Bladder is litterally falling out!

well, that must've been one frightening experience!
I don't know if this is reassuring or not, but there really is a limit to how far a bladder can actually fall. and it isn't to the floor. 27 days pp is very early, very very early. kegels never worked for me in terms of 'holding it in'. and walking the floor with baby in arms was awful for my prolapse too. I had the benefit though, of having previously stabilized my prolapse before I got pg, so I knew that as bad as it was, it would get better.
and double check that picture you saw. sometimes they pull things out further for the photo shoot to make it more obvious for description. and some of the photos I've come across online are taken during surgery so part of the dissection has been done. so it appears worse that it would with the surrounding tissue intact.

I had varying degrees of prolapse after each of my 3 babies. The worst was after my DD who is now 8 years old--it was really bulging out. It eventually went back in and up after a few months pp. Take it easy and it will be ok!

Hi Fruitful Womb

Sorry to hear about yesterday's freakout experience. I too think you need to be very careful about drawing too many conclusions from pictures you see on the Net, especially when you are feeling vulnerable and prone to suggestion.

I had the unpleasant experience on the weekend of lifting a bag of potting mix out of the back of a ute (pickup??). I carried it upright, around the middle, and remembered what it was like carrying a toddler who would not put his legs around my waist, with my pelvis thrust forward, and it came back to me what it was like, trying to remember to stand upright when my arms were pulled forward by a babyload. It is really hard. How *does* one walk the floor with a fractious baby? I could just dump the potting mix, but it isn't that easy with a baby, is it?

Instead of walking the floor, could you sit or straddle and rock, or rotate, using an office chair? Or put baby in the pram and do the old 'push it back and forth over a lump in the rug' trick? My guess is that you were very upset and all hunched over and tense and fearful, and *that* was the problem, as much as the weight of the baby. It is a no-win situation. The advantage of sitting is that you have something stopping the descent, and further damage when you are sitting down. Then at least you know your bladder is inside, and you can let go of the fear. I think kegelling can be counter-productive once the bladder has descended that far, simply squashing it further downwards.

Once baby stopped crying, what did you do? Did the bladder go up again?

Of course you are too early postpartum to think about the longer term. Just deal with today and figure out how to avoid that posture tomorrow. Baby steps. This too will pass.

Cheers

Louise

I had one that I liked to sit on while pregnant. But, thought it was a great way to get the baby back to sleep instead of walking the floor(uhhh!) It keeps you in good posture and you can watch tv doing it!! Or, just keep it in whatever room you want to get the baby down in. Just make sure you have a large enough one so you aren't too low to the floor.

When my youngest was that little her upsets were mainly tummy/gut ones. I have a glider with an ottoman which also glides forward & back as you rock. One of the absolutely most calming things for my daughter when distressed was to lay her on her back on the ottoman, with one hand holding her ankles, legs bent and flexed like a V with the vertex - her ankles - near the diaper area, and then to use her legs like a little pump, toward and away from her body, which also pushed her forward and back on the glider (she'd be moving forward and back head-to-butt, not side to side). This is an adaptation of one of the classic colic massages, the bent V legs pumping toward and away from the abdomen (I probably got it from Dr Sears), meant to help move gas out of the gut, but had the glider motion as well. This became like a magic calming/settling device for her, no matter what the illness, until she was too big to fit her torso on the ottoman!

In earliest months she also loved a very brisk walk through the neighborhood in a Baby Bjorn front carrier, very snug and facing forward, often with my hands cupped over the carrier over her belly, me singing energetically. It was the only distraction that worked to break a cycle of increasing late afternoon fussiness. We went forward facing very early, as she really welcomed the carrier's snugness/pressure over her abdomen, and liked seeing the world as we passed.

Good luck, I hope you find some calming distractions that are easier on you!

alphamom

Just wanted you to know that I am thinking of you and hope you are feeling better. You are going to get better for sure. Keep taking it easy. Elbows and knees when you can....

