? about birthing with rectocele and bladder prolapse

Body: 

im going to be having baby number 4 any day now. although i havent seen a dr ,i know i have a rectocele and my bladder seems to be coming down as well- this just all happened around my 6th month of pregnancy. it seems to worsen when im sitting on the toilet having a bowel movement but then goes back to where it was a little later. so what im wondering about, is there a better position to birth in? usually i birth in a birthing glider chair that i have but when i sit in the upright position it feels like everythings going to be pushed out of me. so i was thinking of trying to birth on my side but then i heard that would require more pushing and thats what actually makes the celes worse and an upright position allows for less pushing and the help of gravity. i was also wondering because we have our babies at home and my husband catches is there anything he can do to help down there? counter pressure against the area or even use his fingers to hold those spots up while the baby is coming down? im getting a little nervous as the day could come at any minute. thanks for any help. Denise

i recently gave birth to #4.i had discovered i had a rectocele after #3. i stayed mobile and delivered on my knees. i too had a cystocele during the later months of pregnancy, or at least thats what i think caused me to have trouble voiding, and certainly 2 weeks after delivery i could see a horrible bladder bulge at my introitus.

the good news is that was only temporary and the bladder seems to have gone back for good.

my rectocele is still there but is not as bad as it was before delivery, but i think that is due to stitching after a fresh tear. i know everyone is different, and you should go with your own instincts, but i can say that for myself upright delivery did not in any way permanently worsen my 'celes, and the post partum period actually saw improvement.

i have taken up yoga with a qualified yoga therapist instructor, and by doing abdominal locks on all the poses taught so far, i am now much tighter down below, and better still my cervix is pretty much as high as it ever was, even when squatting down for self exam!

anyway, i wish you well in your impending delivery. do keep us all posted in how you get on, both now and post partum.

(btw, gmom if you are reading, tnx for the update!)

Hi Deniseb

I have had three births. The first flat on my back, stirrups, full epidural for pre-eclampsia, forceps & episiotomy etc and I couldn't have pushed to save myself. It was a great introduction to birthing, NOT!

Birth number two was a very active labour (I had done a lot of reading in the meantime ;-) ), second stage on my side, and I remember my body delivering the baby, can't remember having to push much. Lying on your side is not conducive to pushing. It seems to be counterintuitive, I mean when else whould you push on your side??? A little laceration but no major tears or other problems. It was fine for me.

Birth number three was on my knees with dh catching. I didn't want to push but the (hospital) midwife insisted, so off I went and pushed him out slowly. My cervix was well and truly ready. I had been on hands and knees with my butt up in the air since transition during which time the baby flipped from posterior to normal presentation. I waited in that position for a longish time, as the doctor had been off umpiring a basketball match; that horrible back pain had gone, so I was in no hurry. I just got myself a bit more vertical to deliver him, ie knelt up on my knees a bit more, and out he came. No lacerations at all this time

I would say go with whatever makes you more comfortable at the time.

Re the sensation of everything falling out. The lumbar curve lessens at the end of gestation, to change your centre of gravity a bit, and to allow the baby's head to engage. You can't do anything about this. It is meant to happen. (Christine talks about this in one of her blog entries, or is it the second edition of Saving the Whole Woman? She explains it so clearly. I think the following is the essence of it, but check for yourself.) This makes your pelvic floor more horizontal, and your pelvis tilts backwards a bit (counternutates), so no wonder it feels like everything is going to fall out! It is OK. This is gravity at work in a good way. During the second stage of labour the pelvis tips forwards again (nutates) to allow maximumpelvic opening space for the passage of the baby's head. It is a really neat trick and happens all by itself. (Use the search box to find out about nutation and counternutation which underpin Christine's work.)

Christine made some interesting points about postpartum prolapse a while back (use the search box) and is encouraging women to re-establish Wholewoman posture as soon as possible after birthing. I now believe that much of the postpartum physiotherapy that women do while still in hospital where we were taught to tuck the butt under and hold the tummy in postpartum is not good at all for re-establishing normal positions for pelvic organs as it makes the pelvic floor horizontal and puts a lot of downward pressure on it at a time when it needs to regain its previous structure as a diagonal, taut stabiliser of pelvic contents.

Best wishes for your impending labour and birthing.

