New here - my story - prolapse after birth of my daughter

Submitted by smu on January 24, 2010 - 9:05pm
Body: 

Hi there,

I am a 36 yo australian woman, and have one child, a daughter, who just turned 3. Her birth was mostly a very beautiful experience - one of the highlights of my life to date. I had practised hypnobirthing so I was in the 'zone', meditating, concentrating on my breathing, not afraid at all during the whole first stage. I had no drugs, just my husband and i were there mostly, I was under the shower a lot.

However, during my second stage I was coached by 2 midwives to push. Since it was my first child I just believed them and did what they said. I am and was quite strong - , and I pushed and pushed until my hands on the birth stool had blisters on them. Still after 2 hours I didn't seem any further along and at that point the Obstetrician poked her nose in and suggested a vacuum extraction. I was demoralised and very tired, the midwives seemed at a loss, and so I agreed. I had an episiotomy and extraction, and she was born very quickly, and she was in perfect health. So, so far so good. I was disappointed I hadn't done it all naturally but it seemed ok and I was elated with the rest of the birth and to have my darling there.

In the days after I noticed I was having difficulty making it to the toilet without leaking, and it was difficult to have bowel movements. I thought everyone must be like that since there was so much that no one had told me about birth and babies, despite the fact that I had read every book I could and asked questions.Prior to her birth i was very fit and strong, I had done yoga, dancing, hiking, soccer etc and had never even considered that incontinence could be an issue associated with having babies. No one even mentioned it in the antenatal classes I went to. Some people vaguely talked about pelvic floor exercises, and i did them sporadically, but other than that I just assumed everything woudl go back to normal itself.

After about 3 months, one time when I was out for a walk, I completely weed myself, to the point where my jeans were soaked through and I was terribly embarrassed. I went to see the physio the next week. She told me I had a mild prolapse, a weak pelvic floor, and to do pelvic floor exercises (kegels), 3 sets a day, of both slow and fast. I kept going to see her and mostly did the exercises and it did get better. But, I still kept assuming it would keep improving.

Here I am, 2 1/2 years after I began seeing her, and, although its better, I still usually leak when I sneeze, can't run or jump without leaking, and so I haven't been able to go back to soccer, dancing, or the lifting and carrying of packs needed for hiking for a few days. I went through a real period of grieving associated with that. No one could tell me it would get any better than it is now (actually, the physio told me that 1-2 leaks a month is normal for any woman... and as long as I didn't run, jump, dance etc or do any of the things I loved to do, I only leaked sporadically), and it seemed i had done everything I was told and everything the books said.

I was really excited to see this website, that there might be more I could try. I have the DVD and am trying the posture and the exercises. I am wondering, do you think they could help me, given that my condition is mild (nothing is outside my body) ? Should I keep doing the pelvic floor exercises?

thanks everyone for being here, this is a really unique place

alemama

January 24, 2010 - 10:06pm

I did hypnobirth too and it was awesome (but not until my third birth)! and I also had coached pushing with my first birth (and stupidly complied)- that went on and on and ended in a deep tear and awful repair. So I kinda feel your pain.
Is the leaking the only symptom of prolapse you have now? I have not had that particular symptom- mine are bulges and aching feelings (that have been helped greatly by wholewoman).
Have you tried a pessary?
What would probably be helpful for you is to understand why you are leaking- I am guessing you have a cystocele? If that is what is going on- then you can certainly get better once your cystocele starts to reverse back into normal position.
Give this a bit of time to start working (6 months or so of very diligent work on your part), stick around and ask any questions you run into...
there are some great old posts about anatomy and leaking you might find helpful

smu

January 25, 2010 - 6:18am

Thanks Alemama,

Yes that coached pushing! I really, really wish I had known how potentially damaging that could be. I could even feel my baby's head before the coached pushing began- and 2 hours later, it was in exactly the same place! If I had just relaxed and followed my body instead, I am sure the second stage would have been much faster. Anyway.... Yes leaking is the only symptom - no pulling or pain that I have noticed. A pessary - no I haven't, and the physio didn't suggest it - although she did mention trying a big tampon if I want to try jogging some time.

I think I have a cystocele, also initially I had a rectocele, but that seems to be now fine. I don't fully understand whether I also have weak pelvic floor muscles that somehow cause or contribute to the leakage? But what I don't understand, if thats the case, is why they haven't recovered after 2 1/2 years of pelvic floor exercises? I am not always diligent, but I have always done them at least once a day, and for periods of a month or two, many more times a day. I can certainly feel a contraction around my finger if I test myself.

smu

February 1, 2010 - 2:45pm

Any other ideas? Has anyone improved their incontinence if it was associated with a 'mild' prolapse through WW posture?

...My update is that, in the last 3 weeks I have done the basic exercises and the firebreathing every morning, basically sat in the posture all day...then last week, just before my period, was a disaster. Leaking every day, and one day, not even after a sneeze or jump. I have noticed in me it is always worse in the few days before my period and the first day of it.

louiseds

February 1, 2010 - 6:57pm

Hi Smu

We have previously discussed leaking around menstruation, and from memory, came to the conclusion that it was related to that part of the cycle, and that maybe it was not even urine that leaks. Trouble is that it is difficult to find keywords that don't hit every Topic in the Forums. One of the other longer-standing members might remember.

