how are the pg mama's doing?

Thanks for posting this, Granolamom.

I am 37 with a 17-month-old boy, my only child. I have a mild(ish) cystocele and "slightly bulging" rectum and uterus. At my last appt, the doc declared me "cured" but I'm aware of the back-and-forth-ishness of this condition.

Anyway, my husband and I are trying to decide whether or not to have another baby, and a big consideration for me is my prolapse. I feel so afraid that having another baby would worsen the condition and that I will have another difficult birth (very narrow hips + very big baby).

So, I look forward to hearing from y'all, too.
Ann

My daughter was looking through the forum when she was here over the holidays and found a past post from Marie asking me about pregnancy and the dvd exercises. I’m sorry I missed your post, Marie!! It was during a time I was sewing up a storm and wasn’t checking the forum regularly. It’s really getting pretty impossible to answer every one. I have a great illustration for you though, granolamom, showing the pregnant uterus being held way out and over the pubic bone, which will visually answer your question. I hope we hear from you again soon, Marie, and I hope all is very well with your pregnancy.

Hugs,

Christine

its been sometime since i posted here.

i did find christine's book and advice regarding conservative management of prolapse to be invaluable after diagnosis.

when i finally got my referral to the gynae (having already decided that surgery was not for me) i was already 4 weeks pregnant with baby no.4 (a little surprise as baby no.3 was only 6 months old).

i am glad the baby was a surprise as i would have been scared to go again.

i'm now 28 weeks pregnant (and the scans seem to indicate another large baby). if anything my prolapse has improved with pregnancy. i leak the odd time if i sneeze. my rectocele is better than it has been for a while.

i would like to breast feed this time. i couldn't with no.1 as he had a birth injury and wouldn't latch. no.s 2 and 3 had jaundice and formula was deemed best in their circumstances (abo incompatibility).

have any other mommas breast fed after delivery and found that it helped recover prolapsed organs. i figure that its got to help, but would be interested to hear from anyone who has experience.

many thanks

I got universal prolapse right after the birth of my daughter. She is 19 months old and I am still nursing. I don't think nursing helped my prolapse or hindered it. I enjoy breastfeeding for many other reasons but I believe the posture helped improve my cystocele and uterus prolapse. Although I haven't had any improvement with the rectocele. My prolapse didn't improve at all for the first 9 months when I was breastfeeding and hadn't found this site yet.

thanks for the feedback.

i have never breastfed but was always led to believe it helped your womb to contract back into place quicker, but i guess this is only with an undamaged pelvic floor.

still, no harm in trying!

Maybe it will help your prolapse but if it doesn't there will be many other wonderful benefits. For example my daughter is sick right now for only the second time in 19 months. It is a great source of comfort for her and myself. The hormones released while nursing do help tone the uterus but they also have a wonderful calming effect. Whenever I nursed longer than 15 minutes approx. I would begin to feel the effects of the calming hormones. It really helped me emotionally while going through the realization of having prolapsed organs. I hope you have the opportunity to nurse this time. You won't regret it!

Nursing does indeed assist with the involution, or shrinking of the uterus post partum, and this is why one feels more of those afterpains while nursing. (My midwife told me that). Like Mommynow, don't know if that would help prolapse, but it can't hurt!

I LOVE nursing and will so miss it after I stop, though that might be a while. :)

thanks granolamom,

i will try and keep you posted when the time arrives!

Hi Babs

I think there is a difference between the uterus returning to normal position, uterus returning to normal size, and the whole pelvic area returning to pre-pregnant state.

Oxytocin is the hormone that is released in response to the baby feeding at the breast. (This oxytocin is what triggers the milk letting down to the wide ducts beneath the areola so the baby can literally squeeze the areola between tongue and hard palate and squirt the milk through the nipple into the back of the baby's throat. The baby doesn't actually suck on a breast the same way as a bottlefed baby sucks on a pacifier or bottle. This is why it is important to not use a pacifier at all if a baby is having trouble latching on - they get confused by the two different actions. They can be taught to suck properly. I have done it.)

Oxytocin also contracts the uterus. (So you may feel flooding of the lochia a couple of minutes after you feel that tingly milk-letting-down feeling either when your baby starts feeding or even thinking about them or hearing another newborn cryng. It's a bit wierd at first but is quite normal and you get used to it.) So breastfeeding helps to shrink the uterus down to normal size by a day or two after delivery, helps to deliver the placenta and helps to prevent postpartum bleeding - very important to put baby to the breast as soon after delivery as possible, before the placenta is delivered if practical.

