Motherhood is many things, but perhaps most of all, it is physical. You need your body for your baby to grow, live and thrive. After giving birth, not only are you expected to feed baby with your body, you also have to heal from the transformational experience that birth itself is. Your body hurts in ways you never imagined. And now you’re peeing yourself, and it hurts to poop, sit, stand, walk or lie down. Pregnancy, childbirth and postpartum are vulnerable states of being in large part because of the compromised body you are living in. And the overriding response to this vulnerability is silence.
All of these could be signs that a woman is suffering from pelvic organ prolapse; and still, not enough of our care providers are addressing it. What is pelvic organ prolapse? Why does it happen? And what can you do to treat it?
Pelvic organ prolapse can be terrifying. It’s uncomfortable, visible, painful; and we don’t talk about it enough. So to help new moms who are suffering from the condition, I put together a guide. Here is everything you need to know about pelvic organ prolapse, along with 7 steps you need to take to treat it.
What is pelvic organ prolapse?
Lindsey Vestal, MS, OTR/L and owner of the Functional Pelvis, explains: "In the bowl of the pelvis, females have 3 organs: our bladder, uterus and rectum. Between each organ are layers of connective tissue that keep the organs in their 'lane.' When the connective tissue lanes become weakened, stretched or torn, the organs shift in their orientation. This usually results in the organs sitting lower in the pelvis. These organs often protrude into the vagina, causing an inversion of the vaginal canal.
There are 5 different types of prolapse: 1) Cystocele (bladder prolapse) 2) Enterocele (small bowel prolapse) 3) Rectocele (rectum prolapse) 4) Uterine prolapse (prolapse of the uterus) and 5) Vaginal vault prolapse, with varying degrees of severity. In most cases, the organ does not actually come outside the body. What you may see or feel is the bulging of the vaginal canal from the shift in place of the organs above it."
Why does pelvic organ prolapse happen?
When your body goes through pregnancy and childbirth, your organs shift position, and the muscles and ligaments that would normally hold them all tidily are stretched and compromised. As a result, pelvic organs fall downward. For example, with a uterine prolapse, the uterus can sink down into your vagina; and sometimes; and with a vaginal vault prolapse, the vagina can protrude from your body.
How does it feel to have pelvic organ prolapse?
It depends on the degree and kind of prolapse. Some women get a sense of pressure in the lower pelvic area, while others feel like something is falling out. Intercourse is usually uncomfortable or painful, and even inserting a tampon can be difficult.
The good news is that your body heals. And given the right guidance and conditions, it will heal stronger. Here’s what you need to do:
1. Get properly diagnosed. Your healthcare provider may not automatically check for prolapse. At your 6-week check up, ask to be examined for all possible organ prolapse. This will help you gather information to design the appropriate course of treatment to recover.
2. Ask for a pelvic physical therapy prescription. Many health insurance plans will cover some physical therapy if your OB or midwife prescribes it. That said, not all pelvic specialized physical therapists are in network. Don’t let that deter you. Pursue the PT you want and ask for paperwork to submit to your insurance company for reimbursement. Some PTs will even work on a sliding scale.
3. You need physical training and strength training. The two go hand in hand. When your body is compromised, it figures out alternate ways to perform all the tasks in your life, from nursing to leaning over the crib to chasing after your toddler. Your repetitive daily activities create what are called compensation patterns. Muscles and joints are doing jobs they weren’t designed for in order to compensate for parts of your core that are no longer functioning.
To help with recovery, turn off the muscles that are overworking and turn on the non-working muscles, which is where PT is helpful. Next, you have to strengthen your newly activated butt, ab and thigh muscles. And for that, you’ll need to do strength training. After all, motherhood is an athletic pursuit. Dig in, it will be SO satisfying along the way.
4. Healing takes commitment, persistence and making yourself a priority. At first, moving your body after childbirth feels awkward, mushy and possibly a little painful. Your body seems foreign, and you don’t recognize any part of your life. This is exactly why taking care of your body after birth becomes a daily necessity. It will give you the energy and strength you need in your new mom reality.
5. Potty positioning matters! When your pelvis is injured and your pelvic floor muscles are weak, the last thing you need to do is exert more pressure downward. You want to set yourself up for success when it comes to your bowel movements. That means aligning your colon so that it can easily contract and release -- something that the common american toilet doesn’t allow. By placing a footstool -- any footstool -- under your feet, you will draw your thigh bones up, releasing your sits bones down and allowing your pelvis to relax into an ideal position.
6. Do your research before committing to surgery. The surgical course is usually a mesh implant that holds your organs up. There have been mixed results, ranging from permanent nerve damage, extreme pelvic pain and complete loss of libido. To top it off, the mesh implant doesn’t last forever and will eventually have to be replaced, which means more surgery.
7. Trust your intuition and get back to what you love! What matters the most is that you feel comfortable, confident and happy in your body. If that means getting back to your favorite yoga class, running trails or barre class, then set that as a goal and use what you learn from PT and your recovery exercises to gently return. You might have to start with smaller movements, modifying lots of exercises or walking instead of running, but keep at it. The upward spiral of motivation, accomplishment and feeling good doing what you love will move you forward.
Taking care of your body the way you want to is important. Women are marching together, advocating for the planet, upending politics - the entire social conversation is shifting with a fierce feminine tide. And yet, there is still so much to learn and to share with each other with regard to our bodies. That’s why we need to challenge the assumptions that would have you live in a painful, disabled body. You are rewriting history, Mama. Your body is your gateway to this work. Love it. Tend to it. Heal it, and it will carry you far.
Rachel Welch is the creator of Revolution Motherhood, a doctor-recommended fitness method that integrates yoga, pilates, barre, and pelvic physical therapy. Her signature programs educate and empower women with techniques to fully recover after childbirth. She offers live classes in NYC and On Demand programs around the world.