Postpartum prolapse??

Submitted by louiseds on August 13, 2009 - 9:37pm
Body: 

Hi All

I have been bothered recently that there are so many women only a few weeks postpartum who are posting that they are desperately worried about their postpartum prolapse. Why is this? It has to be because they have had that worry planted by somebody.

We know that in the UK, and possibly other countries with a taxpayer funded medical insurance scheme, or free medical care, you cannot have pelvic repair surgery until 12mo postpartum. What does this tell us? It tells me that *somebody* is well aware that there is natural healing and reversion of tissues at least up to 12 months postpartum, and that to do repairs before then does not give a 'satisfactory' result.

My guess is that "postpartum prolapse" should not even be in the medical lexicon. It does not exist, other than as a feature of the normal postpartum body.

We don't have a medical condition called 'hyper-alcohol ingestion', caused by drinking too much in one sitting, for which you go to accident and emergency the following morning. At accident and emergency you would be laughed straight out the door again!

You go home, feeling very mellow, go to bed and wait until morning, when you feel much, much worse. You stay in bed cos you cannot get your head off the pillow, and wish you had never imbibed. You might still feel a bit ikky in the afternoon as well, and may not eat a lot during the day, but as the day wears on you feel better and better, until you feel normal by the next evening. You promise yourself never to do that again! In short, you look after yourself, knowing that you will feel like dog poop in the morning, but secure in the knowledge that you will feel better in time.

What is the difference between that and postpartum prolapse? Yes, I know, there are differences, but ...

I wonder who has planted the doubt?

I wonder why we believed them?

I wonder why the temporary nature of quite serious postpartum prolapse is not explained to women before they give birth?

I wonder why women are not told that it will improve considerably until at least 12mo postpartum, and that it is of no longterm consequence at that early stage?

All these wonderful scans that women have early postpartum just scare the living daylights out of women, quite unnecessarily, and put them into hypnotising power of the surgeon. These are the *real* witches. These are the purveyors of fear.

This is a very harmful (to women) example of vertical integration in a marketplace, where the woman who becomes pregnant is pulled into the marketplace from the day of conception and bombarded with products, from pregnancy test kits, through early scans, foetal blood tests, more scans, more blood tests, pregnancy pilates classes, more scans, hospital births, managed delivery, postnatal exercise programs, more scans, artificial feeding products, immunisation schemes, etc. Some of them can be helpful. Some of them can be very damaging.

IMO, early MRI's for postpartum prolapse are simply another means of the medical system keeping normal women in their marketplace, for the benefit of those selling product, not for the woman concerned. As women, we should see them as such. We should treat anybody who suggests that a degree of postpartum prolapse is abnormal with the disdain that we reserve for any person who displays their ignorance of reality, despite the gleaming white coat, silk bow tie (or scarf) and years of university education!

New mothers have enough to worry about, without worrying about something that is normal and will resolve to a great degree (with help from Wholewoman) over time. Phooey to Yummy Mummies! After a woman gives birth is the only time in the world that a floppy belly and a distorted vagina is a badge of honour. Enjoy it.

Anyone want to challenge me on this?

Louise

luvmiboyz

August 13, 2009 - 11:32pm

I would deffinately never challenge you because I think you are absolutely correct...I've been feeling kind of down though because I am coming up on 11 months postpartum and I still feel like I have a ways to go....I hope my healing doesnt stop at one year or even two..i just want to feel normal again. I think things are starting to hit me that this may be how it always is....ill always be managing this and it takes all the strength I have somedays...no one knows what im going through. I want to go back to work so I can save money to go to college to get a job where i don't have to stand on my feet or lean over a shampoo bowl..but i feel like im not going to be physically ready and only make things worse...
Maybe im just having a bad week i don't know..it usually doesnt get to me like this but im just tired of dealing with it.
Amanda

bad_mirror

August 14, 2009 - 12:29am

Don't get me wrong -- I think the internet is the best thing since sliced bread and I am especially grateful when it brings me to places such as this Forum. However, I think my "experience" with postpartum prolapse would have been quite different if I'd not had the World Wide Web at my fingertips.

The scenario as it happened: Anticipating my six-week sign off to have sex again, I took a peek at my undercarriage. Saw the bulge and for some reason the words "uterine prolapse" popped into my head. It was 12 in the morning, my newborn was sleeping, and my husband was out of town. The internet at my disposal, I quickly figured out what I was seeing was a cystocele. I also ran into countless scary pictures and stories, with nary a mention of this being normal or capable of resolution. Let's face it, people usually only relay their experiences if they are sad/bad/scary. If you've nothing to complain about and everything is hunky-dory, you spend our time doing other things. I spent hours and hours on what should have been but a fleeting worry. I really only found one comforting article and Whole Woman out of that whole mess of depressing information.

