New Here - Grade 3 Prolapse

Body: 

Hi Everyone,

I just joined this forum and ordered the WW bundle. I hope it arrives soon. I'm overwhelmed by all the information here and am hoping that this will be the solution. I'd like to post a little about my background and see if anyone can relate or has advice.

I am 36 years old and had my first baby last May (2009). It was a difficult unmedicated labor, 3+ hours of pushing (in various positions but mostly on my back). Ever since then I've had a feeling of my insides falling out (plus frequent urination) but thought it would go away. When my son turned one and it still hadn't gone away, I went to a physical therapist specializing in pelvic health and she said I have a grade 3 prolapsed uterus as well as cytocele and rectocele. She gave me the following exercises: Kegels 5x per day (five 10-second holds and 10 quick flicks each time); various strengthening exercises for glutes, thighs, and stomach (all in horizontal non-weight-bearing positions, very easy as far as exercise goes). She said I can have more children but the prolapse will make pregnancies uncomfortable and possibly higher risk, and that the prolapse will worse with each pregnancy. She also said I will need surgery to fix the prolapse after I'm done having babies. I had resigned myself to this until I read about WW on the Mothering.com forum. Now I'm hoping that perhaps none of the above is true, that I can have as many babies as I want, not have surgery, and still be able to do whatever activities I want. Is this a pipe dream or realistic? I'm also a former personal trainer (now a full-time mom) and love to lift weights and be active. It's driving me nuts that I feel like I have to be so careful at the gym and lift way less weight than I know I'm capable of lifting. I also feel hesitant to carry my 24-pound son around, but he still loves to be held and I don't want to deprive him of that.

Thanks for reading and thanks in advance for any comments!

Carrie

Hi Carrie

My first awareness of what I now recognise as the start of POP was after the birth of my first born, in 1982. I went on to have two more, the second being a very stressful pregnancy for my pelvic floor. It did worsen after the second, but once my pelvic floor was rehabilitated, which didn't take long, I was bck to baseline. It didn't get any worse after the third, and was OK, but not perfect for about fifteen years after that. I then contracted asthma and had a lot of marital problems, which involved a lot of stress and its constant companion, constipation, which I think were the main cause of the worsening. Oh, and I became perimenopausal too.

2004 I found Wholewoman and began to get my head around what I had to do. Nearly six years later, and now having experienced menopause, I have lost the fear of my organs falling out that I previously had, and though my uterus, bladder and rectum *can* all come lower than ever before, they rarely do, because I use my body way differently, both with my posture and the way I do tasks.

There have also been big changes in my head, about adapting my attitudes. I no longer strain to lift anything, having become very resourceful about finding ways to accomplish the task at hand. The task still gets finished!

My body looks different. I have lost the backward tilt to my pelvis, no longer hold my tummy in the way I used to, or tuck my butt under. My posture is always proud and tall with prominent boobs out the front. I have had to get over the idea that a small tummy is good, and a big tummy is bad. My profile is now different. My boobs are farthest out the front, then my tummy. In profile my tummy is at a different angle, and quite taut, with the bottom part of the lower abdominal wall almost horizontal. I can no longer see my pubes when standing properly. My tummy certainly doesn't stick out!

I would imagine that having been a personal trainer, you would find some of these changes very challenging, especially reducing your own expectation of your weight lifting ability. After POP diagnosis a whole heap of things that we really love, or do a lot of, become less desirable when we realise how risky they now are. I am sure that you will be able to find another way of challenging yourself athletically. We have many women on this site who are serious sportswomen.

Yes, your body has been changed forever, but it doesn't necessarilly mean that you will have to change your lifestyle dramatically to match, and become an invalid couch potato. It just means you have to learn a bit more about how your pelvic region really works, and tailor your body movement, diet, clothing, exercise and working environment to match, the same way as you would if you experienced any other sort of chronic injury. You just work your way around it. It may take some time, and a bit more independence on the part of your little boy, before you see dramatic improvement, but I am sure that your body will respond to Wholewoman techniques the same way as it has for those of us who have been doing it for years. The more time and effort you put into changing the way you use your body, the sooner you will see results, just like weightlifting.