Cheers

Louise

I would read the below links and try to let your body tell you what to do - You dont HAVE to push - In my last birth I gave one single push - And she was born... (Not cos of this cos I was avoising it and living on gas and air - but I am sure it helps tho) At the point I puushed my belly went like concrete and I had no choice so all the midwife saying to me - You can push now - Really didn't need to push the body did it all for me...
Pushnot clicky

and

anotherone

You will be fine - Your body will tell you the way...

Sue

Look into the eyes - They hold the key!
http://www.bringmadeleinehome.com/img/maddy544x150Banner.jpg

thanks alot for the encouraging words! i am going to just go with what feels right at the time. one other ?, when you guys mention that you dont push, do you mean that you dont push extra with your body. my body just takes over and pushes automatically and usually i push with it. so when you say you dont push, is that what you mean? thanks again for your words, im gonna have to get christines book and she has a work out video too? Denise

I think it means you breathe thru the contractions until your body FORCES you to push - It kind of sends the baby out with the insides kind of moving the baby down kind of like an internal movement in the way a snake moves without legs etc.

Then in the end your body will tell you NOW - You will have no choice and with one or two pushes your baby will be born - By don't push they mean don't push tons and tons there is no need :)

Hope that helps a bit

Sue

Look into the eyes - They hold the key!
http://www.bringmadeleinehome.com/img/maddy544x150Banner.jpg

thanks to sue's links, my last baby (now 2 mo old) was born without my pushing. what I mean by that, is that I didn't push voluntarily. I was on my hands and knees and the baby found his way out with the contractions. I just relaxed and let my uterus do all the pushing. I don't remember feeling the need to push on top of that, but I didn't hold back from pushing either. my body just did its thing, and he was born in three contractions.

In terms of position, I personally didn't feel that my 'celes were well supported in squatting (that's what I did with baby number three). my body led me to hands and knees this time around.

go with what feels right. good luck and keep us posted!

i keep wanting to post about this, as there have been a few people mentioning not pushing.
First labour midwife told me to start pushing when i had no urge to, and i think i pushed for about 1 hour of useless pushes when suddenly the urge to push took over (though it took a looooongggg time for baby to be born even then). (i'm convinced that it's when my prolapses started!!!!)

labour no. 2, i again had an overwhelming urge to push & when the midwife tried to get me to stop to let things stretch it was like asking me not to breathe! I pushed for about 30 minutes, but had strong pushing urges that whole time (and was upright so gravity helping...).

recently talked to a friend who had second stage for 2 hours but no desire to push...just breathed whilst baby moved down.

do some people just have pushing urges and others don't???

curious about this...

I think its entirely possible that some experience an urge to push and others don't. or maybe we're experiencing similar things but interpreting/describing them differently.

kiki im with you. with all 3 babies so far there was no way to stop my body from pushing. so im figuring that you just dont do any other pushes unless your having a contraction and maybe try to breath through the pushing urge instead of bearing down and pushing with it...which still seems pretty difficult to me. i have also read somewhere that women with the different prolapses may not have the urge to push, like theres a certain "push spot" that the midwife has to push with her hand ...not sure if thats completely true though. Denise

any minute. That is exciting. I birthed my last baby in the bathtub. I only "pushed" for 5 minutes- which I guess was about 4 pushes. But I really wanted to- what was funny was that I was squatting in the tub but with each contraction I sort of stood up- and leaned on the edge of the tub-
What was really stupid that I did was to actively try to push out the placenta. In hindsight I think I just wanted out of the tub so I was rushing the process- So then I was pushing to get it out for another 5 minutes or so (while he was nursing) after the baby was born and I think that was probably a bad idea.
the next time around I will try not to push at all ever- and I think I will try the standing lean for the actual crowning- and labor how I feel the rest of the time.
I don't think your husband will need to hold anything up- I think it will all just push out of the way from the baby's head descending.

thats interesting that you mentioned birthing in the tub alemama, im going to try that this time. iv been swimming alot lately and happen to notice that when im in the pool even sitting that my problems down there are barely there. i could feel them slightly inside my vagina but they werent bulging out like when i sit on the toilet or chair. so maybe thats an answer to prayer and most of my friends swear by birthing in the tub and that way too, my husband doesnt have to be so upfront and close in that area :) and you know, with my second baby i waited and waited and my placenta just was not coming out and it was like 3am and i was so tired i just went to bed. i woke up a few hours later and went to pee and it came right out. sometimes things just take time i guess. Denise