Update 12 months postpartum

Body: 

I am now 12 months postpartum after my second child.

Thought I'd give an update:

Good news first!
-I don't feel any prolapse, bulges, pressures or pain with any activity.
-Sex is fine, no pain, no need for lube.
-Urination is fine-can completely urinate, hold overnight, stay dry with laughing, coughing, etc. No UTIs.
-Bowel control and having a bowel movement is not a concern. I go when I feel the urge and am done going promptly. No bleeding, no hemorrhoids, no constipation or diarrhea.
-Childcare is fine, I can carry my kids in my arms without issue.
-No candida/yeast/itchy butt symptoms for a long time. Definitely not in the past year plus.
-Work is uneventful. No issues there.
-Housework is no big deal. I can clean the house in an hour no problem.
-Driving doesn't bother me.
-Pre-pregnancy weight with no problem maintaining.
Someday I will post all the changes I've implemented to get to where I am now.

Not good news or What I haven't figured out yet:
-It takes forever to wipe up after a bowel movement. No one-wipers here.
-Even if I take time to wipe til the toilet paper is clean and a mirror shows it is clean, an hour or so later I can wipe again and there will be residual matter on the toilet paper. It may or may not leave a skidmark on my undies if I'm sitting in posture afterwards.

That's it. That's essentially what I have been trying to figure out for months now.
-Vegetarian with fruits and vegetables. Minimal non-processed food. Water only, no coffee, etc. Raw milk, if at all. Farm eggs, cheese and nuts and beans for protein. Kefir or yogurt for probiotics occasionally. No chocolate, rarely homemade cookies. Homemade bread, 1/2 whole wheat. Eat the same time, no snacks between meals.

Any advice?

Mindful

Hi mindful - congrats on the one year mark! You seem to be doing really well.

I have a kind of weird observation to share that may or may not be helpful to you.

Ok so - after my little ones poop they call me to come wash them. I have a little water sprayer or hose next to the toilet which I hold in my right hand. I use my left to wash their little bottoms as I am spraying water. So I've noticed that at times their anal sphincter feels really "open" and I know that this means I will need to wash them more thoroughly than usual and that when I wipe them dry afterwards there might still be some skidmarks on the toilet paper. Other times their anak sphincter feels really closed and taut - washing and wiping at these times takes seconds. I don't know what causes these differences but I'm pretty sure birth does a number on the anal sphincter, leaving it in that open/soft /less taut state more often than not.

Congrats on the milestone. Interesting observation by Chicka, and let me add something to it. What you describe has been kind of a mild occasional chronic thing for me, for quite some time, which I have taken to be an incomplete-emptying type of problem brought on by the rectocele and complicated by the fact that some poops hang together better than other poops. It's the main reason I wear a liner pretty much all the time. I never really associated it with childbirth as such, but that makes plenty of sense. My goodness, if this is your worst problem at the one-year mark, you are a champ!!! - Surviving

folks!!

I have the same problem -- have had it for years -- and I've had no children.

I actually find the problem worse when I concentrate on veggies and fruits. If you remember, somewhere here on the forum there is a description of how to create a 'perfect log'. Red meat had something to do with it.

:-)
w2k

Thanks for the update, Mindful! These principles will serve you for the rest of your life.

As for wiping, here’s an anatomic angle on the issue.

The three pelvic organs and their sphincters are embedded in a bi-planar, diamond-shaped pelvic wall. The top anal triangle of that wall is clearly vertical - you know your anal sphincter is directly behind you. The bottom urogenital triangle is more oblique. Depending on how you sit and stand it can be more like a wall or more like a floor. We like to keep it more like a wall.

When you have finished having a bowel movement there is an autonomic response of the pelvic diaphragm. The tailbone moves closer to the pubic bone, the anal sphincter tightly closes, and the end of the feces is ‘cut off’ in the process. This is an adaptation for cleaning the anal opening - although humans want the area cleaned far more than that, so we invented toilet paper.

The pelvic “floor” does not act uniformly on the urethra and anal sphincter due to its bi-planer (it exists in two geometric planes) nature. These muscles wrap very tightly around the junction between anus and rectum and in doing so create a very sharp angle - called the puborectal angle.