Had I not had the internet: I would have seen the bulge and thought "uterine prolapse" and "I better ask about that at my appointment next week . . . can't worry about it until I know then." The midwife would have said exactly the same thing: "definitely no prolapse of the uterus, everything looks good." I would have breathed a sigh of relief, gone on my merry way, and chalked anything unusual up to -- oh gosh -- normal. postpartum. healing. Period. By the time I got to where I am now, I would have forgotten all about it.

So . . . pretty long winded there only to say that the internet is Pandora's Box come true. Lots of wonderful things in there, but maybe they should not be all let out.

I've heard that in some cultures, there is not even a word for menopause, because it is such a normal, almost uneventful event that is considered just another part of life. I agree with you Louise, in that the term "postpartum prolapse" should not exist, for what should be similar reasons. (and my forever thanks to you for your constant reassurances that this "condition" is both normal and transitory!)

And finally (I'll shut up in a minute, I promise) I too wonder why noooooo one says (no one!!) "after you give birth, you may have some sagging or bulging vaginal tissue. this is very common and almost always resolves within the year following birth with proper body alignment (posture) and general good health practices" (?)

louiseds

August 14, 2009 - 12:31am

Hi Amanda

I can relate to your impatience, and your yearning to just be normal. I am not for one minute saying that what your are experiencing is not real. I am sure a bit of the change is normal, because you have been pregnant and birthed a baby. There may be some prolapse that won't resolve. In that sense this is the new normal. Your body *will* never be the same again as it was before you were pregnant, but it will probably be OK, and manageable. The sloppiness does take quite a while to resolve, and by the time it does you will probably have forgotten what your sixteen year old body was like!! LOL!!

The body heals slowly and Time heals, but it also dilutes the memories, and those memories become less important, because your have so many more important things going on in your life. I don't for one moment expect to to accept that this is what happens, but when you are 50 you will understand. Hang in there. Bet patient, do what you have to do, and keep dreaming and planning. Your future will be what you make it.

Louise

louiseds

August 14, 2009 - 12:31am

Hi Amanda

I can relate to your impatience, and your yearning to just be normal. I am not for one minute saying that what your are experiencing is not real. I am sure a bit of the change is normal, because you have been pregnant and birthed a baby. There may be some prolapse that won't resolve. In that sense this is the new normal. Your body *will* never be the same again as it was before you were pregnant, but it will probably be OK, and manageable. The sloppiness does take quite a while to resolve, and by the time it does you will probably have forgotten what your sixteen year old body was like!! LOL!!

The body heals slowly and Time heals, but it also dilutes the memories, and those memories become less important, because your have so many more important things going on in your life. I don't for one moment expect to to accept that this is what happens, but when you are 50 you will understand. Hang in there. Bet patient, do what you have to do, and keep dreaming and planning. Your future will be what you make it.

(((Hugs)))

Louise

kiki

August 14, 2009 - 12:32am

HI Louise,
thank you for your great insights. Interestingly, I'm in the UK and everyone told me "it' will get so much better"--two general doctors, the midwife, a surgeon, and a phsyio. Wow! you'd think i would have believed them! But, it was so hard to believe that this golf ball can ever shift, especially when I read online the info on POPs, and everything mentions "for anything but mild surgery will be necessary." well, that was me--how could i not need surgery? i thin those sites should be banned. they just made me sure this was it....

The only thing that helped me to believe things could improve was hearing the stories of women here. Even then, I doubted it could be me....

If instead doctors said this was a normal thing, maybe i could have felt differently. But, I think it's so crucial we have forums like this, to hear what is possible...

Now if a doctor had even said I'd needed surgery, eek i would have totally fallen apart! But luckily, I live in a country that doesn't want to waste tax payers money on unnecessary surgery...

Amanda--
I am so sorry you are feeling this so much. Don't lose hope! It won't always be like this. I kept having huge improvements until about 2 years. Then I got the DVD and they started again. Then I changed my diet and wow!!! I can't believe how good my POPs feel with the diet changes. I want to stand on a roof and shout out about it (but ours is really slopey, so I won't...). Seriously, so much more can change!
I now often am up all day and it doesn't bother me. Leaning over a shampoo bowl however would be challenging to find a way to do it in posture... But, if you need to work leaning over to get to a better place for you, there's gotta be a way....

