I have a LOT of questions!

hi Mommy2DLM
this i sa very quick quick reply but i wanted to say hi and answer a few questions...
first it's great you've found this site. read about the posture one main wholewoman page under FAQ's, and start with that asap. it makes an amazing difference. re constipation, that is the enemy of our bodies. do everything you can to stop it. however, i do think that you can deal with this through food. since my rect, i've had to alter my diet (it was really good anyway, no gluten, largely vegies, lots of fruit and veg) but now i've had to cut out all dairy and sugar, eat ideally 9 servings of fruit / veg a day, and drink a ton (still breastfeeding, so need even more). if i do eat anything i know i shouldn't, or right before my period, i add in flax seeds soaked in water, rice bran, or soaked prunes to my diet and that usually compensates (but i try to keep that to a minimum). i eat lots more pulses as well. if you can get your body workng really well before you become pregnant again, then you'll be able to avoid constipation with pregnancy.
No idea about Miralax in pregnancy--probably need to talk to your doctor.

re helping yourself become strong...Christine has an exercise programme with a new DVD coming out soon that strengthens the whole body. In her most recent book (be sure it's v.2) she talks about firebreathing, and Alemama on here has talked loads about Nauli which basically got rid of her rectocele. Read her posts, as she's currently pregnant and whilst her rectocele has come back, it seems liveable.

Pelvic pain...did you have symphesis pubis? It sounds like it...I don't know what the answer is. I had it quite badly with preg no. 2, and I really symphathise. it was horrible. I went to the osteopath every two weeks or when really bad weekly which i swear is what kept me walking. Recently my accupuncturist also said they can help. But i did physio, which offered nothing more than kegels which won't solve it (or your prolapses) They did however suggest a support belt which hold teh pelvis tight, which did ease the pain a bit. But from my understanding symphesis pubis isn't about a weak pelvis--it's that the bones separate too much, irritating the ligaments that work extra hard to hold everything in place. what i read about re delivery was to ensure you have a natural, upright delivery. do not under any circumstance give birth lying down in stirrups. also much better for your prolapses, and all of you! but i'm sure there are other things that could help too. maybe Christine has some wisdom if she's about...

okay, sorry..i'm really rushing here but i wanted to be sure to reply!
i hope it helps and i'm sure you'll get loads more. but definately scan through Alemama's posts on her pregnancy and about the Nauli and search on firebreathing. also there are some good threads on constipation if you search on that.
there are babies who have been born here post prolapse, so you'll find a lot of lovely stories here to inspire you.

Hi Mommy2DLM

Welcome to Wholewoman. I can see that you are somewhat frustrated that you haven't been able to get the whole pelvic floor thing perfected while you were working in the Ob/Gyn industry. I am not surprised about that because much of the teaching about the female pelvic floor in the medical world, while making some sense, is based on an incomplete model of how the bones, muscles, soft tissue and pelvic organs interract with gravity. This medical model puts most of its emphasis on the strength/fitness of the pelvic floor muscles and too little emphasis to the orientation of the whole pelvic structure in space with gravity acting on it.

The medical model portrays the female pelvis as trying to do the impossible - defy gravity on order to retain the pelvic organs inside, which means that it must have been been poorly designed and all women have defective bodies.

The Wholewoman model of pelvic anatomy sees the female pelvis differently, with gravity acting straight through the pubic bone, rather than straight down the vagina. This makes the retention of pelvic organs, even with damaged fascial supports, quite workable despite the damage. The organs are literally supported by solid bone. It also sees the pelvic floor muscles into an elastic back wall that stabilises and absorbs forces, rather than an horizontal trapdoor to be kept closed at all costs. The female pelvis is indeed very well designed and is an engineering marvel if you just change the way you look at it.

Obstetricians and Gynaecologists, the medical specialists to whom the medical system has agreed to refer pelvic organ prolapse patients, have little understanding, or interest in, conditions that are structural in nature. After all, most women with POP have nothing at all wrong with either uterus, bladder or bowel. It is damage to their supporting structures that gives rise to POP. Why then are we sent to specialist who treat 'damaged' pelvic organs??? Why do we expect ob/gyns to have a deep understanding of pelvic engineering? The physiotherapists who teach women how to strengthen the pelvic floor use the same starting model as doctors. They speak the same model as doctors and their therapies have to match the model they are based on.

