New here, 3.5 months postpartum, confused, scared and quite frankly, pissed off!

Submitted by Jordansmommy09 on June 10, 2009 - 7:08pm
Body: 

Hi ladies,

I've been reading lots of posts on this forum, and so many of them have been both informative and encouraging. I just received my book, Saving the Whole Woman, 2nd edition, a couple of days ago, so I am reading through it.

I must admit though, with as much research--and as many self-exams!!!--as I've done, I am still confused about what my issue is. Here's a quick back story:

I am 29 years old. I gave birth on 2/25/09 to a healthy, 9lb 4oz baby girl. I was 38 weeks 3 days pregnant, and her size was a HUGE surprise to all of us. I desperately wanted a natural birth, birthing in a squatting or semi-squatting position, but ended up needing pitocin induction due to my waters leaking and labor not beginning on its own. I labored for a total of 8 hours, 3 of those hours being hard/active labor after an amniotomy (no epidural, no drugs, still natural with the help of my doula and DH) and pushed for 1. My OB knew how much I did NOT want an episiotomy, and he said that i probably wouldn't need one as most of his patients do not. Well, my L&D nurse massaged and stretched my perineum during labor, and then while DD was crowning, my OB elbowed my DH to take a look, and my doula and L&D nurse looked too, and I guess it was just not happening without either chance of horrible tears in god-only-knows what direction(s) or a controlled episiotomy. So, there on the laboring table (yes I was laboring on my back because I was SOOOO exhausted from the pitocin contractions) I sadly gave my OB the OK to cut me. Ended up being a 4th degree laceration with I don't know how many stitches. I was then catheterized because I couldn't pee pee on the table after my DD was born. Is this routine? Who knows. I researched birth like a crazy woman (was on bedrest for 3 months due to an incompetent cervix that was treated with an emergency cerclage + bedrest at 20 weeks gestation--we are lucky I didn't lose our daughter), but didn't do any research about AFTER birth.

At my 3 week check up my OB thought things looked good, including my perineum (it felt okay by then, believe it or not) and did a pap, although I was still feeling "different" down there. I just figured it was normal wear and tear and would go back to "normal" by 6 weeks or so. By 9 weeks PP, I knew something was wrong. I did some research and believed I had a form of POP. I saw my OB again, told him my symptoms and what it looked like, and he said that POP is relatively common and did not act surprised. He did not do an exam but assumed it was a uterine prolapse. He recommended Kegels, said that the fact that I am exclusively BFing would help my uterus continue to shrink and pull upwards. He also said time will help, but that if it is still "bothering" me, to come back in a few months so that we can fit a pessary. To be honest, I was just relieved to hear him say that yes, it probably is a prolapse, and that yes, it is common and no, it is not life-threatening.

Okay, so if you're still with me (I apologize for the ridiculously long post), here is what I feel: it feels like a tampon is too low and is coming out, and sometimes when I do Kegels, I feel sharp pains. I have done many self exams with a mirror, and I don't see a smooth bulge--I see a strange, very fleshy-looking, and very tender-feeling thing blocking the entrance to my vagina. It does not look like a cervix, and when I insert a finger, I feel relatively "normal" all the way up--I just have to get my finger to curve around that anterior lump at the bottom. And the lump is hard--not "spongy" like I've read a cystocele being described. I am also on the mini (progesterone-only) pill as a contraceptive, and I've noticed if I miss it by 12+ hours, I bleed for days, and the bleeding causes my supposed prolapse to really act up and feel uncomfortable--even painful. Is that common?

I thought for a while that this lump was a prolapsed bladder because of where it is, but I don't have any of the urinary incontinence often associated with it. And if it is indeed a prolapsed uterus, and it is my cervix at the entrance, why can't I "push it up" to the top of my vagina? Wouldn't I be able to do that? This lump just stays put, although I can push it anteriorly somewhat--it is just super uncomfortable to do so. What does this sound like to you? Does it sound like a prolapsed bladder? Can I have a prolapsed bladder in the absence of urinary incontinence?