There is another fluid, often released during orgasm, sometimes along with urine. It seems to come out of the urethra, and is thought to be from 'prostate-like glands around the urethra' just like the male, which makes sense to me. Maybe this is the nature of it, if it is not urine. Maybe it is urine. Sounds a bit TMI, but if you save the knickers, or pantiliner for a bit you can smell it if it is urine. The smell will be different if it is not urine.

Even if it is urine, the leakage may be quite normal. If you wear pads, rather than tampons, it could be leaking in a minor way right through your period and you wouldn't even know, though it is obviously heavier on the first day. It is also possible that your first day flow has some clear fluid from the uterus mixed with the menstrual flow. The other factor would be that we are often quite bloated just before a period. Maybe some of that fluid kind of oozes out, rather than all coming out via the kidneys. I think our internal tissues might act as semi-permeable membranes, ie when there is pressure in the pelvic area (as demonstrated by vulval sensations of POP), it could be osmotic flow, where the water molecules are small enough to pass through, but salts are too big. I might also be talking out of the top of my hat on this bit! ;-)

You could try a little experiment. Use a tampon, sea sponge or menstrual cup to collect the contents of the uterus, but wear a pad as well, to catch anything that comes from your lower vagina or urethra, this separating the two sources.

Yet another consideration is that when we have POP we can get a bit obsessive about what is happening in our genital area. We certainly take more notice of what is going on down there. Your body will behave differently after having a baby. You might just be noticing it more now you have found your POPs. I am not discounting what you are saying is happening, merely pointing out that it might not be what you think it is.

Hang in there. This period too will pass.

Cheers

Louise

smu

February 2, 2010 - 5:21am

Thanks Louise,

that is a new angle.

I'm 95% sure it is actually urine, though, because I've had chronic stress incontinence since DD was born 3 years ago. Two years ago, it happened 3-4 times a week, not just during my period: whenever I coughed, sneezed, laughed, jumped, danced, and especially when I was tired (which was all the time...DD wasn't a sleeper..).

It'd been a month or more since I noticed any stress incontinence and so I had a bit of shock when it seemed to come back as bad as ever this week. On sat I was walking down the street when I sneezed and a tiny squirt shot out of me so fast I thought it would go right through to the pavement....very embarrassing....luckily it was a warm, slightly breezy day, I was wearing a little floaty skirt, and it dried in no time...

Anyway, because of the 5% of me that thinks it might not be urine, I'll try the experiment and report back next month.

louiseds

February 2, 2010 - 8:59am

Hi Smu

The trial might tell you something. But it might be the old incontinence. This is what we call a setback. You get a bit better and think it is all working out, then wham, back to square one. I guess you have to take a longer perspective and say, "Am I better than this time last year", or six months ago. It can feel a bit like two steps forward and one step back, but you will make slow and steady progress. Do I have less incidents? Are they smaller? When do they happen? Keeping a diary might help to identify what is happening over time. Just use symbols, to differentiate between a big accident and a little accident. Mark in your periods so you know wherer you were in your cycle.

When you had the major spill, was it just after a meal, when you could have had bowel contents shifting around and putting pressure on your bladder? I find that I might get some wind, and will leak a couple of drops while I am actually farting. I am sure that is what it is.

Smu, after 2 1/2 years postpartum I would think you are well and truly over the natural recovery from the birth. In your position I would be pulling out all stops to get this sorted. You've made a start on your posture, which is good. I would get back to the Kegels routine, but I think I would also go and have a urologic assessment, which will tell you if there is anything else happening. It is pointless putting yourself through all those Kegels if there is something else happening. The Kegels certainly won't hurt, but make sure you do them properly. See Christine's blog. Do a diary. The information will be useful for anyone assessing you. You can't go on with an unpredictable bladder for the rest of your life. You might be able to tame it, and know when it is going to happen and circumvent it, but it is ridiculous to live in fear of wet embarrassment.

BTW, it is a major head adjustment having the confidence to stretch right out into WW posture and not tuck your butt. Tucking your butt is often a protection mechanism, but it loosens the pelvic floor and moves the bladder backwards so it can droop down. Lifting your chest and allowing your belly to relax gives your bladder room to tip forward out of harm's way. Your coccyx lifts and your ischial spines move further apart, making your pelvic floor greather in area, but tighter, like a drum and less likely to leak. Opening up the back of your bottom seems counterintuitive, but it is sensible when you think about it. You will need to read Saving the Whole Woman to understand why this happens. Christine describes it beautifully and it has great illustrations to help you to understand.

Of course you will get over it. You have only just started! Maybe your physio was right about a couple of leaks a month being normal? If they are only occasional, and only minor, maybe it doesn't matter. It is the self-judgement that is the hardest part to get over. As you say, it dries, and nobody really notices a little leak. If they do, they don't usually make a big deal out of it. If I see a woman with a damp patch, which I cannot recall ever happening, I would just think she had a leak. Big deal? I don't think so.

Chin up, and on with the trial.

Louise

smu

February 2, 2010 - 7:48pm

Louise,

your experience and advice is very much appreciated. Its hard to get some perspective on this when there is so little reliable info out there, especially from professionals. It takes some time to take in everything and then decide which info is quality and which isn't.

I'll order STWW as I do need to understand a bit better exactly why it works.

I've been doing some kegels every morning along with the basic WW exercises from the DVD. I have been doing them in the kneeling position just on the muscles around the vagina (and hopefully? urethra?), and those around the anus don't contract at all. That is another thing I found out on the web - that it is possible to learn to feel these muscles and contract them separately - I practised for 2 weeks and I got it.

Thanks about the diary - yes, that makes sense.