Diagnosed with prolapse at 28 weeks

[Blondiiii]

I'm 28 weeks pregnant with my second child and have just been diagnosed with a grade one rectocele and cystocele. It's a complete shock as I had a smooth recovery after my first birth and saw a pelvic floor physio at 20 who said everything looked great, so something has gone wrong between then and now and I have no idea what.

I'm absolutely devestated and am now terrified of giving birth and what state I'll be in afterwards. I've literally never heard of anyone getting a prolapse while pregnant, it's always been after giving birth. Has anyone been through this and did it get worse as the pregnancy progressed? I'm considering pushing for a c section but I've been told a vaginal birth won't be a problem. I'm not getting any symptoms other than feeling a horrific bulge down there.

I have a rectocele. It developed after the birth of my first child. However when I was pregnant with second child it got much worse, was unbelievably uncomfortable by 20+ weeks and like you I went to the physio. But it was the weight of the pregnancy and the loosened ligaments that made it worse. After the birth it was much much better. I did physio and it went back to better than it had been in between pregnancies.

I am now pregnant with third child and it is starting to get uncomfortable again. So again I think the pregnancy really exacerbates it. Following on the physio's advice I am mindful of it to try and prevent too much damage - lying down briefly at moments when I can, being careful about lifting and carrying my children, doing pelvic floor exercises, doing core and glute strengthening exercises.

So hopefully it's similar for you and it's the pregnancy causing the symptoms.

Like you I debated Caesarean for second child, but I was told that it's often the pregnancy as much as or more than the birth that worsens a prolapse, so there were no guarantees a Caesarean would avoid more damage. But equally no guarantee a birth will be straightforward and there won't be more damage caused by that!

Thanks for replying @Aroundthelight. I'm glad things got better after your second birth, I've read a few encouraging stories like yours.

I'm doing the same exercises, resting and not lifting etc. so really hoping it doesn't worsen. Do you mind me asking about your recovery after your last birth? Were things initially pretty bad before they got better and how long did it take to feel "recovered"?

Good question and wish I could remember! I can't remember the timeline for recovery but was definitely worse before it got better... I did take the first two weeks to hardly do anything, as with the first I had started going for walks way too soon and so last time was more gentle. In the first few months it was definitely a lot worse, for example on an hour's walk it would be too uncomfortable and I'd feel everything might fall out! But by one year it was back to better than it had been one year after first birth, and by 1.5 years it was as good as I think it'll get. I was breastfeeding all this time and they say that loosens the ligaments, so perhaps if I hadn't been it would have been quicker?

I think the first time round I thought once the tear has healed and bleeding stopped etc that was recovery done. Whereas second time I realised that I needed months of strengthening pelvic floor and also core and glutes.

This week I had a video appointment with a physio and she said that anything that puts pressure over the hips will increase symptoms, so to avoid over the bump clothing and go for under the bump instead. Hadn't thought of this so going to try that!

I had an elective section for the birth of my second baby after developing a rectocele following the birth of my first. My consultant recommended it and signed off on it.

In hindsight I actually also think the weight of the pregnancy played a huge part, especially the second one. The prolapse was pretty bad after the second birth but I have to say now I've finished breastfeeding and baby is almost 1, it feels much much better. I hardly notice it most days and it certainly isn't on my mind the whole time like it used to be.

So.. all in all, I don't know if having the section added any benefit ultimately but it certainly hasn't got worse.

Thanks for sharing your experiences, I'm glad things worked out well for both of you. I'm so conflicted about what to do, I've been told to go for a vaginal birth again so not sure I'd get signed off for a c section but I could possibly push for one. I really don't want this to get worse, it's grade 1 and manageable at the moment.

@Aroundthelight are you going for a vaginal birth again? I was the same as you last time and thought once the bleeding stopped I'd be back to normal but it took me months to feel good again and that was with no prolapse or other complications!

Yes on balance I'm going to go for a vaginal birth, if all goes well. I talked it through with a consultant last time and I think for me I felt the main reasons were that a lot of the prolapse risk and potential worsening was pregnancy itself, not just labour. I had already torn badly the first time and understood that if I tore again it would probably be along old scar tissue so damage already done (dunno how true this is!) whereas a Caesarean would be introducing new scar tissue in muscles that also affect pelvic floor. And I feel like there's the three risks of pregnancy, birth and recovery. And I'll do what I can to mitigate them for pregnancy and to rehabilitate pelvic floor in recovery, and then hope labour is straightforward... I know that I'm risking it getting worse if there are problems in labour, but I think it's a risk I feel comfortable with.

The consultant said that second births were statistically the most straightforward and I found this super reassuring! Less so this time now it's the third...

I'm going to have the conversation again though when I have an appointment as I want to be sure I've thought it all through again and weighed up the risks as much as possible.

Have you decided what you want to do? I think it's so tricky as it's impossible to know what the outcome will be!

Hi @Blondiiii @Aroundthelight !! Just found this post and wondered how everything turned out if you are happy to share? Did you end up doing VB or C section and did prolapse get worse during pregnancy and delivery? I’m in a similar situation and considering the delivery mode options so any experiences would be great to hear! Thanks in advance

Hi @FreshMintTea I recently had a vaginal birth again for my third. It's been pretty similar to the second : prolapse definitely worse now than pre pregnancy for now but I'm working on it. I am confident that with rehabilitation it will go back to how it was before this pregnancy, because it's no worse than it was after the second birth if that makes sense!

Hope you're able to work out the right thing for you, it's so hard to decide when you don't know what will happen and there are so many variables!