10 weeks postpartum via VBAC with cystocele and rectocele - need advice

Oh HOpeful,
First of all huge hug for you and a huge congrat on your lovely new baby. I know what a hard place it is to be in, discovering you have a prolapse amidst looking after two young children, and thinking "if only..." I didn't have a c-section, but I still can find endless "if only's..." it's a hard place to be.

first, remember that you made what was the right choice for you and your baby at the time. there is no perfect choice, only the one we make. and we make what is best for us in that moment.

i just want to reassurae you that things will get soooo much better. heal comletely, probably not--but you've birthed two babies and i don't think our bodies ever go back to normal, prolapse or not. but, my little one is 19 months, & i had a severe rectocele and cycstocele after the birth. now, 19 months later, i'd go to disney world without blinking an eye! i carry my little one (who isn't that little!) lots, go out for the day, play ball, and just get on with life. and i notice my prolapses very little. i remember reading others say that when i first got here, and never believed it would be me. well, it is--and is where so many women here get to!!!

i won't lie and say it's all as it was. i have to eat really carefully now or my rectocele bugs me as i get constipated easily. i also choose not to run, but i was never very sporty in that sense so it doesn't bother me (excuse really....). and i have to learn to work with my body--wearing a tampon to hold things in if they are feeling a bit droopy and i know i'll be lifting my tot a lot, getting on my hands and knees more, lying down if i can. i don't lift heavy things (i figure it gives my husband a purpose in life anyway...), i wear pretty skirts a lot more, i walk tons more...so not all bad.

i hope this gives you a bit of reassurance. please have a look at posts, see the FAQ's on the main page, and ask away as you need. there is so much wisdom and support here to help you come out the other side!

kiki

That tear sounds just dreadful. What a sad thing to have happen. I didn't have any interventions with any of my births but with my first I tore in a big way- up to my anal sphincter and in to about halfway to my cervix up the back wall (or so it seems from the scar tissue). When I think of the tear you describe- I got off easy. My tear from the first birth had me sore for over half a year. In preparation for my second birth I did the massage and stretching and some of the scar tissue softened. So maybe that could be something to try.

As to the VBAC. Well congratulations on that accomplishment. What a wonderful thing to do for your baby. It is the very best thing to do for the baby. I am so sorry you had to tear- interventions suck. And I am not sure if a cut and redo is the best thing for your healing- scar tissue is scar tissue and it just builds up the more you interfere with it.

Will it get better? I think it will get better than it is right now. I think you will be able to go on vacation and enjoy yourself. Start the posture now. Get the book and read up. Rest and let the healing begin.

I think my scar tissue has made my healing very challenging. The fascia is torn and I doubt will ever knit back together properly. I am counting on my muscle strength to keep my intestine where it belongs- my cystocele is totally gone. No tear there to get in the way of my healing. So it can get better. It will get better.

Hey there. I'm sorry to hear about your story. I had a really rough birth with my first baby just 3 months ago. My baby was also face up, so my labor was really long, and I ended up tearing in my upper vaginal wall. I almost had to have a blood transfusion I lost so much blood. I knew right away that something wasn't right...went to the doctor 3 times before they acutally said what was wrong. I'm still early in the healing process, so I'm still waiting for things to physically improve (which I reallllly hope that they do), but emotionally and mentally things are improving. I, too, was KILLING myself with the "what if's". I was constantly replaying the labor and delivery in my head thinking about things I should have done differently...wishing that I had requested a c-section. Just driving by the hospital where I had her made me upset and angry. I still get jealous when I see other young moms or hear about the perfect births of my friends' children. But I'm thinking about these things less and less as the days go by. I think that your decision to have a vaginal birth was a brave and generous one. We did the best that we could. There was no way for us to know at the time that this was going to happen. I look forward to hearing about your healing...and congrats on that baby!
kath333

Hello

I too am in a similar position. I had an emergency c-section due to malpresentation with my first baby 3 years ago- after nearly 4 hours of trying to push him out...this left me with a small rectocoele that has always been pretty symptom free.
Baby No 2 - spent 5 weeks in hospital with pre-eclampsia, and had a c-section scheduled at 36 weeks, however my placenta pretty much gave up at 35 weeks, and I went into spontaneous labour. They couldnt find a heartbeat during my speedy labour, so I ended up with a brutal forceps delivery, a fierce episotomy, but very luckily a live birth. My premmie son spent a week in special care but is now home and doing well.

My first 6 weeks postpartum seemed ok, stitches healed well, and to be honest I was so busy with a prem baby, tube feeding, trying to establish breast feeding, and trying to lavish attention on my 3 year old after spending so much time away from him in hospital, that I didn't really think about myself much. I had 6 week check at doctors, a smear etc and nothing was mentioned.

