New member - second pregnancy

I don't have a lot of time, but read my posts. I developed a cystocele during pregnancy. Read all my posts from November on...I'm 11 weeks pp and things are getting better - no c-section. I really believe I would be worse off if i had one....gotta read a story. I'll respond later

I was in a rush. I should have mentioned there are quite a few members who have had natural births after prolapse. They are wise and have lots of advice to give - see posts by alemama, granolaman, fruitful womb, and others. (I too wanted a c-section when I was pregnant to protect my bottom, so I can relate.) I don't think any of them wished they had had a c-section after the fact. Personally, I couldn't imagine trying to maintain the posture after a c-section......I had a very rough pregnancy and a natural birth (no meds), and a small tear (1 stitch). I felt much better with the weight off, and I'm trying to be patient with my healing. I'm more mobile and able than I was when I was pregnant, and even during those first few pp weeks. I"m staying in posture, doing the exercise DVD (not every day), nauli, and firebreathing. I don't think my prolapse worsened with birth - according to my O.B., it looks better. I was afraid to look during my pregnancy, and am only now getting the courage, so I cannot comment on that. I can only say I feel better "down there", and if I had a c-section, I believe I would be much worse.....Read all the posts. It will make you more confident about a natural delivery - it really is best for baby and mom.

welcome to the site and congrats on the pg!

I had a baby about 18 mo after finding my prolapse. I have to say, give some serious thought to 'going natural' this time. an epidural is not your friend. pain lets us know when something is wrong. pain motivates us to fix it. pain is what tells an active laboring mother how to move and what positions to get into to best protect her pelvic organs and to help the baby move down and out in the most optimal way. laboring and birthing flat on your back is probably the worst way to go (aside from c-section...not talking about true medical necessity here). personally, my last baby was born at home, I was on my hands and knees and did not push aside from what my uterus was doing. I know homebirth is not for everyone (probably not what your dr dh has in mind!) but still you can have a natural birth in a hospital setting if you plan well for it (I'd give thought to hiring a doula too). you are right about worrying about taking a scalpel to the intact muscles and fascia in your abdomen. I haven't come across any research which shows this to be protective of pelvic organ prolapse, and it goes against common sense anyway. in addition, c-sections are more dangerous for both baby and mother.
alemama just had an amazing homebirth waterbirth and even though she tore badly she feels better off than had she had a c-section.

so my advice to you is to read all you can on natural childbirth. I loved my book on the bradley method, though I didn't use the bradley method, it took away the fear. learn all you can about prolapse and the posture although its hard to maintain the posture in pg, it will give you an understanding of how to protect your pelvic organs in labor. plan well for postpartum. do NOT give in to the urge to be up and about, back in full swing at 6 weeks.

can't think of anything else at the moment. will check back later.

Hi Phoebe9,

I was the "Brace Queen" during my pregnancy!!!! I had supports for everything! I was glad to give them up after I had the baby (all except the V2 supporter)! The best support (but it is a pain to put on)is the "Prenatal Cradle". This has straps that go over shoulders and under the belly to take some of the pressure off the pelvis. I used this combined with the V2 supporter (a crotch support that provides some counter-pressure). I also ended up using an SI-joint compression belt to support my Si-joint as it was pretty lax and unstable during my pregnancy. I started wearing them all around 22-24 weeks, when I tried going without them, I wouldn't last long. I wouldn't get out of bed without getting them on!!! I researched all of the supports, and I think I got the best on the market. You need something that goes over your shoulders to provide the best lift for your growing tummy (not pretty, but effective). I purchased them online, there are a few websites that sell them - just google the names I gave you. Good luck and keep us posted!.....By the way, when you got to the point where your prolapses were grade 1, could you feel them? I'm having much better days (especially compared to when I was pregnang), but I'm tired of feeling my prolapse (I'm only 12 weeks pp, so I should be patient).

for more reasons than one you would be wise to avoid a surgical birth if possible. You can check out the website for ICAN- they list all the complications/informed consent information for c-sections. But as far as prolapse goes you are right on to assume that cutting into the abdomen is probably not going to be good for prolapse.
Hypno birth is pretty great- but doesn't always work- there are other forms of relief besides epidural or natural. Of course they all have possible side effects- but still they are there and then you would not be immobilized and still have great relief.

also you are one of the lucky women with prolapse in that you have already experienced just how much you can heal from birth. In 18 months you had an enormous amount of healing- and you were not even practicing the posture or breathing exercises then. Your recovery this time is going to be even better!