So go plan another baby. ;-) I would still leave it a few months if you can before getting seriously pregnant again because your body is still reverting from the first pregnancy, and you want to get on top of this frequent urination thing, which is probably what the physio is targeting. It would probably also be wise to get some progress on reducing your POP symptoms and getting your posture organised, before pregnancy throws in more adjustments.

I think your physical therapist's words are a bit extreme, but without knowing about Wholewoman, entirely understandable. No, the prolapse won't automatically get worse with each pregnancy. It might if you have poorly trained birth attendants/midwives and do much of your labouring on your back, because these two factors will pre-dispose you to further prolapse. Yes, you might have discomfort during your pregnancy, but that is pretty normal at times anyway. Higher risk? What does that mean? Have to have repair surgery after finishing having babies? I don't think so, if the Mamas here are any indication! Of course, having repair surgery before finishing having babies makes it a whole heap more complicated, and no woman would do it on purpose, but it sometimes happens. Having repair surgery before menopause opens up the possibility of this happening to anyone. It is not the end of the world if it happens, but why have the repair in the first place??? (as you have found).

Carrying a 24 lb baby around would be challenging for me. My solution would be to find a sling or two that enable me to carry him, and remain in WW posture, and get down to play with him on the floor.

Get reading Saving the Whole Woman for all the technical lowdown, and get cracking with the DVD. Hope to hear from you again soon.

Louise

I "came here" at three months pp after my first baby, at age 31 and with a cystocele. Scared out of my mind! I read every post and blog and article here, read the book and watched the DVD and learned so much. My body began to respond to these methods, and today, at 20 months pp I have almost completely reversed my cystocele. I have no symptoms, do what I want physically, and feel like a stunning woman. I am constantly being complemented on my posture.
Carrie, I am certain that you can heal well and grow your family. There are woman here who have had two or more babies post prolapse and say they are even better off for having done so. You may want to read posts by alemama who has worked as a personal trainer and is incredibly active -- and has four children.
The way I see it, there is nothing to lose by trying this. The only challenge may be in the patience -- people want instant results and this is an evolution. As you know from weight training, it takes dedicated practice to sculpt your body. This is also a body sculpting of sorts -- you are retraining your fascia to best support your organs. Many cultures believe that it takes a full two years for a woman's body to completely heal from pregnancy and birth -- not just six weeks! So you've got a great year of healing ahead of you! Welcome.

I've had two babies since finding my prolapse and I am no worse off. in fact, my prolapse is smaller, higher and much less symptomatic now than it was when I first found it. WW works!
I hope its ok to mention that another one of our members (alemama) has also had another baby, plus she trains. the woman is toned and strong, I tell you.
I agree with louise, that as a personal trainer, some of the exercise modifications recommended may be off-putting. I'm a physical therapist and I found that in the beginning I had to really keep reminding myself to stay open minded about the posture. it was very different than what I had come to believe in as True.
I'm bad about carrying around heavy toddlers. I know it isn't good for me, but they are small for such a short time and in the moment it seems so important to them, so I do it far more often than perhaps I should. that said, because I'm so careful about my posture, most of the time I am just fine. I even wore my 3.5 year old in his baby sister's sling the other day and no worsening of symptoms. and even if I am worse the next day, I know I can just ramp up the exercises and get back to my baseline.
so no giving up hope yet!
learn the posture, learn nauli and firebreathing (all in the book), learn your body. listen to it, work with it and above all show it some love and respect. you can birth more babies. you can hold those babies and run around with them without fear of your pelvic organs dropping out.

I want to reply to these comments but I'm not sure whether I should "reply to comment" or "add new comment" so I am posting a test message first.

Thank you for the responses. They do make me feel less alone in this. I have to be honest -- some of the things I'm reading about having to stick out your tummy all the time and avoid lifting heavy things are freaking me out. But, I did order the book and will read it with an open mind. My main priority is being able to have another baby, but I have a lot of other "wants" after that one. I think I am a little depressed, thinking that I will be limited in my life by this problem. I wish I could go back and give birth differently. I'm a bit in mourning for my pre-baby body, but not in the way most women are -- in mourning for my previous pelvic area rather than a six-pack of abs or something like that.

Thanks again for sharing your insights. I'm still trying to read all the posts here so I can learn more while I wait for the book.

