A study by Sze in 2002 found that over 80% of new mums had some prolapse present when assessed at 6 weeks. I’m not saying that this means postpartum prolapse is normal but is very common. Perhaps normal or abnormal (or dysfunctional) are the wrong terms (but so often get chucked around). Instead, it can be useful to think about why there may be some degree of prolapse for new mums. When you consider ALL the changes that have occurred throughout pregnancy, birth, and the initial postnatal period, it may seem unsurprising that prolapse is so common.
Changes to the pelvic floor during pregnancy & birth
There are a number of physiological changes that occur during pregnancy and birth.
- growing weight of baby can place downward pressure (on to the pelvic floor) and cause muscles to lengthen and potentially weaken
- changes in posture particularly during pregnancy can change how well you can “access” your pelvic floor muscles
- there is a rapid drop in estrogen post birth and during breastfeeding (estrogen is important for healthy pelvic floor muscle tissues)
- stretching of the pelvic floor muscles during delivery
- there may be damage or trauma to the pelvic floor muscles, tissues, and ligaments which can affect their ability to function (even with a vaginal delivery requiring no assistance such as forceps or ventouse)
- the long pushing phase of labour
- scarring from tearing or episiotomy can affect blood flow and healing
5 ways to improve postpartum prolapse
If we view some organ descent as common, and the experience of many versus a few, it can help build a better strategy for postpartum healing and improved pelvic health.
Here are 5 ways to help improve symptoms of postpartum prolapse
Managing bowel and bladder habits
There is a reason people talk about that first bowel movement after giving birth! Creating an “easy elimination” is a great idea not just for the first poo but as a long-term strategy to avoid straining (and extra downward pressure on a recovering pelvic floor). This may be even more important if you have a rectocele (bulging of the rectum into the vagina).
Here are some ideas for reducing constipation:
- eat nutritious food and eat enough – the body is in recovery mode and quality food and calories are important. The early postnatal period is not the time for rapid weight loss, juice cleanses, skinny tea or any of that diet BS. (I would be cautious of anyone suggesting weight loss for new mums, calorie counting, or using phrases like burn off your baby weight).
- the postnatal body is a thirsty one! Drink plenty of water, even if you aren’t breastfeeding or pumping, and go to the loo regularly.
- relax the pelvic floor muscles and take time to fully void.
- elevate your feet when you have a poo. Changing the angle that you go for a poo helps to make it an easier elimination.
Strengthening the pelvic floor muscles
Knowing where you are in your recovery is SO useful! A great way to do this is to see a pelvic floor physiotherapist. (in this blog, I talk about 3 reasons to see a women’s health physio and some recommendations for women’s health physio’s in Warwickshire). They may suggest pelvic floor exercises or some gentle rehab movements. The reason I suggest seeing a physio is that not all pelvic floors are weak. You may have one which is holding too much tension and may need more relaxation work before strengthening.
Looking at your breathing tendencies
We breathe over 20,000 a day! The pelvic floor (as part of the core) works with the diaphragm, and deep abdominal and stabilizing back muscles. Like an awesome team! When you inhale the system relaxes, expands, and lengthens, and when you exhale, it contracts, creates tension, and draws in and up. Here is a fantastic image from Burrell Education that illustrates this brilliantly.
Pregnancy, birth, and pre-pregnancy posture (and all the sitting, cuddling, and feeding) can influence how you breathe (it may become less coordinated). So, re-establishing a breathing pattern is a great starting point and can help you get more “access” to the pelvic floor muscles.
Managing pressure to the pelvic floor
At a time when the pelvic floor may be more vulnerable, it’s worth thinking about managing pressure. One of the jobs of the core (as seen above) is to manage intra-abdominal pressure. Extra intra-abdominal pressure can come from lifting, baby-wearing or exercise that may not be totally appropriate (plus, loads of other things!). Learning to lift well is important during this early stage. It’s not about avoiding everything but understanding that you are not invincible.
The recovery mindset
This can be a tricky one! Especially if you are feeling good after having your baby and not experiencing any symptoms. Taking time to return to movement is really rewarding! If you are experiencing prolapse symptoms, even if you haven’t had a diagnosis, taking time to rehab your whole body including your pelvic floor can help keep you moving, get stronger and more confident.
How I can help if you have postpartum prolapse
I offer both face-to-face and personalized online programming if you are experiencing postpartum prolapse. These gentle sessions and programmes slowly build your strength (both pelvic floor and full body), as well as provide strategies for lifting and everyday activities. You can find more here or if you would like to chat, you can book a free 15-minute call here