I second the recommendation to read more about birth- Ina Mae Gaskin is a good one. You sound like you enjoyed your first birth and it seems to have been very straight forward- so you are over a major hurdle there- not a ton of birth baggage to go through- and you have the knowledge that your body can do it well and easily.

Congratulations on your pregnancy.

Hi Phoebe9,

Thanks for your info. on your recovery. It does help to know a time frame, I MUST learn to be patient. I do feel I'm SLOWLY getting better, but progress is slow, and it is spring, so I'm feeling energetic, yet limited! I'm doing acupuncture too (so far I've just had one session), so hopefully this will help. I'm actually a P.T, but I've booked myself in with a P.T who specializes in Pelvic Floor for interest sake. I want to see what the field is doing in this area now!

As for the crotch/V2 supporter, I felt it really helped with the feeling of tiredness on my perineum. It's kind of like a little lift i.e. holding yourself when you have to go! They were made for vulvar varicosities, but help with incontinence, prolapse etc. I still wear it. Some days when I haven't worn it (because I'm sick of wearing it), I feel tired in my perineum area by mid-afternoon, and put it back on. It goes on over underwear, and it fits like underwear. Unfortunately if you are wearing smooth, tight fitting pants, you can see thicker "panty lines" with it. I highly recommend wearing pants/shorts with pockets to conceal it!........I didn't get my prolapse til' I was 17 weeks pregnant, and then, wasn't correctly diagnosed til I was 30 weeks. I never imagined something like that could happen to a young, pregnant woman with only 1 child. Anyway, without these supports, I don't know what I would have done. I worked up until 33 weeks, but my job was pretty light. No lifting, mainly educating, consulting, and lots of driving........And yes, I believe it does hold stuff in that is protruding. I never saw how bad mine was, but I think my urethra was protruding pretty badly........Talk to your physio (that's what we call them in Canada), and see what she thinks. Good luck and keep us posted on the rest of your pregnancy. You can do it! And you CAN do a natural birth - it is usually much easier the second time around! (They ususally make the epidural/pain meds ease off before you have to push anyway, so why NOT do it natural. I found being on hands and knees with my husband providing counterpressure to my sacrum good. Also, I used a Thermphore heat pad and brought my IPOD. Some relaxing music (I used ENYA) always helps.

Hi Phoebe

It is not too early for thinking about this stuff. If you need to change your labour and birth plans in some way it is best to start early in pregnancy so you have time to check out alternatives.

It sounds like this OB has a labour and birth package that she sells, which includes epidural anaesthesia, regardless. As she says, she would need a painkiller, because she is not familiar or comfortable with natural childbirth and its course. She wants to be in control. This is ringing alarm bells for me.

I had an epidural for my first labour because I had pre-eclampsia. One of the side effects of epidural anaesthesia is that it produces large decreases in blood pressure, which was needed for me. So much about epidural only affecting feeling below the injection point!! I was so wild about this at the time but decided to go ahead with the OBs plans, cos I wanted to live and I wanted our first baby to live too! I could not feel a thing from the breastbone downwards and could not have pushed to save myself. I had forceps, stirrups, and of course an enormous episiotomy.

I was a completely passive observer. I might as well have watched the whole thing on TV. The little gift-wrapped baby I received at the end of the 'process' dulled my disappointment considerably, but I mourn the loss of active labour and birth for my first baby, to this day.

Yes, I now know that I had POP after this first birth, but nobody said anything at the time.

