Mild prolapse after first baby

[MyGrassIsBrowner]

Hi all. Apologies firstly if this wangs on a bit but I'm looking for some advice/expreriences.
So I'm fairly certain after my DD I now have a mild prolapse, my guess is rectocele with how it looks down there now. I had it checked at my last smear and the nurse said everything looked fine, but obviously the way a was lying on the bed, everything was fairly compressed down there so I feel like she didn't see the true appearance of it. I have no major symptoms per se, no issues with my bladder or urinating, I do sometimes get a bit constipated but I am currently 17 weeks pregnant again.

I had a really quick first labour, 4.5 hours on just gas and air and birthed in the pool on an MLU. I had 2nd degree internal tearing and it honestly took me months to finally be able to sit down without wincing.
I am hoping for a homebirth this time round, but I am also wondering if having another vaginal birth could possibly make my prolapse worse? Have any of you ladies had similar experiences after prolapse? I am obviously going to ask my MW these questions but as this is my second baby, she said that my next face to face MW appointment isn't until 28 weeks which just seems like an eternity away. Am I able to request an elective C-section? I am in the UK for reference. I am quite torn at the moment as I know C-section recovery can be tough but I also would be devestated with possible long-term effects from more trauma to my lady bits. I do my pelvic floor excercises daily as told by the Health Visitor but I am getting increasingly anxious as my pregnancy progresses.

Any help or advice/experiences would be very much appreciated! X

Jesus christ apologies for my shocking grammer and spelling. Typing on my phone whilst running around after a little one year old monster 🙈

Watching. I had the same as you after dd3 and am now pg with no 4. I have always been rubbish with pelvic floor exercises so really need to do them.

I'm sure I read somewhere that it's pregnancy that will effect it, not how you give birth 😩

@Girlmama3 Sorry you're suffering too! For me things just dont feel right down there anymore and I'm over a year PP. Do you have any major symptoms?

I'm 2.5 years after and it almost feels normal now. It did take a while. I'm expecting it this time. I'm going to do pelvic floor exercises religiously!

I have a rectocele too. It started 20yrs ago after my 1st birth. (3rd degree tear and episiotomy, back to back baby) and tbh I got to used to it I didn't really realise it was abnormal. Like I have always had to hold a pad/loo roll to my perinium in order to empty my bowels fully. But only got it investigated between my 3rd and 4th.

I've gone on to have 3 further babies vaginally (all larger babies) and tbh whilst it hasn't got better, the damage was done already and it hasn't got worse.

My pelvic floor is crap but when I do my exercises it is much better. I plan to have DC5 vaginally in June. I've had a second degree tear after dc2-4.

Ive heard the same as @girlmama3 that it's pregnancy itself rather than the type of delivery. I'm 41, overweight, have carried 5 babies and those are all things effect it too..so at 35, when I was a healthy weight, my pelvic floor was far better, but I still had the rectocele and at that point had had 3 large babies.

@BurningBenches Thank you for sharing your experience with me. It certainly gives me a bit of hope. My DD was 8lb 6oz back to back, she wasn't the biggest baby ever but also not small by any means.

My bmi is 30.5 this pregnancy, I was much MUCH smaller before my DD bmi of 24 so I have piled on a bit of weight since then and I am watching what I eat now. I am being sent for gestational diabetes test at 26 weeks with my BMI being over 30 so hoping that will come back clear as I'm anxious about that on top of everything else at the moment.

I have on occasion had to do digital removal during a difficult bowel movement as I'm scared of pushing too hard and causing further damage. I can generally feel the bulge on my back wall when I push for a BM at the entrance of my vagina which leads me to believe that it is most definitely rectocele.

Can you get a referral to a pelvic floor pt? Most hospitals can link you in and prolapses are their thing, they will be able to access your pelvic floor too and advise you on how best to go forward!!

@MyGrassIsBrowner yes I've been there too. I always ask for glycerine suppositories post birth as I have the fear! I guess I'm used to it now and aside from being awful if I'm constipated it doesnt feel like it effects me. My bladder weakness does, but I'm so incredibly lazy!

Dd1 was 8lb11, and the others 8lb15, 9lb10, and 9lb5. I've been sent for GD tests with 4 and 5 and thankfully both clear so far. I just grow big ones. My BMI is 32 this time (was same with #4) but 1 I was a healthy weight and 2 and 3 just overweight.

I would definitely speak to your MW and perhaps try and speak to a physio?

Of course you can gave a c section if you want to. You just need to request it.