8 weeks postpartum I felt a sort of heavy feeling down there, and looked to find rectocoels much worse and pretty significant cystocoele to join it. I feel difigured and horrible about it. I am now 13 weeks postpartum, and whilst things haven't got worse they def haven't got better either. I am trying to do my PFEs but have very little feeling that I have much muscle tone to work with.

I too am feeling pretty traumatised and angry that this has happened to me. I want to know when I can start enjoying things....and if this will get better too. The thought of more time away from my babies in hospital and surgery terrifies me....

Maybe we can help each other through this?
Henny xx

Hopefull

You are so right. Positive thinking is the answer. I am sorry if my post sounded self pitying.

You too sound like you had a horrible time with your birthing experience. It is so upsetting when such a joyful experience is overshadowed by physical discomfort that goes on for weeks after everyone expects you to be 'back to normal'.

As for your decision to try for VBAC - I too did all my research and had decided it was what I wanted. I had no idea of some of the implications of it though - but easy to have hindsight? All you did was follow advice, and chose the best option for both of your children. You mustn't blame yourself for things that you cannot control.

Interested to know about how you go with the accupuncture. I tried if once (in conjunction with an ivf cycle) - the cycle failed and I am a bit sceptical. I too have ordered the book as I am keen to do anything to manage this without opting for surgery - in the short term at least....

Patience is a virtue.....shame I'm not blessed with it.....

Henny xx

Just wanted to share that I went to accupuncture & it really helped. initially with the bladder frequency and backache, which passed quickly, but I think it also helped to "lift". I took herbs that were breastfeeding safe--you just have to be sure they know their stuff, but many herbs are safe. those helped a lot, and i felt a noticable lift.
i also used homeopathy which again really helped--i felt a lift with each time i took my remedy for quite a few weeks.

and, it helped my general health, stress, anxiety, and all that stuff--which can only be good!

re disney...i had a trip planned 4 months after our baby was born, involving an 11 hour flight, a total of about 20 hours travel door to door. i postponed it for a year, as i decided that everything in my first year had to be about healing.

at 15 months pp i did the trip, with no ill effects. i was glad i waited till i felt more confident, and my body was stronger. i'm sure i would have been fine earlier, but...i do think that learning to give ourselves time to slow down and heal is so much of what this is about...

and tears, i forgot to mention...lavender and frankincense in the bath can help heal them. i had nasty tears this time, that were agonising...but that really helped.

Hi Hopefull

Life isn't fair sometimes, and you're right, it is hard looking at other people who had the 'perfect' experience. No doubt there are other areas of their lives that are not perfect. At the time though, it doesn't seem to help much to think of it this way. :-(

Firstly, prolapse is not only caused by vaginal birth or its interventions, though a less than optimum labour and birth no doubt do contribute a lot, and they often show up after vaginal birth. The process of prolapse seems to start with intraabdominal pressures going in the wrong direction at some stage in the life of a girl/woman and putting undue strain on the fascial internal supports for our organs. Poor posture, constipation from poor diet and stress, and straining on the toilet, constrictive clothes, labour that is hurried along, inappropriate lifting techniques, poor physical education, all contribute over time. No doubt there is also a genetic inheritance component as well.

Sometimes these fascia get pulled and pushed out of shape like a nylon jumper that has been washed in hot water. Sometimes the pressure just tears the fascia if repeated often enough and for long enough. Sometimes the fascia are artificially breached by surgery such as episiotomy, caesarian section (where the fascia surrounding the uterus has to be cut through to get to the uterus itself), pelvic repair surgery and other surgery. When they are breached, surgeons usually sew them together again, but it is a little like sewing up a tear in a lycra t-shirt where the torn extra edge bits have to be trimmed off before sewing the edges together, and it will always cause pulling and puckering in a different spot, that will eventually break down again. Suturing an episiotomy is a very complex process, done at a time when all the tissues are stretched and often swollen. It is often not given the time and skill necessary to do a good job. A woman's body goes through so many size and shape changes during her life. It is no wonder the internal supports have a hard time retaining their integrity.

You are probably right. OB's should educate us better, but their training does not equip them well to understand what is happening in a woman's pelvis, according to the Wholewoman model. If they don't understand it and/or act on their understanding they become simply birth engineers who take over the process of birthing from the woman, and save her from herself, for better or worse. I think they are indeed part of the problem much of the time, in conjunction with the hospital and nursing systems they work in and administer. Treating the normal bodily process of childbirth as a medical emergency to be hurried along and managed does not help the woman birth as nature intended. It could be likened to giving yourself a mechanical enema every day instead of sitting on the toilet for a few minutes in order to empty your bowels.