I know for a while things felt much better for you. Has something shifted that you think has made it feel worse again?
Also when you say you always have to go, which POP is it feeling like that with?

I will say that I do think I will always have to manage my POP. I will at the least always have to ensure I eat so I'm not constipated, not lift insanely heavy things, and stay in posture. But, I don't feel it day in and day out anymore... so yes, you may need to be mindful always, but that's different to feeling it all the time...

Hang in there!
Kiki

louiseds

August 14, 2009 - 12:46am

Thanks Kiki, your encouraging words to Amanda are great. You are right. Improvement does have so many faces.

All the world is a sale. Everything has something to sell. That's what keeps the world going around. Marketing works on fear, the most primitive emotion, that prevents us from being gobbled up by lions and tigers. It is very valid. However, when commercial interests plant fear in our hearts, hiding behind ad clips with glamourous characters, catchy music, attractive colour, humour and general feelgood stuff, it is about as hard to resist as a computer virus. We are literally seduced by possibilities. If we hear their speil often enough we do begin to believe it, especially when we start hearing it from different sources. This is how humans take a shortcut to sorting out fact from fiction. If you hear it from one source it might be true, two sources it is probably true, three sources and it becomes cold, hard fact.

The moral of the story is find the evidence yourself, rather than swallowing what you are sold.

If it looks too good to be true, it probably is.

And Kiki, what you say about the Net is so true. In that sense, my Mum who does not have POP, and was zonked out on twilight sleep for my birth, does not have a clue what happened during her labour and my birth. She also does not have a clue about how her body works. Naive and happy, I call it. But I wouldn't be in her shoes for the world.

Cheers

Louise

luvmiboyz

August 14, 2009 - 12:41pm

I keep trying to post again but everytime i get ready to the kids need me! be back later! to explain whats going on with me

mzimm

August 14, 2009 - 7:42pm

I have my best friend in town today--her first time seeing our little girl. It has been SO refreshing to have her here and have something else to occupy my mind!! I was just telling her today on our walk that I don't think I would have known anything was wrong if I hadn't looked! Sure, things felt funny for awhile, but it was my first baby and a very traumatic birth. By the time I was 10 weeks postpartum, I don't think I felt anything out of the ordinary, but I KNEW there was something wrong so I continued to feel constant anxiety. I really wonder if my doctor would have mentioned anything at my checkup...who knows. I am, however, very thankful for this website as a positive alternative to all the depressing google results!

Also thanks, Louise, for your original post--I have found several studies online that show a degree of prolapse in the postpartum period to be very normal. I agree that the response to those of us who have discovered "the bulge" ourselves often makes things much worse in terms of mindset!

luvmiboyz

August 15, 2009 - 12:38am

I think you guys are so right....when i looked at 3-4weeks postpartum i really didnt think anything of all the bulges and weird things i saw...i just thought oh it will go away ...or hmm was that there before? no i dont think it was...and i thought surely this is normal and will resolve itself..and then i didnt give it a whole lot of thought after that until a couple more weeks went by and the bulges didnt change and so i started looking up "bulges" in vagina and when i found out what it was i didnt panic but thats when my symptoms seemed to get worse. A lot of it has been in my head im sure...of course not being able to empty my bowls was a problem and deffinately not in my head..and that horrible feeling of falling out which i actually dont feel that often anymore wasnt either.....I guess my main problem is that i just feel weird down there...I have such good days and then i have some bad ones and it just sucks...I know some of it is just me being paranoid about it but even if it isnt realphysically it is real in my head and i dont know what to do about it....i wish i was blissfully unaware and naive and didnt take notice of the weird things going on in my vagina but i am too aware of my body and notice any changes at all so that would not be possible.
~Amanda

kiki

August 16, 2009 - 12:39am

I hae to be very very quick but...amanda, you are reminding me of something. I remember that up until a year or maybe 18 months, even though it was soooo much better, i just felt weird. I just felt something there, and it really bugged me. So, I decided to see if I could change how I felt about it, and experimented with my reaction to my sensation. Rather than thinking of it as horrible, I tried to think of it as an awareness of a part of me I was rarely aware of. Or, could I tell myself this was a pleasant sensation?
I didn't get there 100%, but it changed my way of thinking about it which really helped. Instead of every time I felt my bulge thinking "this is horrible!" i tried to be kind and loving to my body, and just think "hello, there you are" and just be aware and think loving, positive thoughts. It helped me to feel better about what was going on, as I do think how we react to our bodies is very much in our heads...
And then, with time, I stopped noticing anything much of the time. Now when I do it's very much my body trying to tell me something, so I have to listen in a whole different way.
(this is not to say I didn't still wish everythign felt normal or panic as Louise and everyone else here can atest to! but, it did help to reshape my thinking / feeling...)

okay gotta run...sorry! but wanted to share....