I should also mention that I often have days in a row of feeling almost normal again. It's then that i think "hey, maybe it wasn't a prolapse after all, and I'm back to my old self again!" But then a few days later, I feel the bulge and heaviness again. I also feel my best first thing in the morning.

I also must admit that this curve to the bottom of my vagina has always been there. It is just far more pronounced now seeing as though it is lower, and rubs my vaginal wall causing that "tampon" feeling. And I can REALLY feel it when I bend over to pick something up.

Also, I have not been intimate with my poor DH as of yet because I am SO very scared and freaked out by this whole thing. And I'm worried my poor poor perineum will be in pain as well. I feel awful for my sweet husband, especially since we have not been intimate since last October (due to bed/pelvic rest, then baby having...). He has been so patient and wonderful. He is truly my best friend.

Okay, this post has turned into a novel. I'm so very sorry. I would appreciate any insight you wise women would be willing to offer. I am still not fully convinced that this is a prolapse, but then again, what on earth else would it be?

I cannot believe how much I took my "normal" vagina for granted, and am still angry about my 4th degree episiotomy. It was my worst nightmare (except a C-sec would have been worse I think). Oh, the anger, frustration and general bitterness would consume me if it weren't for my sweet baby girl. For her, this was all worth it.

Looking forward to your replies, and to getting to know you ladies,

Shannon

alemama

June 10, 2009 - 8:49pm

There is actually a self exam article here posted under the articles section on the main page. You will probably be able to read it through a few times and know what you have going on. You can have a cystocele (bladder prolapse) with out incontinence. Since you have no other symptoms it is hard to guess if you have a cystocele or a rectocele. I would guess rectocele since it is your back vaginal wall that was compromised during your birth (episiotomy). Your symptoms definitely do not sound like uterine prolapse (cheer).
No it isn't normal to catheterize after birth- though it does get done (darn). Most often if you are allowed to walk a bit and have some time (a few hours) you will empty no problem.

Shannon you are amazing. You had a natural birth with pitocin in the hospital. I don't know how you did it. I know if I had been in reach of an epidural during any of my labors I would have signed right up!

I encourage you to go for it as far as sex goes. Your partner sounds understanding so just be gentle. It may even help you to feel better.
You can try seasponges or tampons to hold that bulge up
Recently there was some talk about lubrication and how it helps ease the low tampon feeling to be well lubricated

There is some great exercises here (search Nauli, Firebreathing, and DVD) and good advice on bending over properly-
downward dog is great for me- and so is childs pose and elbow and knee postures.

granolamom

June 10, 2009 - 9:08pm

hi shannon, and welcome to the site

I agree with alemama, its not often I hear of a woman sticking out for a natural delivery with pitocin in a hospital. now THATS strength!

without having seen you and without really the expertise anyway to diagnose, I'd guess that what you describe might be either a cystocele or urethrocele. sometimes a prolapsed bladder actually prevents incontinence due to the angle it forms with the urethra. I have a cystocele and have never had issues with incontinence.

re the minipill, breakthrough bleeding is a common side effect, especially if not taken as directed (ie the same time every single day). and many of us find that our symptoms are worse 'round our periods.
its also a common experience to have the symptoms subside and then reappear.
so pretty much, you're normal!

again, agree with alemama about giving intimacy with dh a go. use plenty of lube and go slow. if anything is uncomfortable, you'll change what you're doing or stop. but its worth trying out just incase it isn't uncomfortable! and believe it or not, many of us find sex is actually good for prolapse. kinda pushes things back into place for a bit.

davemayamom

June 10, 2009 - 9:11pm

Hi Shannon,

Congrats on the baby! My little girl is 4 months old - born January 25th! Sorry to hear about your rough pregnancy and delivery! Good for you for doing it naturally! Is she your first?