For the second birth the second stage was on my side. Yes, it was pretty good, a little laceration, but nothing major, no tear, no stitches. I wouldn't have wanted an epi though, because the labour was very active, with lots of walking, right up to transition. When I stopped walking the contractions would stop, so I just kept pacing the corridors with DH. The poor darling was exhausted the following day! With an epi I wouldn't have been able to walk, and that would have slowed or stopped my labouring.

The third was on all fours, which was even better, cos I wasn't lying down, so I didn't feel like I was a passive participant, and I could adopt positions which were most comfortable for me with posterior presentation right up to transition, when DS2 suddenly flipped over into normal presentation.

After that first experience of how helpless I was in the birth of my first child, and the results of the epidural being forceps, cos I could not push, and episiotomy because without it they couldn't get the forceps in, or out, and a reduced space for the baby to come out because I had to be on my back and my coccyx was pushed towards my pubic bone, there is no way I was ever going for an epidural out of choice. All it did was cause a cascade of other problems which were medically induced. I wish there was another way of reducing blood pressure. To this day I do not know if there could have been. I certainly wasn't offered it.

What I am getting at is that doctors, and especially specialist OBs are experts in medical action thinking. They are not in the business of helping mothers to birth naturally. That would be too unpredictable for many (though not all) of them. They are in the business of managing labour and birth the way that is comfortable, and low-risk for *them*. They often choose the advantages of things like epidural anaesthesia for them over the advantages of no epidural for the labouring woman. Most people are uncomfortable with seeing another person experiencing pain, and would rather do something, anything, to alleviate it. Your OB may have transferred her experience of birth to you, thinking you are like her.

You would think that the POP penny would drop for her, but she is probably too busy to think about how she got her POPs in the first place, or to think about other ways of looking at birthing, which are not medical. She is, after all, a doctor! And she *will* have that op later, if the penny doesn't drop in the meantime. Hopefully, if nothing else, you have challenged her thinking, and if you leave and go to somebody else, she will realise that you are serious about not wanting an epi for good reason, related to POP. She possibly sells POP surgery as well as managed births. It's called value-adding in Marketing-speak.

I don't think you will change her mind in a hurry, and I wouldn't be comfortable having her deliver my baby if she is not experienced with a hands off approach, with no epidural. I would be exploring a different OB, or you might find that she will pressure you to have an epidural (for her benefit) late in pregnancy, when it would be difficult to change OBs.

In addition, you would be well-advised to find a good series of natural childbirth classes so you can gain the confidence necessary to embark on birth, knowing that you will probably experience pain, but it is pain with a purpose, that mothers from time immemorial have experienced and birthed through. What a wonderful achievement that will be for you. (I think your DH needs to be in on this too, so he can gain confidence in you and your ability to birth your baby without anaesthetic intervention. A scared DH is no asset in a birthing room.)

Cheers

Louise

I haven't yet read louise's post and I'm sure its alot more sensible than mine will be, but...

that isn't very nice of your ob. your husband I can forgive if only because I will assume he's just afraid of your being in pain and the laughter was his defense mechanism. but your ob should know better. You are a young, healthy, strong woman. your body was designed to birth babies. yes, in some cases of prolonged labor, pain meds are in order. but I think in the overwhelming majority of cases where a laboring mother chooses an epidural, she is lacking in support. obviously, the choice is yours and honestly (even though I'll admit it might not sound that way) I totally support a woman's choice of having an epidural. I'd just like to see every woman supported to choose either way. know that if you wanted to, you could birth this baby totally naturally. hands and knees is not at all tiring. you can bend the elbows to rest on the floor if you need to, and easily shift your weight around too. much less tiring, ime, than the squat. hire a doula if you want to go natural. sounds like you'd do well with someone in your corner, believing in your ability to do this. I forget where you are, but 'round these parts there are always student doulas offering free services in exchange for experience, so money doesn't have to be an issue there.
you probably could be on your side even with an epidural, but the point is that you won't be able to be active, or respond to the signals your body sends you. though I would say sidelying is preferable to flat on your back for sure. I think chances are that your OB sees few squatting/hands & knees births because the women in her practice likely aren't encouraged to move freely during labor and assume any position they please. while she probably doesn't discourage, I doubt she suggests these positions either.

in any case, you still have plenty of time to go. plenty of time to figure out how you'll want to do this, but don't let anyone tell you that you can't.

