Help/advice/tips for my sister - 36wks pregnant with #4

Body: 

Hi everyone

I haven't been on this site for a little while, apart from a bit of reading here and there...have been going through my own rollercoaster journey with this thing, and also very busy with what life is bringing me.

However, my sister is due to have her fourth baby in a few weeks and I'm wondering if you can offer her any tips on getting through labour and delivery with least damage to her pelvic organs.

Since I found my prolapse, I also discovered two aunts and my grandma had surgery for prolapse and my sister's ob/gyn has told her she has a greater chance of a POP due to the family history and she is terrified that she will have problems after this birth. She had a great problem with incontinence for three months after her last delivery.

I said to her that I would see if any of you wonderful women could offer any support.

Many thanks in advance..

I think the most important thing about protecting pelvic organs during labor and delivery is to understand optimal positioning. if you have the second edition of the book, there are some really good diagrams in there that you could share with your sister. if not, you can still try to describe it to her.
basically, you want the uterus and bladder over the pelvic bone. which means no slouching back on the couch. in late pg, its probably best to spend lots of time on hands & knees, or sitting at the edge of a chair, straight back with belly hanging between the legs. this not only keeps the bladder in a safe place, but it actually helps encourage the baby to move into a good position for delivery (and helps prevent back labor according to the literature my mw had me read last time around).

during labor, stay far away from anesthesia. lack of sensation means you cannot respond to your body's cues. and the body DOES give cues to help a laboring woman move into a safe position. it also follows, that a laboring woman should be allowed, encouraged and supported to move around freely during labor and delivery.

no laying flat on the back on the bed. this puts everything into vulnerable positions. preferable positions for delivery include standing, standing leaning on a wall or over a table, hands & knees. not sure what I think about squatting. I was in a full squat when my third child was born and I'm not sure that was a good thing. maybe a squat with the woman leaning forward on something would be better. point is, you want to keep the pelvis oriented so that the bladder moves out of the way.

and postpartum, I hope by number four, your sister knows to rest when she can! no superwoman stuff.
posture posture posture
good food is necessary for healing
empty bladder completely at least once a day
avoid constipation like the plague and do not ever strain on the toilet

sometimes though, even with all of our good planning, things happen. so even if she does wind up with a touch of prolapse, all is not lost. many times, as we've seen here, pp prolapse heals on its own. but I believe with posture and good diet, she can stack the odds in her favor.

best of luck for a safe, healthy and wonderful birth