As for the prolapse, I was puzzled by mine too! Mine developed during pregnancy and it was misdiagnosed as a varicose vein til' 30 weeks. As it turns out, I believe mine is primary urethrocele, although this term is now being abandoned in favour of cystocele. I can't really feel my bladder either, but what I feel is rough skin (rugae), that seems to have fallen off a "shelf" (for lack of a better term) along the front/anterior wall. I can push it back up and it tend to fall down. It's not as big as a what I believe a bladder would be, and does not feel soft or spongy........Try not to get caught up in what type of prolapse you have - I know I was. Just try doing the work. Although mine is still there, it is bothering me less and less. You've found the right place. There are lots of us here who know what you are feeling and we'll support you!

louiseds

June 10, 2009 - 10:22pm

Hi Shannon

Great advice from the other posters, once again. We have all learned a lot from Christine, and now we teach each other.

One thing that has not been stressed yet is that you are only four months out from pregnancy and birth. Your body will have a natural period of reversion on the inside for about a year, then at a lesser rate for some time after that. It is so easy to think that you will be like this forever. You won't. The six week postpartum checkup checks that your uterus has shrunk properly, and you are otherwise OK, and will check that baby is growing well, and that you have thought about contaception. It is too soon to diagnose prolapse, which is probably why your OB acknowledged it but was not distressed about it. It was probably the best advice you could receive from a doctor, because they are not trained in all the things we can teach you about looking after your body and allowing it to heal as best it can during that next 11 months. We are not trained as doctors either! I look forward to a time when all doctors receive Wholewoman training.

Now get your posture organised, your diet, your clothing and the way you go about your life, and gently get into sexual relationships again. With care and being slow and gentle, I am sure it will be good for (both of) you. First time after pregnancy is always a bit unknown. I too will say, *plenty of lube* and use the postural principles to allow your body to keep your bladder and uterus forward. DH's penis will make a great short term pessary! Use regularly for best results. ;-)

Cheers

Louise

bad_mirror

June 10, 2009 - 10:57pm

As I'm sure you've read in other posts, 3.5 months pp seems to be the pinnacle of the worst of times for many, many women. My cystocele HAS gotten better since then, and I'm sure that whatever you've got going on will improve too. I'd like to add that I noticed feeling much better once I started moving. I really stayed bed and couch bound after birth, had a burst of activity, discovered the prolapse, then back to barely moving out of fear. I don't think this helped. I started walking several miles daily, and it has really helped my mental state and my body. Perhaps as you ease (stress the word ease) back into errands and exercise, you will likewise notice a change. I think that our human bodies are at their best when able to move and walk (in the correct posture, of course *wink*) the greater part of the day, and really feel the difference when we lack such activity.

kiki

June 11, 2009 - 12:44am

another congrats on your gorgeous baby. I am sorry about your delivery--but again, you are amazing!!!
It is good to find out what is going on, and as mentioned the self exam is really good. Keep trying, you'll figure it out.

As mentioned, 3.5months is really really early. My little one is 2 1/2 years now, and I still feel changes. Just be prepared it can be a bit up and down, and that's really really normal. Around six months things got a lot better for me. then i got sick, and they got a bit worse, then a lot better and plateaued for a while. But then started improving again...I recently finally got it together to start firebreathings / nauli / pelvic rocks (it's all on Christine's DVD) and again, things got a lot better again... So have faith things can really really improve.

Sexwise, my physio ordered me to have sex ;-) Your partner sounds lovely, and as long as you can go nice and slow to see how things feel, the prolapse shouldn't make much difference--lying down it all goes back in. He probably won't even notice. If it is uncomfortable, just try another position. Some people find their POPs feel great after sex. I find mine can feel a bit odd for about an hour after sex, and then move to the great stage. The odd isn't worse, just my getting used to them rearranging themselves to a new place...

keep posting here--anything and everything (we all have!)

and look after yourself--this will get easier.

Kiki

Jordansmommy09

June 11, 2009 - 12:33pm

Ladies, thank you all for your responses and encouragement. I knew I had found a good support board!