Hi Phoebe,

Listen to G-mom and Louise! You CAN do it! I was open minded about my first baby and always left open the possibility for an epidural. My water broke with him and contractions were hard and fast and we barely arrived at the hospital in time. I told them immediately I wanted an epidural, but I was almost fully dialated and was told "no time for one now". So, I had an unmedicated birth! The pain was short lived, and yes I was on my back (i didn't know any better), but immediately afterwards, I said I would do it again! A few weeks after he was born I realized I had an extremely colicky baby, and I remember thinking birthing was easy, it's dealing with the newborn that was the hard part. (At 4-5 months he was waking up every 1-2 hours at night, and he's still a very intense personality!!.......With my daughter I knew that I could do it, and I just told the OBs that I didn't want any pain meds. As I said I laboured on hands and knees, and found it quite comfortable (not tiring), I did most of my pushing in side-lying - started on hands and knees, but wasn't working for me. The pain is so easily forgotten, and is so short-lived. I've always felt great right after delivering the placenta........By the way, there are other non-medicated ways to combat pain - acupuncture (during labour), TENS machines, and MUSIC!........I KNOW YOU CAN DO IT!

Hi there Phoebe
I don't know enough about the relative risks for the prolapse - will leave it to others to advise, but I wanted to add my positive experience of the natural route in hopes it's of interest as you make your decision.

my first labour, like davemayamom's, was so fast I barely even had any entonox (gas and air) before the wee one fired out like a cork from a champagne bottle.

I chose to have the second at home, and got through most of the first stage with Tens machine. When that stopped having enough effect and I needed to progress to entonox, i discovered that the tank the midwives had brought wasn't working properly (picture my expression at this point! I may have uttered the odd curse too...!!)

It was too late by then to go to hospital for any other kind of pain relief, so I had to take a deep breath (as it were!)and deliver without. I must admit I was rather terrified that I wasn't going to be able to cope with the pain this time (which felt more intense than for my first child), but my midwives were great and with a lot of loud lowing and mooing (I really did surprise myself by how much I sounded like a cow) I got through it. I was kind of kneeling up over a chair for the exit - the midwives wanted me to go on my back but I knew that wasn't right for me and they were happy to go with my instincts (I think things are a bit easier in the UK than the US because childbirth here is much less medicalised and in practice is usually mid-wife led, rather than obs led.)

both my babies were smallish - less than 7lb - and had small heads(!) so I had some advantages for the natural route! But a good friend has given birth to a couple of whoppers (11lb and 10.5lb!) naturally - she did water births and recommended it very highly.

You're sure to get lots of - frequently conflicting! - advice over the coming months about what's best. but whatever you choose to do it'll be for the right reasons - for you and your baby's health - so i hope you don't find yourself worrying and agonising over it too much (I reckon that bringing a baby into the world is enough of an achievement however you do it, without feeling you need to be either a natural-birth-superhero or a 'good patient' who does what the doc says.) But, it was a lovely experience to do it naturally, so if you're able to make that work for you, then that's great.

And I think the advice from louise and others to find an obs who's willing to work with you and support you to make your own choices is really sound.

For what it's worth, after the rectocele came back with a vengeance after no2 (barely a prob with the first), I spent a lot of time beating myself up for not going for a c-section to minimise further damage. But have since heard from my PT that there's no way of knowing if it'd have helped, and it could have left me in a worse position, so I'm now glad I didn't!

PS someone gave me the ina may gaskin book - I found it interesting and a good counterpoint to medicalised approaches, but it did seem rather, umm, extreme in parts to a stiff Brit like me - especially the bit about kissing your husband during contractions to help release happy hormones to ease the pain. I don't know about you but I really was NOT in the mood to kiss my husband during contractions - hit him with a stick while shouting "I can't believe I let you get me pregnant!", maybe, but not kiss him...!!;-)

Wishing you all the very best for both pregnancy and labour.

Mumtogirls London