Pelvic organ prolapse after birth

I wish I had known about exercises that should be avoided that weakens the pelvic floor instead of strengthening it. I am surprised to read about so many fit and active ladies developing POP and so many say that they didn't know that the exercises they were doing was putting them at risk of developing POP. I think these exercises are fine if men to them but are not designed for the female physique:

12 Unsafe Abdominal Exercises with Prolapse Problems

Intense abdominal exercises should be avoided or modified by women with or at risk of pelvic floor dysfunction to minimize the risk of pelvic floor strain and injury, particularly after prolapse surgery and with poor pelvic floor support.

These intense abdominal core exercises will have the potential to overload the pelvic floor in women with pelvic floor dysfunction:

1. Traditional abdominal curl or sit-up exercises unsafe abdominal exercises
2. Incline sit-ups
3. Intense abdominal exercise machines
4. Oblique sit-ups
5. Oblique machine
6. Exercise ball sit-ups
7. Exercise ball leg raises
8. Bicycle legs
9. Double leg raise
10. Hanging knee raise
11. Pilates Table Top or The Hundred
12. Intense core Plank or Hover exercises.

Read more about good exercises for pelvic floor health here:

www.pelvicexercises.com.au/unsafe-abdominal-exercises/

www.pelvicexercises.com.au/basic-yoga-poses/

Knowing how to do a kegel excercise to strengthen your pelvic floor muscles is very important. If you do it wrong it can actually do more damage than good. This video helps to show which muscles are important to learn to contract and relax:

For those ladies who are interested (and I believe every woman on this forum SHOULD be interested if they love their organs high up) :

More information from the Voices for PFD website:

Am I at Risk?

Pelvic organ prolapse is common in women. The incidence increases after childbearing and as women increase in age.

Childbirth (vaginal or operative vaginal delivery) can cause injury to the muscles or fascia of the pelvic floor. The increased pressure of childbirth on the internal organs in the abdomen can lead to POP. Operative vaginal deliveries (forceps or vacuum deliveries) may also increase the risk of pelvic floor injury and increase a woman’s risk of developing prolapse. Route of delivery is a very important and complicated topic—discuss the risks and benefits with your doctor.

Though pregnancy and vaginal birth does contribute to the development of pelvic floor disorders, there are women who have delivered many times who never developed prolapse. And, others who have never been pregnant who leak urine and stool. Risk factors, which predispose, cause, promote, or worsen pelvic organ prolapse, include:

Genetics

POP is a hereditary disorder, meaning that it runs in families. Our genes influence the strength of our bones, muscles and connective tissue. Some women are born with weaker tissues and are a higher risk for prolapse.
Caucasian women are more likely than African American women to develop pelvic organ prolapse.

Lifestyle

Smoking increases your risk of developing POP.

Pelvic Floor Injury

Injury to any part of the pelvic floor can occur during vaginal delivery, surgery, pelvic radiation, or fractures to the back and pelvis caused by falls or motor vehicle accidents.
Hysterectomy and other procedures done to treat pelvic organ prolapse also are associated with future development of prolapse.

Other Health Conditions

Chronic constipation and chronic straining.
Chronic coughing.
Obesity—obese women have a 40 to 75% increased risk of pelvic organ prolapse.
Menopause
Nerve and muscle diseases, which contribute to the deterioration of pelvic floor strength.
Heavy lifting and intense repetitive activity such as CrossFit.

Hi Vendah,

You can try Dr. Paul Swart at Femina or at the PTA Urology hospital.

www.ratemds.com/doctor-ratings/3373729/D...art-Pretoria-GT.html

hi gloeiwurmpie

thank you for the quick reply

i have been trying to google a urogynecologist and i am not winning do you know any around Gauteng? preferably Pretoria? thanx

Hi Vendah,

Thank you for the kind words of support. I agree, it sounds like a myth (POP). Who would think that such a thing is possible, yet alone happens very often?

One of the reasons it took me so long to post about this is because I don't want to spread panic among pregnant ladies (especially). So, please, try not to panic about this. Information helps, therefore now that you are aware of this, one can start to take care of your pelvic floor and assess if you are at risk.

First I would suggest that you speak to your mom and sisters and hear if anyone has symptoms of POP. Often women don't know that all the "strange symptoms" they have been having for years may be POP and doctors often don't diagnose until it is already very progressed. Any signs of incontinence (not even leaking drops are normal), difficulty having bowel movements - often woman have to push stool out through their vagina (sorry TMI but it is important to mention it ), this is called "splinting". The cervix should be higher up in the vagina roughly a finger length, if not it would be worthwhile to go for a pelvic exam.

One of the problems it seems from all the forums and groups I have joined is that medical professionals, that is doctors and even midwives often know very little about POP and don't diagnose it early enough. If you are really concerned and would like to get checked out I would suggest seeing a urogynecologist. I wouldn't be surprised if your midwife would brush off your concerns easily as this is a very "uncomfortable inconvenient discussion". I am disappointed that I mentioned repeatedly to my caregivers that I am really battling with constipation and I also mentioned that I suffered from incontinence during my pregnancy. Although these symptoms could just be "normal" in pregnancy these symptoms do put you at major risk for having POP. Being constipated for 9 months is NOT A GOOD THING. I should have been advised to increase my dosage of Movicol and MAKE SURE THAT I NEVER EVER NEVER EVER STRAIN A BOWEL MOVEMENT. NEVER. But instead I was just told that, "yes, constipation is NORMAL" in pregnancy. Long term constipation should never be just classified as "normal". It should be treated aggresisvely to prevent POP as far as I can gather from information.

Do your Kegels faithfully everyday. Make sure you pinch your butt (as preventing from wind to escape), pull up the vagina (as trying to pull in a tampon) and pinch as to stop the flow of urine - do this all together to make sure you do a Kegel correctly.

Do not lift heavy things as this puts a lot of strain on your pelvic floor especially if not done in good posture.

Also have a look at the list from the first post that I posted and see if you have can tick any of those mentioned items.

Your symptoms could just be normal expected pregnancy pains, but I think it is worthwhile to get it checked out. Bladder infections are also quite common in pregnancy. But looking back I had a "borderline bladder infection" at almost every check-up from my second trimester and it was just "brushed off" as my bladder is irritated by the weight of the baby. Like I say, I don't think caregivers think of POP when you come to them with your symptoms.

Remember that you can only do your best and be sensible about taking care of yourself and the rest are not in our hands. Genetics play a role it seems and there isn't much that one can do about it. Hyper mobile (people who are very flexible or double jointed) women are more prone to develop POP.

Natural birth is a wonderful experience to have, don't let this ruin it for you. We can't stress about everything that "might" go wrong. I know this is hard.

I will try to post some more tips on how to prevent POP and general good ideas for taking care of your pelvic floor.

Hope this helps Vendah. xx

hi ladies

i read this last night and i hardly slept. i am currently 8 months pregnant with my first baby, i am planning on giving birth naturally at genesis hospital. i have had pelvic bone pains from my second trimester and some days are just worse than others, the pee problem only started recently were i feel like i need to pee but only a bit comes out and after 10 minutes i feel like peeing again. how do i get tested to make sure i am not at risk?

gloeiwurmpie SORRY TO HEAR ABOUT YOUR STORY AND THANK YOU FOR SHARING IT. I HOPE YOU GET A FULL RECOVERY. I HEARD ABOUT THIS YEARS AGO BUT I HAVE ALWAYS THOUGHT IT WAS A MYTH