I am relieved to hear many of you mention the fact that 3.5 months out is still early. So many women (including my own mother who had 2 vaginal births and 2 C-secs from '69-'81) have told me that they were "back to normal" and feeling great within 6 weeks of their births (and my mother has also had a radical hysterectomy, and says she still feels normal and functions normally--why couldn't I have inherited that from her?!), so when I was still feeling odd at 9 weeks, I felt very abnormal, and a little inadequate. Especially given my diagnosis of an incompetent cervix (don't you love the medical terms they give us?), I was feeling especially inadequate already! So I will be looking forward to the natural improvements time should bring. And will also be getting back into an exercise routine. I think I'm going to order the Christine's DVD. I have a hard time getting the hang of exercises without a video as a visual. I tried the firebreathing, but am not sure I'm doing it right... Is Nauli also taught on the DVD?

Yes, I agree that this is most likely a cystocele, and perhapse a urethrocele. But here's another question if you don't mind: why does my bulge look so fleshy? Could it be that my vaginal wall tore a bit on the inside during childbirth, and has since then healed all "flappy-like?" I would think that if something is pushing the anterior wall of my vagina down, that it would look just like that--a smooth wall of a vagina. I must admit, the first time I looked at it a few weeks ago, I cried and cried because it looked so scary!

I know one poster on another thread mentioned that what she had thought was her cervix making an appearance was actually her urethra as her doctor pointed out. I don't even know what a urethra looks like! But if it could be mistaken for the cervix, the perhaps that's what my bulge is... I'm still trying to figure out how that's even anatomically possible!

I can't look back at the posts while writing a new one, so I can't remember who it was, but congrats to the poster who had the baby on January 25th! It is nice to connect with someone who has had a similar experience as myself so recently. We will have to keep in touch and keep each other encouraged and up to date on our progress.

Thank you once again ladies. I'm so glad I found this support group, and am already feeling better after reading your responses. It's nice to find people who understand.

Shannon

clavicula

June 11, 2009 - 12:56pm

I am 7.5 months post partum, but started the WW lifestyle only 2 months ago, so I am kinda new to this. Well, after my first period (c'mon, I am tandeming, how could that happen?!?! lol) and a yeast infection I am not in my best shape right now, but I have to admit, I feel so so much better compared to my first months.

I also would guess a cystocele/urethrocele, but do the self exam if you want.

The Nauli and firebreathing and the cool excercises will help you to improve gradually. Many members here, including me on the "2 steps forward one step back" route so don't be discouraged if you are not a different woman tomorrow.

Liv

luvmiboyz

June 11, 2009 - 2:18pm

I think you are refering to one of my posts about getting my cervix confused with my urethra.....i felt pretty stupid when the dr. got a mirror and some q-tip looking thing out and pointed to it and said thats not your cervix its your urethra...well i had never seen my urethra because it was high before my 2nd son was born and afterwards fell quite a bit and has sense then risen alittle but is still visible. According to my doc most woman's are visible so go figure. Sounds to me like your bulge and my bulge are a lot alike....to be honest im not sure if i have a urethrocele or cystocele..or both...im thinking i have both but i guess it really doesnt matter...I do have a rectocele that behaves when i eat well. I haven't had urinary incontinence but in the last week i started feeling like i had the urge to go a lot and i wonder if it has something to do with the fact that my bulge is less noticeable and that now puts my bladder at a different angle which gives me that feeling. I think its just all part of the healing process...you will be amazed at how your body heals over the next few months...hang in there! I had an episiotomy that left me with a 3rd degree tear and then a 2nd degree tear the second time and my body has healed so much. Keep practicing the firebreathing...that's when i started to notice a huge improvement, but i didnt actually get the hang of it until a couple months of doing it.

