Pelvic pressure due to pregnancy or worsening prolapse

Prolapse goes through different stages throughout pregnancy. The exercises you are doing with your PT do not sound helpful; in fact they sound like they would aggravate things. Maybe some of our other experienced moms (who are following a Whole Woman protocol) can be of more help, and give you the encouragement you need to get going. - Surviving

Because tucking the belly and squeezing the muscles are two of the things that push the organs down and back into the vaginal space. With WW posture they are held forward. At 32 weeks pregnant it would be a pretty unnatural and uncomfortable move to tuck the belly.

Prolapse changes as you go through pregnancy and tends to move out of the way for the birth. During the PP healing period you may find things are no worse and can actually improve if you cultivate an understanding of WW posture and tools for managing prolapse. Personally I would rather see you focus on that, rather than all this PT stuff, and for as long as you continue to post on the WW forum, you will hear these suggestions like a broken record. But that is why this site and forum exist. - Surviving

Lacy Ann,
If you continue to post questions here on the whole woman forum, you are going to get answers from the whole woman perspective. We have had many posts from our postpartum moms who follow the teachings of whole woman, and have had great success with it.
Start studying the whole woman work; that is what this site is all about and will be the most help for you.

If you must pursue kegel-type muscle contractions, lying down is the worst position. Do them in strong Whole Woman posture. - Surviving

Christine talks about it in this blog post:

https://wholewoman.com/blog/?p=1528

She also has blog posts about kegels here:

https://wholewoman.com/blog/?p=1497

https://wholewoman.com/blog/?p=118

Lots of great stuff on Christine's blog!

Hi Lacy Ann,
It's because with each kegel or contracting of those muscles, you are pulling your pelvic organs from the lower belly into the vaginal space. Did you see the part where Christine says it is not bad to contract those muscles during sex? She explains that the penis is actually in the way, so the pelvic organs don't fall back during the contraction.
Understanding that keeping our pelvic organs moving forward is the basis of this work, and the reason that it is so important to work on getting our bodies back into our most natural posture. Kegels only work against that very dynamic.

Lacy Ann,
I think there has been a bit of misunderstanding here. This isn't the difference between doing kegels standing or lying down. It is if you have your heart absolutely set on doing kegels, you should at least be in strong whole woman posture. That is when the pelvic organs are moving forward and stabilized the best, preventing the kegel from pulling your pelvic organs out of place. But, think about these forces working against each other. Does it really make sense to work against our natural bodily forces?

Hi Lacy Ann,
*disclaimer* I don't know all the anatomical terms but I thought I'd add in my thoughts.... i've thought about this more in the past 5 months than my entire life combined.
when you squeeze those muscles (like your pt suggested - as if to hold in gas) you're doing a kegel, except a kegel is not only the anus, it's all 3 (urethra, vagina and anus). I've never been able to isolate just one area or another but somewhere in Christine's writing she wrote that the strongest contraction is urethra, then vagina then anus and you can feel this for yourself.
now i've done some kegelling in my life, in the thought that it will make the area 'strong' etc etc i've never done it religiously.... when my dr had me do a kegel around her finger she said wow! you've got great muscle tone! (and this was 6 weeks pp so this 'great muscle tone' did nothing to prevent prolapse). My sister on the other hand went in 6 weeks pp and the dr told her wow - you have no muscle tone! and without doing many kegels (because she said she just never bothered/remembered) she went back a while later (6 months maybe?) and her muscle tone was great again. Now neither one of us kegelled religiously but we both do a ton of walking....
so all these pieces of info i use as tiny pieces of a big giant puzzle - in that 1) your muscle tone down there has nothing to do with preventing prolapse and 2)kegels aren't the best or only way to keep/maintain good muscle tone down there.
I do believe that you should be able to perform a kegel - in that sometimes post partum everything down there feels a bit numb and detached, and these muscles are contractable, meaning nature has made us be ABLE to contract them so there's nothing wrong with keeping yourself aware of these muscles... but in and of themselves, kegels aren't a good practice (in my opinion - you do what you wanna do)
now to my rudimentary anatomical portion -
i can do a really strong kegel when i'm loose and relaxed lying down on my back, stomach or side.
when you do that, all your walls pull together. so if you have a cystocele - you're pulling that wall back. if you have a rectocele, you're pulling that wall forward. if your uterus is falling back, I don't know what happens there actually, but basically you're pulling everything into your vagina.... i think of like sucking the air out of a paper bag and all the sides being pulled inwards.
if you push your organs forward and stand in posture - you'll see that you can barely do a kegel. you can - but it's way smaller of a motion.... that's because the muscles that run from your tailbone to your pelvis are pulled taut - they're already 'engaged' - so this will already 'tone' this whole area while you sit, walk, eat and breathe... and it'll tone it in the right direction. it won't be pulling everything into the middle, it'll close your vagina the way it's meant to be closed and flattened with everything pulled forward.
when I first came to this site - I was skeptical. I was also thinking I'd look into this process but I thought the medical route would be inevitable.... but when you try this stuff out on yourself, you'll see that you can come to understand what's going on in your body and it's all true... it's all right there.
the best visualization I found in these pages was an image christine posted of a cadaver uterus and bladder - shown as if you're looking down at your own organs. seeing the bladder and uterus like that was eye opening - the second visual that helps me immensely is thinking of the organs as water balloons in the bottom of a water filled bucket. they'll move around depending on how the bucket moves but if you want to keep the balloons pressed against the wall of the bucket, you need to tilt the bucket even slightly... the posture does this and keeps them in place.

but i digress - i believe your original post was asking about pressure and if that's prolapse related - now your physio said your prolapse was minor.... if it is in fact minor, it shouldn't be causing you many symptoms at all. Since we know prolapse moves around, either she checked you at an opportune moment or maybe it really is minor. Either way, i don't believe cystocele would cause anal pressure - you can check yourself out (altho - you might be too big to see anything) but you should check for a rectocele. that might not be very apparent if you were lying on your back to get checked out by the physio.
either way - i hope the pressure has eased off, whatever it was... you have a great opportunity to heal post partum so it's lucky you're here now so you can start out on the right foot.

With regard to the anal pressure....at 32 weeks pregnant, isn't that fairly common? All kinds of things are pressing on other things. And you can't go by previous pregnancies - every one is different. So, relax and turn your thoughts to the days ahead..... - Surviving