@BurningBenches I remember the absolute horror that was my first BM after birth, I let myself go a whole week without having one and I was in bits but I was so fricking scared. Sat on the toilet for an hour sweating and panting until I finally had no choice but to manually remove so I will bear the glycerine suppositories in mind. I remember sending my DH out for a bottle of lactulose and I nearly necked the full thing in hope that I would finally give me some relief 😂
There's a history of big babies on my mums side, my auntie having two 10lb babies vaginally but she breezed it and has had no lingering effects whatsoever.
I'll get onto my MW as I have a lot of questions I need to ask. It seems that it can just go either way having another vaginal birth with regards to the prolapse worsening or not but I need to weigh up my options of c-section over that potential risk I guess. My main fear is a life of incontenence or bowel issues, I know it's a bit far fetched but it would just devestate me.

@ChikiTIKI Thank you, I haven't done much research into elective c-section or what the requirements are so it's something I need to get onto my MW about.

Almost the opposite to you, i also have a prolapse after dc1 and am currently fighting the consultant who wants me to have a section - I'd rather have a vb! (I have major anxieties about a section) So based on that an elective section seems a valid request.

A tricky thing might be that women's health physio may not do much with you if you're pregnant, mine discharged me to "do kegels" until after the birth. But it's definitely worth asking for a referral.

@KitchenWarrior What grade is your prolapse? If your prolapse is bad I would be be inclined to definitely go for a c-section but then again I have never had an operation in my life so I can totally understand your fear. Chosing a section over a VB would be a big decision for me as I really dislike hospitals and I know I'd have to stay for a while afterwards which is the total opposite to what I wanted this time as I wanted a home birth. I'll also be really scared when my partner has to leave. So I'm utterly torn and it certainly wont be a decision I choose lightly.

I didn’t have a confirmed prolapse, but had a weakened back wall, verging on rectocele. I’ve been reading a good book by a pelvic floor physio called ‘why did no one tell me’ by Emma Brockwell who had a prolapse. I’m pregnant with my second and things feel very heavy down there already (only in second trimester at the moment)...last time I felt heaviness and bulging in the last few weeks and giving birth made things worse, but not by much and with a physio things were almost back to normal. I am hoping for a home birth this time, but am worried that prior to giving birth I’m going to have a terrible prolapse and it’s definitely pregnancy that makes things worse for me. However, I did read that each pregnancy can only worsen a prolapse slightly (10 percent chance of having one with subsequent births) and that most damage is done through your first pregnancy and labour. I’ve read a lot of stories that have said similar.....and the GP also told me a c section doesn’t necessarily prevent prolapse as it’s often pregnancy related

@Lenny86 I feel like I am in the complete same boat as you on this one. I will definitely have a look at that book you recommended. I've also read that c-sections aren't guaranteed to prevent prolapses from worsening which is making me wonder if I just try for a homebirth anyway and hope for the best. I've fantasised about a homebirth after my last birth and I'm currently under the homebirthing midwife team in my area so I'm well prepared for that avenue. However I know things can change. My first labour was so quick and I definitely didn't listen to my body and pushed at times when I shouldn't have. I've been reading a bit on hypnobirthing and breathing techniques so I'm hoping that may help me through it this time, plus I know what to expect this time.
How far along are you? I'm currently 17+4, haven't felt any movements from baby just yet.

mygrassisbrowner grade 1-2 cysto and slight recto. I too subscribe to the theory that most of the damage is done first time round (had a very fast induction).

My gynae consultant had been trying to persuade me to have repair surgery before second baby and have a section with the repair in place. Ultimately I'm headed for repair surgery either way so think i might as well have the vb I'd prefer first (all being well).

Also due to covid I didn't really fully explore the improvements that I could have made with early referral to a good physio. I did make a lot of progress, felt I'd got to a really good place physically despite the prolapse and that recovery seems entirely possible a second time.

It's such a personal decision isn't it.

I did hypnobirthing etc last time and although my birth ended with ventouse and episiotomy the actual birth didn’t do much more damage - I think it’s because I refused to push - I said to the midwife during labour that I thought I already had a prolapse and didn’t want to do coached pushing. I joined the home birth uk support group on fb and that’s got so many amazing home birth stories for second time mums - I am just hoping my body does everything without any coached or forced pushing. I’m 22 weeks now - feeling the baby move quite a lot now, but was quite anxious as everybody kept saying I should feel them really early...think it was around 19 weeks this time

@KitchenWarrior Wow, I'm suprised they recommended even looking at corrective surgery before you have finished having babies. From what I've read it's fairly redundant as the pregnancy could reverse the surgery essentially. I do hope you get the VB you want this time and that it causes you no further damage. I'd definitely look at the physio route also before any decisions on surgery, if you could avoid surgery - massive bonus!
It's the recovery from gynae surgery that really turns my stomach. I'd be too frightened to do anything in case my stitches came undone. My first PP poo was traumatic enough 😅

@Lenny86
Sorry to hear you had a bit of a rough ordeal with your first birth. I have stated both times now that I refuse any instrumental intervention unless it was a total life or death situation. I had a call with the MW at 14 weeks and she asked me if I was feeling flutters and I was like surely it's too early.. so she said well it's your 2nd baby so it's possible and of course, that set the bloody panic in for me straight away 🙄

I have 3 DC, all vaginal deliveries. All over 9lb. I’m 8.5 stone, so no additional weight. I have a slight prolapse. I’ve probably had it since baby 1, but I only got diagnosed (privately, via a pelvic floor physio) 2 years after DC2.