Carrie

Well, you don't *stick out* your tummy, you just don't *suck it in*. Can you see the difference? Check out this picture: http://www.wholewoman.com/picture_library/goatgirl.jpg This *is* whole woman posture, and her tummy sure isn't sticking out. I think the word "relaxed" makes the stomach aspect of the posture a difficult concept to grasp. Really, by lifting the chest, the abs are lifted but there is no holding, clinching, clenching, or sucking of gut going on. They are taut just by the way the upper body is used. Look at Shakira in one of her Hips Don't Lie performances on YouTube. Her stomach is a perfect example of the whole woman look -- softly rounded, feminine, but toned. Yeah, not a six pack, but strong in a very feminine way that cannot at all be called dumpy or lax.

As for the lifting, many here enjoy using free weights, and I know that Louise is always out wrestling a sheep or a boulder, building a fire break or otherwise moving the earth. These things can be done, you just learn a way to do them that protects your body.

And wow, I hear you on that sadness. It has been mentioned before here that this is a definite grieving process, but take heart, because you will move beyond it in your time. You will.

Hi Carrie

No, Badmirror is right. You don't stick your tummy out. I just posted an explanation of all the abdominal muscles in reply to, Happymum, under "Anyone else has this symptom?" Have a read of that. It might help you to understand it a bit better.

Carrie..........
I feel for you. Your story was my story and when I came here I was terrified I couldn't have another baby. I had all three like you following traumatic delivery of my son - and still do. He was fine thank god but I ended up with corrective surgery where they botched my episiotomy a year after his birth which helped my pain down there although I couldn't tell where it was all coming from. I refused prolapse repair surgery a) because I'm a homeopath and wanted to see what I could do and b) because my mum is a PT and we wanted to combine forces. Then I found WW and began to get to work once I'd ordered the book. I rememebr thinking before I was diagnosed, 'you know, I think I have a prolapse - but these poor women, they have three! Poor things! How do they cope?!' and then I got my diagnosis. Ha haaaaa! Little did I know I did too! And so I got to work. Really hard. And it all paid off as I had my beautiful daughter almost a year later at home, in water. It was beautiful. I didn't tear or need one stitch and I wanted to go and show those medics what we as a team had achieved as they told me to 'go home and count your blessings'. It's NOT worse, in fact I would say I'm in better shape than I was a few years ago. You CAN make a difference and I would say in all of this not to forget the part that your emotions can play in all of this too. I needed to heal emotionally as well as physically after my violent birth and thankfully I didn't come down with PND but I'm sure I would ahve done had I not gone to live with my wonderful mother. All I would say to you is get to work, stay positive, seek refuge here as it is wonderful this place and get doing research now about who you'll have as your midwife for your next whole woman baby. And look at doing it in water as then all your organs will be supported and you'll S-----T---------R----------E--------T---------C------------H rather than be on your back in an unnatural position forcing your organs out. You can do it! And last week I ran the race for life with some amazing women for charity and I tell you waht, if you'd have asked me to do that 4 years ago I'd have told you it would have been totally impossible. There was no way I could walk, let alone run. You go girl. x

OK, you all are officially awesome. I feel much more hopeful after reading these last few comments. I really hope my WW bundle arrives soon.

Regarding midwives -- my first birth actually WAS midwife attended. I had my prenatal care at a local birthcenter and was supposed to give birth there. However, my labor had to be induced because my water broke and I did not go into labor (we waited roughly 48 hours). Because of the induction I was in the hospital on continuous fetal monitoring. Because of the monitor, I could not walk around (though I was allowed to stand next to the bed and did stand for most of the labor before the pushing stage). I'll spare you the details of how the induction went (ugh), but I fully believe that if I had been able to go into labor naturally, I wouldn't have had to push for three hours. The other thing is, I was allowed/encouraged to push while I still had a lip of cervix left, so I believe I was basically pushing my uterus and cervix out with the baby instead of pushing the baby through the cervix. I have since heard so many cases of women being encouraged to do this and I don't understand why.

I'm not sure of anyone around here who does water births, but I'm intrigued by that. They have tubs at the birth center but they are not allowed to use them for birth, only for labor.

