Prolapse After Pregnancy – It’s Not Your Fault.

Prolapse After Pregnancy - It's Not Your Fault.

Around 6 weeks postpartum, I had expected to feel a bit more like myself.  I had avoided exploring anything in the vaginal area for fear of what I would find, but had felt a general heaviness since I had given birth.  Not knowing for sure if this was normal, I made an appointment with my doctor to get checked out. 

Upon examination, my doctor confirmed that I had a prolapsed bladder.  His tone was nonchalant, as if it was totally normal and something that just happened sometimes. 

I was completely shocked. What had gone wrong?  And why did I never hear that this was a possibility?  I immediately started blaming myself.  Why had I not done more kegels during my pregnancy?  Why didn’t I do more research to know that something like this could happen?  Did the decision to use a vacuum during the last bit of pushing influence this?  What could I have done to prevent this?

But the truth is, some women really are just more susceptible to prolapse.  While a prolapse can occur for many reasons, some women have more of a genetic risk for the condition due to the strength of the connective tissues.  It’s not your fault. 

That being said, there are some things that may help you either avoid a prolapse, or at least improve your symptoms if you have one.

How to improve symptoms of pelvic organ prolapse

  • Maintain a normal weight.  If you are overweight, you are more susceptible to a prolapse due to increased pressure inside the abdomen. 
  • Avoid constipation.  Becoming constipated can cause you to strain during bowel movements, increasing the chance of a prolapse.  Ensure you are eating a high fiber diet and drink plenty of water every day.
  • Keep active.  A regular exercise plan keeps your weight in check, and also helps promote healthy bowels.  Be sure to include your pelvic muscles in your daily workout routine too.
  • Avoid extra pressure inside the abdomen.  Things like lifting heavy objects, and chronic coughing, create persistent pressure, which can increase the likelihood of developing a prolapse, or making your symptoms worse if you have one.  Stay healthy and avoid strenuous lifting. 

Whatever you do though, don’t blame yourself for developing a prolapse.  Instead, use that energy to find out what you can do to improve your symptoms and treat the condition.  Talk to your doctor about your options, and find a qualified physical therapist to help you learn how to strengthen your muscles to improve symptoms.

Postpartum Isn’t Easier When You’re a PT

Postpartum and Physical Therapy

….But it helps

Pregnancy can be a wonderful time of growth, change and anticipation.  As the baby grows, the mother’s body goes through normal musculoskeletal changes.  Muscles in the abdominal and pelvic region stretch, ligaments soften and joints loosen.  Some women handle these changes with ease but others may need the help of a physical therapist to manage pain and incontinence

After the birth of the baby, there are still changes. The postpartum (or post-birth) period can be a beautiful yet challenging time for the mom too. We call this time period the fourth trimester. 

As a PT and mom, I can attest to the challenges I listed above. I can also say that postpartum doesn’t get any easier or feel any better because you’re a PT and you intellectually understand the physiological changes in your body after having a baby. I’m a PT and I know what I need to do for myself and my recovery but knowing what to do and experiencing the discomfort and managing it are different.

Hormones greatly affect the mom emotionally and physically and the pelvic floor muscles are overstretched and weak.  The new mom likely has an incision to care for and may be experiencing some urinary leakage. Ligaments and joints gradually tighten as hormones begin return to pre-pregnancy levels.  However, muscles like the lazy.  If a muscle isn’t exercised it will remain loose and weak.

My prescription for healing after having a baby? Kegels, Tummy Time and Walks.

The secret sauce to making sure that prescription works? Repetition

Understand the purpose of kegeling

The pelvic floor muscles create a natural bowl or basket supporting our pelvic and abdominal organs.  The pelvic floor is vital in controlling our bowel and bladder, is part of our core muscles, assists in our sexual response and must stretch to allow for the baby to slide through the birth canal.

A kegel is the contraction of the pelvic floor muscles. You can learn more about how to kegel, here.

Mimic your baby + get on your tummy

Use that tummy time to kegel from a new position and just take in the moments you have with your new little one.

Try to walk at least once a day

You need socialization and your baby needs it too.  Lucky for you, walking is a great pelvic floor exercise.

At the end of the day, variety and repetition are key. As both a PT and a mom, I’ve found that strengthening the pelvic floor by challenging those muscles in a variety of ways will allow the muscles to become strong enough to maintain dryness. Eventually, your pelvic floor wall will become strong enough for a return to pre-pregnancy activities.

Although we all have to deal with this postpartum changes, being a PT certainly helped me have perspective. I hope this article can help you too!

P.S.  Remember that whatever you do in the name of healing your body is a way to take care of yourself. If you don’t take care of yourself, how could anyone expect you to take care of your little one? Take a deep breath and give these suggestions a try. If you need an extra boost to get you going, read this blog post for inspiration!

 
About the Author, Michelle Herbst:    I am a wife and mother with a passion of helping women live to their fullest potential.  I am a women’s health physical therapist and for nearly decade have helped women with musculoskeletal conditions during their pregnancies, postpartum period and into their golden years.

About the Author, Michelle Herbst:   I am a wife and mother with a passion of helping women live to their fullest potential.  I am a women’s health physical therapist and for nearly decade have helped women with musculoskeletal conditions during their pregnancies, postpartum period and into their golden years.

 

What No One Told You About The 4th Trimester

what to expect after you've had the baby

When you were pregnant, everyone joined you in counting down the days, weeks, and months until your baby would be born. Now that your little one is here, the countdown is over. But that doesn’t mean the woes of pregnancy are over.

