How to prevent and manage pelvic organ prolapse following childbirth

Approximately 50% of Australian women who have had children will develop some degree of pelvic organ prolapse in their lifetime. Pelvic Organ Prolapse is when the organs of the pelvis such as the bladder, uterus and/or bowel descend into the walls of the vagina. This occurs when the connective tissue that surrounds and supports the pelvic organs become stretched and potentially torn.

During pregnancy, our bodies produce hormones that soften our connective tissues to allow for growth and accommodation of a baby. These hormones in conjunction with the weight of a growing baby places increased pressure on your pelvic floor muscles that may lead to them becoming weak and/or uncoordinated.

Your pelvic floor muscles support the connective tissues that hold your pelvic organs in the correct place. Pelvic floor muscles that do not support the connective tissue adequately may lead to a lowering of the organs. Therefore exercising your pelvic floor muscles early and adequately post childbirth is important.

Other risk factors that may lead to development of a pelvic organ prolapse post pregnancy and childbirth include:

  • Having a Forceps or Vacuum assisted delivery
  • Long active pushing during second stage labour (greater than an hour)
  • Large baby birth weight (close to or greater than 4kg)
  • Excess body weight/ obesity
  • Repetitive heavy lifting
  • High impact exercise too early post childbirth (running, jumping and/or heavy lifting)
  • Chronic constipation and/or
  • Family history (mother or grandmothers with pelvic organ prolapse)

Common symptoms of pelvic organ prolapse include:

  • Sensation of vaginal heaviness and or/ dragging
  • Visible lump at the entrance of the vagina
  • Urinary urgency with or without incontinence (leaking)
  • Incontinence with high impact activities and exercise (running, jumping and/or heavy lifting)
  • Incomplete emptying of bladder and/or bowels
  • Low backache and/or
  • Irregular vaginal bleeding

If these symptoms are identified early and adequate treatment is provided, it is possible to significantly improve the symptoms and prevent worsening of the prolapse. In Australia, approximately 20% of women will undergo surgical management of pelvic organ prolapse. It is important to remember that regardless of opting for surgery or not, having strong pelvic floor muscles is an essential part of improved outcomes.

Pelvic floor muscles can be strengthened like every other muscle in your body through specific training. There are specialised pelvic floor Physiotherapists who can assess your pelvic floor and provide you with a specific and individualised training program. Pelvic floor muscle training can take time to show improvements and therefore starting as soon as possible post childbirth will give you the best chance of recovering adequately.

Along with your training program, your specialised pelvic floor physiotherapist will provide you with advice and education regarding lifestyle factors that may be contributing to development of a pelvic organ prolapse. Some of the topics your therapist may discuss with you include how to manage constipation, ways to avoid/ modify high impact activities and/or how to return to exercise appropriately post childbirth.

If you are concerned that you have pelvic organ prolapse or would like more information on how to prevent prolapse occurring post childbirth, please contact one of our clinics to make an appointment.

Womens Health services are available with one of our womens health team – Heather Minnich, Samantha Khanna, Lara Pogrolesky in both our Westmead and Penrith rooms.