My Pelvic Organ Prolapse Story

Let me tell you my prolapse story. After an unmedicated VBAC with no tearing, I thought I would be in the clear. I went home with the usual aches and pains, a lot of pelvic tension, a little heaviness. Then, the bleeding picked up. I needed a D&C due to secondary postpartum hemorrhaging.  At 6 weeks, my swelling went down and it was clear that something was not right. 

I felt like I couldn't relax my pelvic floor, I felt like there was a tampon in, I felt like I needed to Kegel constantly to "hold things up". It was miserable. When I held my son, wore the baby carrier, sat too long, stood too long, walked too far, tried to exercise, all of it was a mess. It was a grade IIa cystocele. 

Everything was still inside the vaginal canal, but my bladder sat lower than before, it bulged toward the lower part of the vaginal canal. I felt crushed. I didn't think I would ever lift, run, or climb again without symptoms. I felt lost for a bit with symptoms that felt constant. 

I hear this story from women all the time, and I remember vividly my own emotions around early diagnosis. 

I wallowed briefly and then took a very nerdy deep dive into how I could find a way back to what I loved. 

I started with basics: fixing my posture, breaking bad habits, addressing tension, and rebalancing muscles. After 5 months of reading through all the research I could find, taking all the continued ed I could consume, and implementing it into postpartum life, I started to feel my symptoms less and less. 

I progressed my strength training, focusing on eccentric work and rebuilt myself little by little. 

By 6 months on examination my prolapse had improved to a grade I (grade improvements do not happen for everyone, but are most common in the early months postpartum).

By 8 months I felt my symptoms only with higher level activities and when tension crept up.

By a year I was symptom free with climbing, running, jumping, and lifting. 

I’m now over 2 years postpartum, and I very rarely feel symptoms. But when I do, it’s hard to not have a moment of panic. The “oh no! I made it worse” reaction. 

Just this week I completed a dependent transfer on a patient and felt the pressure come down. With the positioning and level of assist required, my mechanics weren’t the greatest. I was about to start my period, I was feeling some tension in my pelvic floor. It was really the perfect symptom storm. 

I was so frustrated that it had been so, so long since I had felt symptoms. And now I felt like I couldn’t stop clenching my pelvic floor against the uncomfortable “tampon” sensation. I felt defeated and worried about what it would feel like on our climbing trip in a few weeks, I started to spiral a bit. 

But then I remember all the things I tell my patients. 

I took some deep breaths.

I relaxed my pelvic floor. 

I unclenched my butt, my belly, my jaw.

I stretched and shook my hips.

When I got home I pulled out my pelvic wand and did release work.

I reminded myself that my symptoms are more noticeable because the tension is pulling my pelvic floor into the bulge, not that I made the bulge worse.

I reminded myself that my uterus is putting more pressure on my bladder right now because it is full of tissue and blood waiting for my period to start.

The next morning I woke up feeling normal again. I lifted my kids a million times. I ran 3 miles, I jumped on the trampoline. I was comfortable.

The following day I felt it again, tension was up, on my feet all day. Repeated the cycle of management, and felt more in control of my symptoms again. 

It will likely be a few more days of on and off, stretching, observing, listening, supporting, unloading and loading. But I feel like my prolapse is very well managed, it doesn’t run my life. And not panicking about it, having tools to help alleviate symptoms is so important.

Not everyone has such long stretches between symptoms, not everyone sees a reduction in grade. Some need pessaries, others opt for surgery, some use support garments. The good news is that there are options. 

What doesn’t work is cookie cutter advice of doing kegels and never lifting more than 10lbs again.

When it comes to managing prolapse symptoms, I think we need to focus on finding ways to support women in building themselves up to what they love again and giving them the tools they need to get there.

So to my fellow mamas with prolapse, I hope you take a moment to remind your body it is safe and find ways to listen and support it when your symptoms pop up.