Tuesday, April 30, 2013

Vaginal Prolapse

As I explained in her birth story, Charlotte's delivery was very intense. In the midwife's words, she pretty much came "crashing" out of me. Her exceptionally fast delivery, coupled with the fact that she was extremely low during my last few weeks of pregnancy, means she basically trashed my pelvic floor. As a result, I have what's called a vaginal prolapse. Specifically, a cystocele, which means part of my bladder is sagging into my vaginal canal.

Anatomy diagram, because this shit is hard to explain

Your pelvic floor runs along your vaginal canal and is basically responsible for holding up your internal organs, including the bladder, uterus and rectum (see healthy pelvic floor on the left). When the pelvic floor is weakened or damaged from child birth, the muscles can no longer hold your organs up, which means your organs can sag into your vaginal opening (see damaged pelvic floor on the right).

Many women have a minor vaginal prolapse following child birth, but it's so small that it can't be seen or felt (stage 1). As you heal after child birth, the pelvic floor strengthens and your organs slowly pull back into place.

I have a moderate cystocele (stage 2-3) which means I can both see and feel the prolapse. I'm fortunate that mine is relatively small (the size of a nickel), and doesn't cause any pain. More severe prolapses can be extremely uncomfortable, cause incontinence, and require surgery. Although my prolapse may never completely go away, my midwife is optimistic that we can get it to stage 1 with enough rest and physical therapy.

I noticed my prolapse about three days postpartum. I had been complaining to Ben that I had a lot of pressure in my bottom following Charlotte's birth... something I don't remembering feeling when I was recovering from Will's delivery. As it turns out, this pressure was my organs sagging through my pelvic floor. A quick inspection with a hand mirror revealed a small mass at the opening of my vagina. It totally freaked me out, and I made an appointment to see the midwife the next day. A vaginal exam confirmed the prolapse, which I had already self-diagnosed with Dr. Google.

We'll have a more thorough conversation about my recovery and treatment plan at my six week postpartum appointment, but I do have some lifestyle modifications in the meantime, including limited physical activity (light walking only), a 10 lb. lifting restriction, and a daily regimen of Kegel exercises. The lifting restriction has been the most challenging, as I can't lift Will or Charlotte's car seat. But we're making do.

Even with physical therapy, my prolapse will never completely go away. As a result, my midwife has advised that we not have any more children. Another pregnancy and delivery (even c-section) would significantly stress my already weakened pelvic floor. I would likely need surgery to repair the damage from another pregnancy, and would risk dealing with a moderate to severe prolapse for the rest of my life.

Although Ben and I were seriously considering only having two kids, it was really upsetting to hear that we shouldn't have any more children. It was a decision I wanted to make for myself, not a decision I wanted to be forced in to. But we have our two sweet, healthy babies, and we're reminding ourselves to count our blessings.


  1. Sam, sorry to hear about the complication. I can absolutely relate to the "advising no more pregnancies" thing - although Issac and I were so sure we were finished months and months before my diagnosis, it was so difficult to hear someone ELSE tell me that I was finished. That is supposed to be one of those things we have the deciding vote on, right?!

  2. Wondering how your recovery has been? Did the PT help? I am 10 weeks pp and swing with the same issue. It has been devestating to me and just searching for some hope. Thank you!


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