When your pelvis is counternutated (tailbone tucked), you can strongly feel a pelvic floor contraction around your anal sphincter. When your pelvis is nutated (tailbone lifted), you can feel the contraction most strongly around your urethral sphincter.

When your pelvis is counternutated, the puborectal angle is slightly slackened, but your anal sphincter can pull together into a very tight purse-string closure.

When your pelvis is nutated, the puborectal angle is sharp, the pelvic diaphragm is closed like a pair of elevator doors, but your anal sphincter is more slack.

Whether your anus is open or closed when you wipe depends on how much tension is on the puborectal angle and whether a counternutated pelvis is closing the anal sphincter. Maybe wiping is the one thing we shouldn’t do in WW posture. ;)

As humans who maintain natural human posture, we have traded a tightly closed rectum for a slightly relaxed anus.

We’ve been highly influenced by a medical culture whose first tenant is sterility. Try not to get too hung up on a skid mark or two. It is lactobacilli that maintain the health of the skin surrounding the anus, therefore, trying to keep the area too clean is unnatural and probably unhealthy.

Of course there are dietary and even hormonal factors involved in the condition of the anus, but I believe it mostly comes down to biomechanics and microbiotics.

Christine

Thank you for all your thoughts ladies.

I generally dislike washing with water afterwards because that causes itchy butt for me even if I pat dry.

I also would rather just change my undies as needed than to wear a liner as that can contribute to candida for me.

Like one of you mentioned, I know it doesn't always happen due to childbirth, but I did have a 4th degree tear with my 1st baby. I'm just stubborn enough to think I can still fix it though. Definitely too many fresh veg and p fruits (peach, plums, etc) are not the best equation.

I appreciate your perspective, Christine. I have been wiping in WW posture!! I will do some experimenting.

Thanks again

Mindful

This is a topic I would never have thought to bring up. I have the same problem In recent months and did could not understand why. I am still not sure why but it is of some comfort to know I am not alone in these issues. I am brand new here and can see I have a lot to learn. Thanks to all.

Mindful, wiping aside, you are doing amazingly. My second child just turned one and I have been meaning to post an update on how the year has been, but at this point in time I notice my prolapse most days and for most of the time on those days. Thanks for the update as it's reminded me I really need to focus more on my diet.

Mindful, I noticed the same problem postpartum and I think for me the culprit has been an eensy-weensy rectal prolapse. Different from a rectocele, it is when the skin on the inside of the rectum starts to come out of the anus. A little extra skin pooching out around the anal opening can make it harder to wipe clean, so that might be your problem. That realization actually freaked me out more than the cystocele, but I'm hoping the whole woman work will have similar beneficial effects as I coax my rectum upwards and forwards. I also had a bad tear - 3rd degree - so I'm not sure how much that has to do with it.

Kiko, I'm pretty much at the same stage as you. I've been loving the FAFP dvd and the exercises have been making me feel great and lose some of the baby weight, but my prolapse seems to be up and down regardless. I'm sure it is better than it would be if I were not doing the work, however. Also I'm doing a lot of lifting of a hefty one-year-old and increasing my activity level as I start to feel better, and I notice that my prolapse is more noticeable at the end of the day than when I was taking it easier. Diet may be a factor too, I have been slipping a bit! I love whoever posted about "the perfect log", LOL!

Remember Bonne Maman, that it's the retraining of your body into the posture all day, every day, that does the work over time. The exercises help enormously to strengthen and lengthen where needed, and they are by far the best exercises for any prolapsed woman. It takes time to restore lumbar curvature if it has been lost to any degree, which in most of us it has. So really really concentrate on posture as you go all throughout your day, and try to maintain it during lifting. Once you are standing with a child in your arms, as long as you are in good posture, the extra weight-loading will actually help.

I'm sure you know all this, but from time to time I like to issue a reminder to all, that this isn't just an exercise program but a life change! My prolapses are also "up and down". There is no cure.....but there is maintenance and stabilization and even some reversal, especially in those like you with youth on your side. - Surviving

You are right Surviving. I draw a lot of inspiration from posts you have written about how you saw the biggest results in the second year of WW work. I think it will take me at least that long to attain a "critical mass" effect in terms of how much I can maintain correct posture throughout the day.