Pregnancy and prolapse - what to expect when you're expecting (and have prolapse)
If you have pelvic organ prolapse and you’re wanting to expand your family, the thought of pregnancy and birth with prolapse can feel very daunting. As a strength training and pelvic health specialist working with pregnant and postpartum women, I’m here to guide you through what to expect and how to navigate this journey confidently.
Understanding pregnancy and pelvic organ prolapse
While research on pregnancy following a prolapse diagnosis is limited, current evidence suggests encouraging news: it’s typically the first birth that causes significant pelvic floor changes, rather than subsequent births. A key study examining the difference between women giving birth vaginally once versus multiple times specifically looked at levator ani injury and anal sphincter tears, offering valuable insights for those considering pregnancy after prolapse.
Trimester by trimester changes
First Trimester
During early pregnancy, you may notice a temporary increase in prolapse symptoms. This isn’t necessarily due to worsening of the prolapse itself, but rather several pregnancy-related factors:
- Morning sickness creating sudden changes in intra-abdominal pressure
- Pregnancy fatigue affecting your usual pelvic floor management routine
- Hormonal changes leading to constipation
- Increased stress and anxiety, particularly if you’ve experienced previous pregnancy losses or fertility challenges
Second Trimester
Many women experience welcome relief during the second trimester, with:
- Reduced morning sickness
- Increased energy levels
- Greater emotional stability after passing key pregnancy milestones
- Often fewer prolapse symptoms, especially if you were asymptomatic pre-pregnancy
Third Trimester
As your pregnancy progresses, you may notice:
- Changes in core and pelvic floor muscle coordination
- Increased challenge in everyday tasks
- The need to adapt your support strategies
Managing prolapse symptoms during pregnancy
Your prior experience with prolapse symptoms can influence your pregnancy journey. Factors that may affect symptom levels include:
- Pre-pregnancy symptom levels
- Sensitivity to hormonal changes
- Overall activity levels
- Stress management
- Sleep quality
- Previous birth experiences
Prolapse pregnancy tips for a safe pregnancy with POP
1. Professional support
- Schedule regular check-ins with a pelvic floor physiotherapist
- Keep your healthcare team informed about your prolapse history
- Maintain open communication with your birth team about your concerns
2. Movement and exercise
- Continue appropriate movement – this will be on an individual basis
- Focus on quality over quantity
- Adapt exercises as your pregnancy progresses
- Work with a strength training and pelvic health specialist. who can programme in line with your body, pregnancy and any symptoms
3. Daily management
- Maintain good toileting habits, ensuring you are eating well and eating plenty of fibre eg fruit and veggies
- Stay hydrated
- Practice stress management techniques
- Get adequate rest
4. Birth planning with prolapse
- Discuss birth options early with your care team
- Share your concerns and preferences and remember you don’t need to justify YOUR choices
- Remember that each birth experience is unique
If you are pregnant with prolapse and want to continue (or start) exercising, book a Free Call to Discuss “Bump to Barbell” – Your Personalised Pregnancy Training Program
✓ Expert guidance tailored to your symptoms
✓ Safe, effective exercise programming
✓ Direct access to pelvic health and strength training during pregnancy expertise
Research and evidence
Current research supports that subsequent pregnancies don’t necessarily worsen prolapse. Key studies include:
Oher useful studies:
- Delivery mode, levator avulsion and sphincter injury
- A traumatic normal delivery – how many women get what they want?
These studies provide valuable insights into birth outcomes and pelvic floor health.
About the Author
Beth Davies is a highly experienced personal trainer and coach specialising in female pelvic health, pelvic organ prolapse, and strength training. Her evidence-based programs have helped numerous women navigate pregnancy and postpartum recovery with prolapse.
Beth has been featured in women’s lifestyle magazines and websites, including Stylist, Metro, Woman & Home and Marie Claire UK
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