Hi Fruitful

I mean that once the bladder or even the uterus falls backwards and down far enough, eg by flattening the lumbar spine, the higher up parts of the pelvic floor, ie up towards the sacrum attachments, can be squeezing the body of the uterus or bladder across the middle, rather than behind them, so they can be squashed outwards, not inwards. I think this is one of the reasons why women with POP experience frequent need to empty the bladder, even if their PF is quite active and 'strong'. I think the bladder gets irritated by being squashed across the middle and thinks it is full, and wants to empty. The pelvic floor muscles squeezing it will indeed increase the internal pressure in the bladder and it might indeed start to pee as a result of that. That's my theory, anyway. I have personally experienced the desire to pee after getting out of the car after a long drive with a full bladder. If I get out of the car carrying my heavy rucksack (with my abs braced) and remember to bend over from the hips straight away, then do a couple of kegels, I can get my bladder forwards and out of the danger zone, but if I don't, the bladder complains and wants to empty right there and then. Very weird sensation! Very embarrassing and messy too. ;-(

You can see diagrams on pp 25-27 of STWW, ed 2, that the pelvic floor muscles attach quite high up to the bones of the pelvis and sacrum (when the woman is standing) and are in slightly different planes from each other. POP is a prolapsing backwards, then downwards; it is not just downwards, onto a 'trampoline-like', 2D sheet (as it is so often described in the material we read). I guess they describe it like that because it is simple to visualise, whereas in reality the PF is quite geometrically complex, even though it is functionally more complex.

BTW, my Oxford Dictionary defines prolapse as "organs slipping forward and down". It would seem that either Bladder and Uterine prolapses are misnamed by the wise medicos who named them in the first place (There is only forward slippage if you are referring to rectocele). Or else the Oxford Dictionary is wrong. I know where I would put my money!

I guess the problem lies with the fact that medicos visualise the body from a horizontal position, and do not speak the same language as living, breathing, vertically-oriented women. It you are lying down, the change in position when bearing down is downwards and outwards. Forwards doesn't come into it! Go figure. No wonder we have difficulty communicating with doctors! >:-[

Christine, do I have this pelvic floor explanation right?

Cheers

Louise

It may be that you are trying to suck it all in so much that you are sucking in your lower belly as well. Remember that inside the relaxed lower abdominal wall is the pozzy reserved for your uterus and bladder to live in. If you contract those muscles too much the organs will slide backwards again. I think this is probably most important when you are postpartum and very 'slack' on the inside. I hope I am right on this!

L

fwiw, I think you are right on that

Hi Fruitful

There's not actually anything wrong with tightening your PF muscles. God gave us the nerve pathways to allow us to do it, so it must be OK.

However, if you tighten when you get that fullness and pressure my guess is that your organs are already down in a position where kegels will simply squeeze them, rather than lifting them. There is nil research that says that kegels will improve prolapse. These muscles are thin and sinewy, not meaty and designed for lifting anything. When in WW posture they stabilise from the back.

I suggest that you save the tightening for things like sneezing and coughing and lifting babies. You can do some kegels every day if you feel your PF muscles are like jelly. They are useful for helping you to get your bladder under control again after having babies, but don't overdo them, or your P/F really will feel like jelly, cos they get tired. Do Kegels properly as Christine suggests in her blog, rather than just rying to keep the PF tight all the time, and do as much walking and flapping as you can. Simple walking, nice big strong strides, gives the PF a good workout.

Re the lower belly, think about your pelvic cavity as a simple 2 gallon laundry bucket. Mentally hold it up by the handle, then stand a full 1.5litre (80 fl oz?) softdrink bottle in the bottom of the bucket. Now tip the top of the laundry bucket slightly, and the softdrink bottle will fall over onto the side of the bucket. Much of the bucket's weight will now be carried by the side of the bucket, and much less weight will be carried by the bottom of the bucket. Half the bottom of the bucket can be missing, and it still will not fall through! The bottle will not rest on the side of the bucket unless you tip the bucket and give it room to tip.