Returning to normal position is not quite so straightforward, but may be helped by lying on your tummy as much as possible in the first day or so, before your milk comes in. This will allow the uterus to flop upwards, and well over the pubic bone. This is the start of keeping it where it belongs after birth! Don't keep doing it after your breasts start to swell when your milk comes in after a couple of days as it may compress the breast tissue and cause blockages, to be avoided at all costs.

Re everything in the pelvis returning to normal, this may take twelve months or more, but may be much quicker. Getting back into posture and active after birth may help this process (see Christine's blog entry on postpartum prolapse). Just be patient and don't let gynos or obstetricians talk you into surgery for something that will often, but not always, fix itself with time.

Hope this rather wordy response is some help. Have any other Mums got anything else to add or disagree with?

Cheers

Louise

with abo arn't all your babies going to have it? and doesn't it get worse with each baby? did your babies have to be in the NICU? or get a transfusion? I ask because I think breast feeding would be a wonderful way to feed your new baby but.....I am imagining you will have the same jaundice issue you had with the other two- if that is the case you can definatly still breast feed you are just going to have to do ALOT of work. I imagine that the dr. will still want to use formula but you can do both especially if you know what to expect.B

thanks louiseds, and alemama,

regarding nursing, i think the lying on the tummy is a useful idea, as i did try that after the descent and rectocele showed up after my last delivery.
however, i do recall before i had any children being told that my womb was retroverted (i think) meaning it was tilted back. my mum and at least one of my sisters is the same.

regarding the jaundice thing, i am actually O-ve, and my husband is A+ve.
our first child was O+ve (so my hubby's make up must be AO), our second was A+ve (her jaundice was quite bad. she escaped a transfusion as she was 9lb 8 oz! and had double phototherapy for about 6 days as her bilirubin levels rebounded when the lights were removed. our third baby was O+ve and developed jaundice on day 3 which persisted for several weeks and did require readmittance to hospital for phototherapy, but it was nowhere as severe as no 2. the explanation i was given for her jaundice was bruising from birth (she went from -2 to head out in one push - i dont know who was more shocked - me or the midwife!).
despite being rhesus negative, so far i haven't had those antibodoes which are the ones which get more severe. abo isn't supposed to get worse, but a lot will depend on the genetic makeup of the baby and how my body reacts to it. abo is only supposed to cause problems after the birth. the placenta cleans up everything before delivery (or at least thats how i understand it)
ill keep you posted!

Hi Babs

I agree with Alemama that you could breastfeed this baby, but you may have to do a fair bit of expressing for maybe three or four weeks until the baby 'wakes up' a bit and can give your breasts enough stimulation to keep your supply up (and you have enough help at home for the first few weeks to enable you to spend enough time expressing to produce enough milk to feed the baby and stimulate your supply).

Why feed a newborn baby formula when your breasts will be ready to make copious amounts of the perfect food for a newborn?? Your baby *needs* your colostrum. I just don't get that.

And why feed a newborn anything out of a bottle which will just teach him an incorrect milk sucking technique and require re-teaching to get him to milk your breast by himself later??

There is a lot of information out there about breastfeeding ABO babies, and I am sure that your national Breastfeeding Association will be able to provide information for you to support your decision to give it a try. They may even be able to hire you an electric breast pump for a few weeks.

Also try googling "breastfeeding abo", to find out what mothers, doctors and child health nurses are doing in different parts of the world. I have just found some great info on Australian sites. Oz is big on breastfedding any babies!

It will be important to discuss feeding this baby with both the obstetrician and neonatal care staff at the hospital where you will be birthing, to ensure that they provide the type of care that will ensure you have the best chance possible of breastfeeding this baby after initial difficulties (ie encouraging and teaching you to express; *only* giving the baby your colostrum, and later milk if possible; feeding ny necessary supplements from a spoon, syringe or artificial feeding aid which is used to deliver expressed milk through a fine tube next to the nipple while the baby is at the breast.)

If they are not happy to do as you *the mother* wish after you have researched it, think about speaking to other hospitals until you find one that will support you. Hopefully you may end up succeeding very well with breastfeeding, or it may not work that well. There are lots of factors and all babies are different. Either way, every day your baby receives *your* milk will give him/her the best food there is for a newborn baby, and the longer you can keep your supply going the greater the chance of breastfeeding normally after the first few weeks, even if he/she needs some suck coaching to get the technique right.

Hope this will encourage you to seek some more information and succeed as best you can.

Cheers

Louise