Kiki

PS Louise, i know blissful ignorance can be a bit to ignorant. I just hate that every site except this one just says "you will need surgery, you will get this problem, you will get that...." it's horrible! wow am i glad i found Christine's site...anyway, really do need to run and work. sorry!

fc12

August 17, 2009 - 5:04am

Kiki
I think your post is so spot on and very valuable to read. It's like feeling eczma or some other 'condition', acknowledging what it is, perhaps using this awareness to either check posture, do a quick nauli etc Sort of saying 'oh there it is' instead of despairing that it's about to 'fall out' or degrade very fast from 'mild' to 'severe'. I panic when I get the sensation thinking it's the beginning(again) of the end. Recently my celes have got much worse and suddenly so. I'm so scared of that moment in the day when I first feel it because it gets me thinking of how bad it's feeling again.

Your words resounded for me. It's about doing some thinking work to improve our feelings towards our bodies and specifically about the POPS. I know my thinking needs to improve if I'm going to see any positive change to my Pops. Or even appreciate life a bit more.

Hope this makes sense. It's hard typing such posts in your iPhone on the train!!
Cheers, fc12

mzimm

August 20, 2009 - 2:46pm

I just wanted to add that I had an interesting conversation with my OB yesterday along these lines. I will be exactly 3 months pp tomorrow. When I saw her for my pp checkup (at 8 weeks pp), I had already been in to see another doctor in the practice because I was SO freaked out after looking in the mirror (at 4 weeks pp). She told me I had a mildly prolapsed uterus and very slight cystocele (although, she didn't examine me standing but that seems to be the norm for OBs). My husband and I both thought she appeared surprised at how mild the prolapse was.

Anyway, I have often wondered if I'd even know I had anything "wrong" if I hadn't looked. I feel I have a very open and honest relationship with my OB, so I finally just asked her if she would have said anything about it at the 6 week if I hadn't already been concerned. She told me that she probably wouldn't have mentioned it, especially since I had more trauma than the average delivery that would take longer to heal. She said I am not abnormal and to give it several more months as many women take that long before they begin to feel "normal" again. I am very thankful for her honesty, and will hold onto the words "you are not abnormal" because it makes me feel better. That has been my biggest mental obstacle is feeling like a weirdo when all my friends seem to have wonderful deliveries and quick recoveries. Now I wonder how many of them weren't much different than me but never knew (or won't know for many years)!

This conversation left me feeling very mixed, though. On the one hand, I wish I hadn't taken a look so early and googled and freaked out. Mostly because it took away time that I should have been focused on my sweet baby. On the other hand, I am thankful that things ARE getting better and I know that there are important lifestyle changes to make to ensure the best chance at healing. It is just such a fine line from being aware of my prolapse and obsessing about it. While I am dreading going back to work in some ways, I am also excited to shift my focus a bit and get out of my own head (and my own "plughole" as Louise always says!).

badgermum

August 20, 2009 - 4:32pm

with bad_mirror and kiki about the perils of the internet. I discovered my pop at about 3.5 weeks when I first decided it have a look to see how things were (after only one stitch compared with loads first time around I was expecting much less of a horror story, but then I found the bulge!). It was only after I looked that I became especially aware of my rectocele. I'm in the UK and to be fair to my doctor she did tell me that it just looked like a vagina that had given birth recently and that it was likely to get better. I think that after frightening myself with what I found on the internet (until I found ww site) and the prospect of surgery I just didn't believe her. So I think that part of the horror of the prolapse was of my own making (with worry enhanced by post-partum hormones/emotions and tiredness).

I think the reason I was so shocked and horrified is that I didn't know that prolapse was so common, it hadn't occurred to me that it would happen. I think if women were better informed of the possibility of it occurring and the scope for improvement it would be much less scary. There was certainly no mention at antenatal classes, appointments with the midwife or in any of the books on pregnancy and birth that I have. I found it very difficult to find any information on what is "normal" for postpartum vagina anywhere else (incredible that there are so many of them but that no one seems to talk about them!). For me the greatest solace was from members of this forum.

I'm 4 months pp now and feeling much better about things, not sure how much physical improvement there is yet (trying to keep in posture but been pretty terrible at making time for the DVD) but definitely hugely improved on the emotional side (acceptance and refusal to let it dominate these precious early days with my baby).