DC3 didn’t make it any worse.

I do suffer from stress incontinence which really affected my confidence, but I have now started to wear a pessary while running and it has made such a difference. It’s not what I wanted, but I do hope that it and continues pelvic floor exercises will help to lessen the problem.

Reading with interest OP as this is something I worried about alot too. I've always gotten awfully constipated and it worsens with pregnancy which feels like it puts a strain on me down there, although I have no symptoms either, I do feel like things feel different.
However I would say that I had a home birth with my second and it was a brilliant choice, in terms that I was so relaxed and had no tearing at all despite dd being 9lb8. So maybe a home birth would help in that respect so you could be more.in control of your pushing and so on! I'm also 18 weeks with my 3rd and can see the appeal of a section from this aspect!

@Luckystar1 It's good to know in your experience your prolapse didn't get worse with subsequent births, that gives me a bit of hope at least. I have looked into pessaries too, but I dont think my case is servere enough to warrant one at the moment.

@mamamalt
Thanks for sharing your experience with a homebirth! I too am thinking that being in the comfort of my own home may help me be absolutely in the best place mentally. It's my home and it's where I feel most at peace. I'm lucky that the hospital is pretty much round the corner from my house so if I had to rush off in an ambulance, with blues on it would probably take around 2 or 3 mins to get there. Congrats on your 3rd pregnancy btw! Has your pregnancy been any different to your previous ones?
I had hurrendous sickness between 14-16 weeks with my DD but I breezed it after that. This time my sickness started very early on and lasted until I hit around 10 weeks but I wasn't vomitting, just constant nausea. All my symptoms have dissapated now but I dont know if I should be jumping for joy or worrying🙈

I really recommend investing in Kegel8 machine, it's really helped me no end.

@mygrassisbrowner no worries! Any home birth questions I'm happy to help! I loved it, also near hospital so probably helps feel relaxed!
I felt horrendous when I was pregnant with my second, I definitely put that down to her being a girl!
I definitely felt very sick for the first 8 weeks this time but more knackered. That hasn't gone away yet though so that just might be my natural state now! 🤣
I've invested in some fybogel this time to avoid incidents! I like you deffo had to manually remove in my last pregnancy it got so bad!

@mamamalt Oooh thank you, I do have a few questions actually! Did they bring the entonox to your house before you were due, or did they bring it along when the midwife arrived? Did you have a dry landing or birth pool? I had a water birth with my DD and in all honesty it was nothing to write home about so I'm thinking of just setting up shop in our back bedroom or the living room. What did you use to protect surfaces? I hear women say to buy cheap shower curtains rather than plastic sheeting from a DIY store. When did you know to call the midwife over?

Oh bless you I hope you start feeling better soon. There's nothing worse than the sickness you get with pregnancy!
I'm also going to be prepared with laxatives this time, I refuse to end up in the state I did first time round, nearly passing out on the loo cause I was too scared to push 🙈😂 x

I love talking about my home birth, I don't mind at all!.I copy and pasted as I didn't want to miss any!
Sorry if it all ends up in one lump!

Did they bring the entonox to your house before you were due, or did they bring it along when the midwife arrived? They brought it before, maybe after 37 week app? It's still here, I didn't get time to use it! 🙃

Did you have a dry landing or birth pool? I had a pool which I loved as I missed a water birth first time round! It was alot of faff though and I'm considering going to hospital this time so I can just use theirs! 😅 it was easy to set up and empty though and mess free!

What did you use to protect surfaces? I did have a couple of shower curtains I think from wilko! But also a big box of bed mats from tena, again loads left as I didn't use much as was in the pool!
When did you know to call the midwife over? I don't really remember I think I was timing contractions so called when they advised to..? Not that I can remember when that was! I may have called before that as a heads up! Midwife was only here for about 40mins before baby so we just had one, she called an ambulance just as back up and they were actually fab!

If you think of anything else let me know. The Home Birth UK group on FB is brilliant also for a browse. Threads on here tend to draw attention from the same people who tell their one awful story over and over again about how their baby would have died so not always helpful!
I'm 19 weeks now with number 3, number 2 was so quick I think home birth is probably the way forward again!