Tipping the bucket is what you do when you relax (not push out) your lower belly. The weight of your pelvic organs (in their still-very-stretched fascia) flops forward, and their weight is largely transferred by your lower abdominal wall and your pubic bone. There is not a lot to push down into the top of your vulva. With your breasts prominent your ribcage rises, and extends your rectus abdominus anyway. If you tighten your transverse abdominus which sretches across the front of your pelvis you will push your organs backwards and over the abyss. Your transverse abdominus, rectus abdominus and transverse abdominus muscles act like a trampoline when you move, absorbing intraabdominal forces and rebounding them onto the sacrum, spreading out their effect, neither fully stretched, nor fully contracted, simply 'being'.

The other effect of 'tipping the bucket' is that it nutates your pelvis slightly, around the sacro-iliac joint, rotating the two halves forwards slightly. Because the two SI joints are not parallel, the ischial spines at the back of the pelvis move further apart. The coccyx also moves away from the pubic bone. This has the effect of stretching all the pelvic floor muscles (front to back and side to side) more tightly over the pelvic diaphragm, so they become tauter without your needing to contract them all the time! Magic, eh? This nutation business and its effects on the pelvic floor are all explained and illustrated very well in STWW, ed 2.

DH tells me he gets much more contact between his penis and my vagina during coitus if I am in this nutated-pelvis position, so it definitely is evidence for me that it works. The poor darling put up with my 'jelly jinie' for a very long time before I found out about WW posture. Now jelly jinie has turned into elastic-jinie, *and* I can still squeeze my PF muscles on top of that! (Sorry ... TMI.)

That's the long and the short of pelvic floor muscles and lower abdomen relaxation.

You are only 34 days postpartum!! Give yourself a break! It might get worse before it gets better, but I bet you will feel a *lot* more together in six months. I'm glad you are making the most of DH's time at home. Don't lose faith in your body. Trust it. Go easy on it. It knows what to do. Frustrating I know, but time is a wonderful healer.

Cheers

Louise

I have read and read and watched the videos with firebreating and all and am not getting the nutuation and counter. Do we do both? Just not getting it. Please Help or anyone who has gotten it. Got to do this all right. Don't want to screw up and do more harm than good.
Thanks

They are both to do with the small amount of movement in the sacro-iliac joint (between the sacrum and the iliim bones of the pelvis - the big wings). It is only a minor amount of movement. There is also a small amount of movement between the two pubic bones at the pubic symphysis (under the pubic hair, centre front).

When you lift your chest and relax your belly, the weight of your belly will tip the pelvis forward slightly on your SI joints (remember the bucket with the full bottle of softdrink?). Your coccyx will move up and back slightly, and because the SI joints are not exactly parallel, the ischial spines on each side of the pelvis, move further apart, and your lumbar curve will become more pronounced. Also your pelvic organs will flop forwards (just like the fish in the plastic bags in Looking for Nemo), so they are positioned over the pubic bones, rather than over the vagina.

This is nutation, and it naturally/geometrically tightens the pelvic floor muscles, because they have to stretch further from side to side and from pubis to coccyx.

Counternutation is the opposite. If you tuck your butt under and pull your tummy in the bottle of softdrink in the bucket will stand upright. Your pelvis will tip backwards at the top, your lumbar curve will decrease, and your ischial spines will move closer together. Your vagina will also be more upright, and your pelvic floor muscles will be floppy because the places they join onto (ischial spines on both sides, pubis at the front and coccyx at the back, will move closer together. This sets your body up for prolapse because your pelvic organs can easily slide backwards and down the plughole.

When we walk, the two halves of our pelvis move independently. The half with the foot down counternutates while the half with the foot in the air nutates. There is slight movement at both pubis and SI joints to enable this to happen. That's why our pelvis is not completely fused at the front, and the SI joints. They are both short, fat, very strong ligament joins. walking in WW posture gives your pelvic floor muscles a good workout with every pair of steps you take.

Is this any clearer?