~Amanda

davemayamom

June 11, 2009 - 6:07pm

Hi Jordansmommy,

It's me that had the January 25th baby (girl too). Anyway, don't feel inadequate about the "bad genes". Prolapse is foreign in my family too! My mom had 4 babies; her first complete breach with an episotomy to the anus, then when on to have 3 more kids with episiotomies, and no signs of prolapse. Her mom (my grandma) had 5 children - no prolapse, and her sister (my aunt) had 4 children - no prolapse.......I had 2 kids 4 years apart with natural deliveries - no induction, medication, or episiotomy, and I get prolapse!!! My reasoning is that I've always had an "irritable urethra", and that my son came so quickly, my vagina didn't have adequate time to stretch!!!!.....Anyway, you can't change what has happened, and many others here on this site have gone on to have more kids and have stabilized there prolapse once again! You will get better and start noticing some improvements soon! I still have my bad days, but they are a lot better than they were right after the birth, and one heck of a lot better than when I was pregnant (my prolapse made itself known for the first time during pregnancy)!

I recommend getting the DVD. Much easier to follow than the exercises in the book. Nauli is demonstrated on the DVD, but not well explained. If you search this site for "nauli", you will find it well described. Also, if you search "youtube" for nauli, you will see demos with the shirt off, so you can really see what is happening in the abdominal region.

Keep posting with questions. The women here are the best - so helpful and supportive! I honestly don't know what I would have done/would do without this site!

Jordansmommy09

June 12, 2009 - 4:25pm

Liv, Amanda and davemayamom, thank you for the encouragement! I am already feeling better now that I've talked to some women who understand what's going on.

davemayamom, isn't it so bizarre that you can take all the precautions in the world during birth and end up with a prolapse?! That was one thing that I was angry about for a while. I guess I figured since I tried SO SO hard to do the right thing for myself and my first child, (and by that I mean still have as "natural" a labor as possible in light of the pitocin and amniotomy), was in SO much pain, and still ended up with issues. My sisters had typical american labors/deliveries with pitocin, epidurals, episiotomies, etc., and have healed perfectly fine. Not fair. But ya know, at least I have a beautiful healthy child, and am able to manage the mild (I like to call it "mild"--it makes me feel better! :) prolapse, and when I'm distracted (by visiting with people, doing light shopping with my husband, etc.), I don't notice it at all! So that's good.

I will definitely be posting my questions as they arise, as well as continuing to read older posts and Christine's blog posts.

Take care,

Shannon

louiseds

June 13, 2009 - 4:56am

Hi Shannon

Nowhere in the holy books does it say that life should be fair, or that if you do everything right the gods in charge will look kindly on you. That is one of life's hard lessons. You are wise to try and not compare yourself with your sisters.

It is still early days for all of you. Many women who have POP that is attributable to birth 'trauma' are asymptomatic for a long time. Let's hope your sisters' bodies hold up OK. If they don't, they will be very lucky to have you there to help them through adjusting to POP.

After the birth of my first child, which was a fully managed labour (NOT my choice, I thought I had healed completely and well. It took a second difficult pregnancy to realise that this was not the case. Nevertheless I had two lovely natural (apart from artificially ruptured membranes for the second), active, painful labours with my second and third babies, and having been through the POP diagnosis and recommendations for all sorts of complicated surgery, I am just doing fine, five years later, as I am, still in one piece, albeit a little ragged on the inside.

Life is not perfect, but it is good, and I have a prognosis that is one helluva lot better than it would have been, had I consented to the repair surgery. As a woman who has experienced the very powerful process of giving birth with your body, you have experienced something very precious. I would not choose to do it any differently if I was given the choice, except perhaps to have birthed at home with a familiar midwife instead of midwives who just appeared and disappeared as shifts changed, and with whom I shared no relationship. It is such a privilege, pain and all. It makes us fully human, and I regard it as a very important rite of passage for a woman who has kids. Some would say I am nuts saying that, but that's what I think. When it doesn't go as naturally or as easily as we hope, we just have to take what we can from the experience and move on.

Cheers

Louise