Don't get me wrong. OB's have their place in saving the lives of both mothers and babies. Many mothers (including me) and no doubt babies too, are damaged on their way through the obstetric process, and unfortunately that, in my opinion, is the price we pay for the lower maternal and infant mortality rates in Western society. If I were in charge, things would be done very differently! But I am not a midwife or a doctor, so that is unlikely. It is only by women standing up and saying, "This is not good enough!" that things will change.

However, I think that even a full oil tanker can be turned around if the pressure is applied by enough little tug boats in the correct places for enough time. Medical practices will always change. It just has to be in the right direction.

Cheers

Louise

Hi hopeful,
I don't have much advice to offer because I'm in a similar situation. My first was a scheduled c/s for breech presentation. I had my daughter (a VBAC) 9 weeks ago and suspected something was wrong shortly after her birth. She wasn't huge - 8 lbs 7 oz, and I only pushed an hour - one small tear for me and that healed well. I had the feeling when I was pushing like I was pushing my insides out, but I figured that was normal. Maybe it wasn't? I asked about prolapse at my 6-week appointment and was told that things looked fine. Now I started Pilates again in an attempt to regain my abs, and I wonder if that made things worse... Just in the last week I have a much larger bulge that I'm quite sure is cytocele. I don't have any symptoms except for a "full" feeling but it's plain disturbing.

Please don't think you ruined yourself! A VBAC was the best thing you could give your baby and you DID recover more quickly I bet. We'll all figure this out. 10 weeks postpartum isn't very far along and our bodies still have a lot of healing to do. Hang in there.
Karen

Hi Karen

Welcome. Yes, indeed there are some Pilates exercises for abs that seem to aggravate or worsen POP. eg, I would steer clear of crunches. I don't do Pilates myself but it has had some bad press here on the Forums. It is most important to get to know how to exercise in ways that don't aggravate POP, and to begin to recognise the things you can and cannot do safely with your body when you have POP. Once you recognise the positions and techniques that tilt the pelvis back and then apply the pressure, you are well on your way to avoiding damage from exercise. I have come to the conclusion that the 'neutral pelvis' that they talk about is not neutral at all for women. For men maybe.

Wholewoman techniques including the dance routine in Saving the Whole Woman (2nd edition) and the routines taught by Christine at the Wholewoman Center keep the pelvis from tilting backwards, and keep the pelvic organs well forwards over the pubic bone. You can do anlmost anything if you keep your organs well forward.

Try putting 'pilates' into the search box. There have been many discussions.

Cheers

Louise

Thanks for the workout tips, Louise. I just ordered the Whole Woman book, which I gather comes with a CD (do you have it?) Does the CD have a voice-over that tells you what to do with the workout or is it just music? I have been practicing changing my posture but I'm not 100% sure I'm doing it right. Hopefully I can figure it out after reading. I'm a biomechanics professor and this whole topic is really interesting to me at a professional level too. I wonder if there's some research that could be helpful for us?

Anyway, thanke for the exercise tips. Lots to think about as I begin to deal with this whole thing....

Hi Karen

The CD is just music, but it is just the right music for doing the workout if you can get the timing right. The forthcoming video will be a welcome addition. You can also do the workout without the music, or with music of your choice, though some of it is in 3/4 or 6/8 time, and some is 4/4 so you have to choose the right music for each exercise.

I think you will be able to figure out the WW posture once you have read the book. The mechanics of it are very well illustrated in the book. Also there are quite a few conversations about specifics of posture on th forums, but it is not that easy to search them. Some of the aspects of WW posture are subtle. It may take a while for you to make it work for your body.

When you have digested the book, ask some questions here and we will help you to try and make sense of it. Have a look at the FAQ's on the main website too. With your biomechanics background it will be interesting to hear your comments too.

Re the research side of it, I have been looking for several years for research into the effect of posture on different aspects of health and I haven't had a lot of joy. Christine will have found it if it exists, and it may be listed in the reference list in the book. I think the research needs doing, but it would be quite difficult to design the trials. Also, there doesn't seem to be anybody with a vested interest in finding out about it. Sponsors of research seem to need to have the opportunity to make money out of the research results before they will put the money up, and it is difficult to think of any companies that would even look at it. It is women who have so much to gain from it, not companies.

Cheers

Louise

Hi ladies,

As a new VBAC'er to prolapse would love to know how you are doing to date? Have things improved for you? I'm looking for some sort of inspiration. I'm sick of this consuming my life, thoughts, mood. Thanks so much.