Carrie

Glad to hear it! Well no wonder you are where you are. Cause and effect.....You can get it better, honestly you can. Ok so I'm in the UK and I'm guessing you're in the US - that's just dreadful that you're "allowed" to use the tubs for labour. Do you see how we have become conditioned? That we think it's ok and don't question what we are and are not "allowed" to do during a time when our bodies want and need to be instinctive.....ooh, it drives me mad. Of course, there are times when the medics need to step in but we've become too afraid of litigation that it's affecting the way we're "allowed" to birth.
Perhaps someone can begin to point you in the right direction as far as water births are concerned wherever you are....perhaps a home birth with a private midwife might be your solution???
J xxx

Hi JBee,

The tub thing is actually a Pennsylvania law. A tub has to be open on/accessible from at least three sides to be used for birth, and the tubs at the birth center are only open on one side (like your typical bathroom tub). So, if they were to let women birth in them, they would be shut down and the midwives would lose their licenses and perhaps be prosecuted.

Not sure how I feel about home birth, but I did a quick search on water birth in my area and didn't come up with anything, but I will probably start asking around to see what I can dig up. There may be some independent midwives who are not tied down to a birth center.

I just don't get this whole thing of women pushing with a lip still on the cervix. If I had known what I know now, I would not have pushed until I had that feeling like you're going to just DIE if you can't push RIGHT NOW. Instead I was told that the urge to push feels like pressure sort of like when you have to have a bowel movement but moreso. Having experienced the urge to push, I think that's a load of hooey.

Regardless, I can't change the past, so just need to figure out what to do in the future.

I had an appointment scheduled today with the Pelvic and Sexual Health Institute of Philadelphia, but I had to reschedule because there was terrible weather and flooding. Bummer. I was looking forward to hearing what they will say and perhaps getting fitted for a pessary.

Carrie

Hi Carrie

So you are in Pennsylvania!

I was in Pennsylvania (Lancaster) for a few days, a couple of years ago, and was dying to find out how Amish women 'do' labour and birth. Unfortunately I got a migraine type thingy and was out of service for most of that time. I was so p***ed off! I never did find out, except one Mennonite woman I spoke to, who took us on a car tour of the area, who told me that many Amish woman have 'wrecked bodies', or some similar description, which I took to mean birth trauma and related ongoing gyn / uro problems. She just shook her head when I asked her to explain further. Perhaps it was all TMI for her. I really think she didn't have the words, or perhaps the cultural permission to tell me. There may be a conspiracy of silence surrounding things that go wrong. Or matters 'down there'. Or perhaps it was because my husband was with me at the time. Yeah, probably was!

Do you know if there is a home birth tradition among the Amish? I would have imagined that they would have homebirth all sorted out but, perhaps being so conservative, and patriarchal, and Old Testament "in sorrow shall you bring forth your children" that the knowledge was never developed for safe, active, natural birth. Perhaps trauma is the norm because that is what God apparently said would/should happen?

Oh, I do hope you can find the right support.

Louise

I have just had baby number three and can honestly say that my cystocele is no worse his tome round than with the others. It has gradually improve each time as the baby weans and stops breatsfeeding as much but I have never felt tis was a reason for me to stop nursing early. I am trying homeopathy as well this time in an effort to reduce the symptoms but I really don't feel that the cystocele has worsened due to more pregnancies and it was never a problem during pregnancy or birth either so don't let it pit you off having more babies if you want

Hi Lollyb

It is so refreshing to hear from a Newbie who has the confidence to say that your POP has not worsened, and not stopped you from having another baby, and encouraging JDsmommy to go with her heart on this.

Fear is a genuine and basic emotion that can save us from all sorts of horrible things, but if we don't rationally assess the evidence before locking in to its clasp it can deceitfully rob us of so many wonderful opportunites in life.

Louise

It's gonna get better.
she said
" but the prolapse will make pregnancies uncomfortable and possibly higher risk, and that the prolapse will worse with each pregnancy. She also said I will need surgery to fix the prolapse after I'm done having babies"
and....she's wrong!
isn't that great. I bet her knowledge isn't first hand. I bet it's something she was taught by some other people who have no clue :)
You are gonna be able to lift as much weight as you want chica.
Get into the posture. Make it yours. Live in it. When it seems second nature to you then get back into lifting. Your body is capable of being very very strong.
and of having more babies.
You are going to get the birth you want next time too.

