsdontjump.com/
and found it really helpful to understand more about what had happened to me (prolapse following a long second stage of induced labour and forceps delivery).
Hope it helps someone else too.
I completely agree that if this was a problem affecting one in four men there'd be billions in funding and a government task force!! Instead it's just women left trying to figure it out themselves.

I think @ChocBeforeCock has explained it very well above....if your priority is not to make the prolapse worse, then push (and be adamant about) your wish for a caesarean). However, if you want to try for a “natural” birth, or are worried about complications from a caesarean, then go for a natural birth. Basically it’s your choice and don’t let anyone else make it for you.

Personally in your shoes I would go for the section, as I wouldn’t want to risk making the prolapse worse.

Thank you for for all your info ladies it's been very helpful. This is my last baby so just want them here safely.
I don't want to cause anymore damage and feel it's likely I'm going to have a battle on my hands. When am I likely to discuss this with a consultant? I'm 16 weeks currently, haven't had an appointment as of yet x

I also have a stage one prolapse after my first (forceps) birth and am now pregnant again.
I requested a consultant appointment to ask for a c section and one was arranged for just after my 20 week scan and the consultant approved my request immediately! I was a bit shocked as I had heard they can be very reluctant. I had prepared my 'argument' first and knew that I could be referred to another consultant if they wouldn't agree. Ultimately, it's your choice (and right!) to have the birth you want.

@bloomety what was your outcome in this? I'm now 24 weeks pregnant and have see. A consultant but they really wasn't very helpful and just said it's my decision. I really don't know what to do 😭😭

Did any of you find your prolapse has got worse? My cervix is like a grade 4 now and I'm 11 weeks 😭 was a I would say a grade 2 before pregnancy. Going to gynae tomorrow hoping they will offer me a pessary 🤞

Jumping into an older thread, but has anyone any updates on this or experience? I was told that my cervix is low lying, and I'd need to be careful as prolapse is a concern. I'm in the early stages of my second pregnancy, so on top of hoping that everything goes well, I'm trying to gather as much information as I can regarding prolapse, birth and what others have experienced. Would love to hear if people were willing to share x

I can update on my situation so far:
Currently 38 weeks pregnant with baby 2. DD was a forceps birth after a very long induction and I had a uterine prolapse.
It felt 'heavier' during weeks 10-20 of my pregnancy this time but actually hasn't got worse and I can't 'feel' it currently. It certainly hasn't progressed to a more serious prolapse during this pregnancy.
Consultant was very understanding and I will be having a planned C section in two weeks.

Thank you so much, that's reassuring! I know I'm getting ahead of myself thinking about the birth already, but I want to feel that I've made the best decision I can.
Glad your prolapse hasn't gotten any worse and hope all goes well with the birth ❤️

Thank you @Lilkat
Good luck with your pregnancy!