How does Pelvic Organ Prolapse effect Pregnancy and Childbirth?
Being diagnosed with POP (or Pelvic Organ Prolapse), can be a lot to take in. There is still so much stigma around prolapse in general, largely due to miseducation and the fact that we are not talking about it enough. So it makes sense that breaking the stigma can only happen by starting the conversation and ultimately educating each other on things we feel fear or shame around, so let’s start talking.
We treat Pelvic Organ Prolapse a lot in The Clinic and categorise POP into stages. We see varying degrees of POP every day from women who have a low stage, mild prolapse and are seeking support to prevent it from worsening (often via lifestyle advice and pelvic floor exercises), right through to women who have been living with stage three, large prolapses for years. These women may have been pushing on, ignoring it sometimes out of shame, and sometimes because they genuinely don’t know help exists. That’s something we hope to change.
We know education is the antidote to fear because it’s human nature to fear what we don’t understand, so let’s address some of the very common questions we get in The Clinic and help you get your head around POP.
Commonly asked Questions about Pelvic Organ Prolapse:
Does prolapse impact getting pregnant?
A POP is a mechanical change to the supporting structures surrounding the vaginal canal and it’s true that if there is a large pelvic organ prolapse (particularly uterine), it can be uncomfortable to participate in penetrative sex. BUT the good news is that you can rest assured knowing POP has no impact on the rate of fertility.
Can pregnancy worsen my prolapse?
Whilst it’s true that the biggest lifetime risk factor for women developing POP is having been pregnant, the evidence suggests the largest increase in the prevalence of pelvic floor dysfunction (including POP) - is actually associated with the FIRST vaginal delivery. In saying this, depending on your individual anatomy and circumstances, it is true that pregnancy itself may mildly worsen prolapse.
Should I have a C-Section if I have a prolapse already?
This is a very common question! And we can understand why women think this may reduce the risk of worsening their POP. But unfortunately, the guidance isn't clear on this. Pregnancy itself is an independent risk factor for pelvic floor dysfunction, and it is not clear whether a C-section can fully prevent urinary incontinence or POP worsening. As there is insufficient evidence that C-sections prevent the development or exacerbation of POP, it is not routinely advised to go down this route. In saying this, everyone's body is different and there may be individual risk factors to consider when making this decision. We always advise that you speak to your medical team so that you can work out the best birth plan that works for you.
Is there anything I can do to prevent my POP from getting worse during pregnancy?
In short, absolutely! There are loads of things you can do! First and foremost, we recommend seeking professional help to get a plan specific to your pelvic organ prolapse and personal needs, but read on to learn more.
How best to manage Pelvic Organ Prolapse during pregnancy
Pelvic floor exercises first and foremost. We always, always, always recommend checking with a women's health physio to make sure you are doing these correctly. A women’s health physio can help you to engage the pelvic floor so you are working smarter, not harder.
Keep your whole body strong! Having a physio or trainer who specialises in prenatal exercise can really assist with this, ensuring you are moving safely but effectively for your growing bod.
Keep up your fibre intake and try to prevent constipation or any unnecessary straining.
Beware of heavy lifting (which we get can be a stretch if you also have a toddler in tow that wants to be picked up constantly). Couch cuddles whenever possible as a start.
And lastly, in some cases, having a pessary fitted can help to give you support and alleviate symptoms. This can be explored as an option if symptoms are very bothersome and can be done under guidance of your professional care team and women’s health physio too. Book an appointment with us to learn more about pessaries and how they might help.
The common theme here is that ultimately, having a trusted women’s health physio as part of your tool kit is an invaluable resource.
If you suspect you have pelvic organ prolapse and want to look at treatment, or if you want to put steps in place to minimize the likelihood of POP developing, please get in touch with one of our women’s health physios. Pelvic Organ Prolapse is not a load you have to bear on your own. It is treatable, and we can absolutely help in managing symptoms.