The fourth trimester, or the recovery period and adjustment period of your body after birth, is a very formative time period. This month is filled with changes in your body, your household, and your baby’s body. Now that your little one is out of the safe cocoon of your womb, they’re learning to latch on to you for feedings and lay near you for warmth and comfort. All the while, your organs are resituating themselves and your hormone levels are skyrocketing to fuel these shifts.

Although everyone knows about the exterior changes that come after having a baby, many women are still surprised to feel so out of control with their bowels and bladder.

Childbirth—cesarean or vaginal—does a number on your organs. The trauma of childbirth weakens your pelvic floor muscles, often leaving them feeling like they had their own personal cross fit session.

Understand the level of work your body has done for you and react appropriately. The fourth trimester is a period of rest and recuperation. To treat yourself like anything else will only put you at risk for less than ideal symptoms in the long run.

Take time to map out a recovery plan for your bowels and bladder so you can ease your way back to a pre-baby stage. If you are experiencing urinary or bowel leakage, or a frequent urge to go often, start with a bladder and bowel diary. Fill it out and take note of what your body is responding to and then bring it to your doctor in your next postpartum appointment. 

Here’s What Your Doctor Won’t Tell You About Your Post-Pregnancy Recovery

Post Pregnancy Recovery

As a pregnant woman, you are bombarded with information – books, blogs, websites, and even strangers on the street love to regale you with stories about what you can expect during this glorious time.  Overly emotional? Check.  Crazy heartburn? Yep.  Strange cravings?  You got it.  Everyone has heard these stories and for most women, it’s not all that surprising when they experience them.  

However, it’s what happens after pregnancy that no one talks about.  But they should. 

Urinary incontinence affects many women during pregnancy. The added stress and weight of your baby pushes down on your bladder, causing leakage that occurs when you cough, sneeze, or exert pressure on your abdominal muscles.  This is known as stress urinary incontinence, or SUI.   But did you know that you might also experience urinary incontinence after you have your baby?   

Most women will experience some leakage after they give birth.  This is natural.  After all, your body has been stretched and pushed to its limits during childbirth, especially if you have given birth vaginally.  However, while most women will see this symptom fade within the weeks after delivery, some will still experience leakage for months or even years after birth.  And even if you saw this symptom disappear after childbirth, there is still a chance you may find it reoccur later on in life.  

The good news is that there are things you can do to treat this problem.  Pelvic floor muscle exercises can help strengthen your muscles during pregnancy, and also restore your muscle function after you’ve given birth. Need some guidance on how to perform them?  Find a physical therapist that specializes in women’s health.  He or she will conduct a full examination, and show you how to perform the proper exercises for your condition.  A PT can be seen as soon as 6 weeks post partum to ensure that things are healing properly and to help you start getting your muscle control back.

The truth is, a good pelvic floor workout should be a part of your daily routine no matter where you are in life.  Pre-pregnancy, you’ll build up your muscle strength, which will help you if and when you become pregnant.  Postpartum exercises will help you get your muscle tone back to where it was before you had birth, which can help ease or even eliminate incontinence symptoms you might experience. And continuing these simple exercises into your later years will help keep you strong as your body and hormones change and make you more susceptible to incontinence symptoms.  So start today – it’s never too late, or too soon to get these muscles in check.


SUI Treatment Tracker

SUI Treatment Tracker

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Misconceptions About Being A Mom And Bladder Health

Moms and Bladder Health

Becoming a mother is one of the most joyful things that can happen to a woman.  But it can also be challenging.  Not only are you dealing with the demanding task of raising a little one, your own body is undergoing constant change as well.  There are a lot of misconceptions out there about how our bodies should perform after we have kids - many of them false.  Take a read below and learn some of the most common misconceptions around bladder health and becoming a mother.  

Misconceptions around bladder health and becoming a mother

Fact or Myth?  After having kids, it’s normal to pee a little when I laugh, sneeze, run, etc.

Myth. While this can happen for a few months after childbirth, it is not something that is “normal.” It should be dealt with.  Talk to your doctor or a trained physical therapist about some exercises that may help get you back to normal, and product suggestions that can help you manage incontinence in the meantime.

Fact or Myth?  If you’ve had kids, you can expect to have urinary incontinence or OAB when you become older.

Myth.  It’s true that sometimes incontinence does not rear it’s ugly head until well after you’ve had your children – often in your 40’s or 50’s.  But that doesn’t mean that it’s a sure thing you will suffer from incontinence – especially if you are proactive in getting your pelvic floor strong now.  It’s never too late to start incorporating your pelvic floor into your workout routine.

Fact or Myth?  I might as well get used to being incontinent – now that I’ve had a baby there is nothing I can really do about it anyway.

Myth.  As we mentioned above, incontinence is certainly not normal, and there are a host of things that you can do to manage, and even fix it for good.  For starters, adult absorbent products can help you manage immediate leaks that you may be suffering from post childbirth until you are able to build up your strength again.   When you schedule your 6-week postpartum check up with your doctor, schedule a visit with your physical therapist as well – it’s a great time for an initial evaluation and you can learn some good postpartum exercises to start right away.  And if you are still feeling like things are not quite right after a couple of months, talk with your doctor about what you can do.

Fact or Myth:  I don’t have to worry about working on my pelvic floor until after I’ve had the baby.

Myth.  One of the best things you can do to prepare yourself for childbirth is to start working out your pelvic floor today.  Not only will it make your delivery easier, but you will be that much stronger and your recovery in the postpartum days ahead will be much faster.