"Allowed" ... I like your style, JBee;) It is a totally insane world when a birthing women needs permission to do this or that in labour (insert Monty Python line here , 'You're not qualified!'). Unfortunately, as Carrie explains, stepping out of one's home and into an institution means that their rules trump most else, thus protocols like birthing in a tub with x sides, etc. For goodness sake, the mind boggles!

Re encouraging women to push with a lip or some cervix remaining...there coupld be a number of reasons for this and I am happy to chat with you about it further. Most often, encouragement to push is concern over time frames, because it has now been noted on the chart that Birthing Woman is nearly completely dilated, pushing has commenced, thus you are on a time frame to push the baby out (what is it these days, 2 hrs for primips and 1 hr for multips?). So if the choice is between letting nature takes its course (nature rarely gets the memo about time frames) or 'helping' a bit of remaining cervix to slip past the baby's head, well-meaning care providers think they are actually protecting women from further interventions down the road (vacuum, etc). Many care-providers are also working under the faulty assumption that a lip is always a problem, and while sometimes it might be, it often is not if you have the tools to figure out what is needed in a situation. And these tools do not come from the machines that go ping ;)

Amish births - I have learned SO much through the years from listening to midwives to Amish communities Amish talk about birthing with these families for decades. That is where you learn about long term effects of births, when you get together for tea with a woman you attended 20 yrs ago. Homebirth is alive and well for sure and there are plenty of homebirth midwives who could care less about the number of sides on the tub. Good luck Carrie, I hope you find the support you need!

I haven't been able to get on the forum recently, and now I find there are several wonderful responses to my original post that I had not seen before. I will have to poke around this forum to see if there is a way to get notifications emailed to me.

I have been feeling really scared, depressed, and angry about my prolapse. However, after reading your posts, I'm feeling hopeful. You all are so wonderful to take the time to help educate and reassure some random woman in cyberspace whom you don't even know! I'm really grateful to all of you who have gone before me.

Aza, thank you for addressing the pushing-with-cervical-lip issue. I would be very interested in learning more about the reasons for this. I'd be surprised if timing were the motivator in my case since I was attended by midwives, but who knows -- maybe they're beholden to hospital rules about time (I was in the hospital instead of birth center because I was induced). I have a lot of emotions about the fact that I was coached to push early. It bothers me that I have lost some of my confidence in the birth center due to this. Before I have another baby, I'll have to either a) regain confidence in the midwives at the birth center or b) find a midwife outside the birth center. I do not want to switch to an ob/gyn practice because I'm sure they wouldn't let me birth on hands and knees if I want to do that to preserve my pelvic organs, and they may even want me to have a cesaerean. I did think about having a doula with me if I have to have a hospital birth, but I don't think a doula would be able to influence hospital policies about monitoring, walking around, etc.

Alemama, thank you for addressing the exercise issue. The prolapse has brought into focus what a huge part of my identity seems to be based on being strong and fit. I feel sort of lost without that. I'm OK with cutting back and not doing the feats of strength I used to do, but I'm definitely not OK with having to eliminate strength training altogether -- which it sounds like I won't have to do. Plus, my family tends to get osteoporosis, so I strength train to prevent that.

I have to say, I was really blown away by Christine's book. Thank goodness there are a few people in the world who are willing and able to question the status quo. If it weren't for the work she has done, I would have no idea that there is any alternative to the supposedly inevitable "mommy makeover" surgery.

Carrie

Hi Carrie,

Who knows what the real reason was...any chance you are willing to get your notes and have a read through them? Sometimes this brings new and enlightening info, sometimes nothing, and who knows how it will all make you feel...but the info is yours to have, if you want it. I am happy to help work out the lingo if needed.

Timing - unfortunately, every employee of every hospital / birth center is working under some sort of regulations or protocol. Often time concerns and other warped ideas about birth are the result of this.

This midwife, one of the few I have ever met who truly knows real, raw, and wholly physiological birth, might shed some light on what you experienced:
http://www.glorialemay.com/blog/?p=7

This is info that your future docs, midwives, whoever, may or may not have...but you will, and that is most important:)

Hi Aza,

I never thought about reading my birth notes. I'll have to think that over.

Are you a midwife? You sound very knowledgeable.

Thanks for responding.
Carrie

Hi Carrie, yes, I am a midwife.
Most hospitals have - of course ;) - a procedure in place for releasing your records to you, just call and ask ;)