I went along with this medical model for probably thirty years until I learned the other half of it from Christine, the half of the model that recognises that a female body lying on an examination table is quite differently supported than a female body standing on two legs or sitting down. It is not that the medical model is wrong. It is just not sophisticated enough; too simple to be useful in understanding why POP symptoms happen, even if it useful enough to treat damaged organs.

Sorry, I digressed. I suggest that you try and suspend your belief in the medical model and learn again from scratch all about female pelvic anatomy from Christine's book and this website. Then you will hopefully understand why you have thought in the past that your pelvic is 'weak', why you have never perfected pelvic floor exercises and you will realise that you are normal after all, and that you can stop feeling guilty about being defective, cos you are not, and neither is any of us!

We simply have damaged endopelvic fascia from whatever cause and need to prevent further damage, eg prevent constipation and learn to use and look after our bodies differently. No Ob or Gyn is equipped to do this. They don't understand it. We do it ourselves, thanks to Christine's years of research. Just start with the baby steps you are taking, and you will get there eventually.

Cheers

Louise

H Mommy,
I am so so so glad i was able to help. I absolutely sympathise with the pelvic pain, and it's so great you found someone who knows about it and an OBGYN who does as well. That's what is apparently hardest, is that a lot of people underestimate how debilitating it can be. so to know what's going on, and to find support, is just fabulous.

I have been wondering if Christine has any thoughts on it with regards to posture...if she doesn't happen to read this post (very busy at moment i know!!) i'll post seperately to get her thoughts.

Out of curiousity, has your pelvic pain gone since the first few weeks after the birth? I found last summer i wore too thin crocs, and i started to get a sore pelvis again. I also occasionally feel like someone is standing on it just before my period--I thought it was my prolapses though it was clearly in the bone, till i read that can happen after symphesis pubis.

please stick around as you'll find great support here for everything you are dealing with, and if you do have another baby be very very informed and be sure everyone is informed about how your birth needs to be. i was petrified of ending up in hospital in labour on my back. luckily i had great midwives and delivered at home, totally upright, just as one should anyway but especially with SPD. but i had a clear birth plan stating exactly what i could not do and had everyone briefed...

Kiki

hb isn't common here either, but that doesn't mean it wasn't right for me
re breathing difficulties, our mw brought all sorts of resuscitative equipment along with her. she can give O2 to babies while we call paramedics if need be.
my third baby (a homebirth) was also born with a nuchal hand. mw told me to get into a half kneel (on one knee and one foot) and do some pelvic rocking/rotation type thing. yah, it wasn't too fun, I can still feel his elbow poking me on his way down/out. felt kinda like he was posterior and with each contraction I got massive pain in my sacrum and head. weird.
but manually turning a baby is nothing a mw can't handle at home.
typically, a woman is in a better position to be active during labor/birth when she's at home, and thats what you want when you have a less than optimal presentation (aside from true emergencies like a prolapsed cord, in which case you transfer asap to a hospital).
when we first considered a hb (I was 3 mo pg with our third) I was scared of the what ifs. if something went wrong would I always regret not having gone to the hospital? by the time I finished my research (8 mo pg) I felt that if I went to the hospital and something went wrong, I would definitely regret not having stayed home. because people tend to forget that things go wrong in hospitals too. and think of all the nasty germs. who wants to expose a newborn to all that?

I can only guess regarding pain in the area between the pubic bones, as little research exists on the matter. When we assume upright positions - standing or sitting using the strength of our own spine - the symphysis pubis widens in front and narrows slightly in back. When we sit back, lie down, or slouch, the symphysis narrows in front and widens in back. Remember, the s.p. is a long, disc-like structure positioned front to back underneath you - not up and down in front.

Pregnancy greatly enhances the natural geometry of sacral nutation (see book) by adding weight to the front of the horizontal pelvis - where all intraabdominal pressure is directed in the non-pregnant state.

Pregnancy demands full range of motion at the symphysis pubis and it is possible that some pregnant women have not previously developed that range because of - you guessed it - poor posture. Therefore, there is pain from the inevitable stretching of the soft tissue structures between the bones.

I think gentle plies in first and second positions would be better therapy than bedrest - but that is only my opinion. Thinking about it as a “weak pelvis” I think could more accurately be described as a “tight” pelvis.

thanks for your thoughts christine. i've been curious about your thoughts on this for a while. it does make sense. a physio said he sees it a lot in dancers and that might be why i got it (ex dancer) but i'm not actually that flexible anymore, so it never made sense to me! but, what i do have in common with dancers is having stood too straight and tucked under for too long...tightening in the way you say. makes perfect sense....

thanks!