Birthing positions and prolapse


i've been browsing many threads in this forum where everyone seems to agree that birthing on your back sets you up for problems... yet i had my last two babies on all fours (hands and knees), fairly quickly and easily (no intervention and no coached pushing), and my POP didn't show up until some time after the first of those births. in theory, my births were ideal for the prevention of prolapse, right? so i'm trying to figure out why "this happened to me"....? (was it all due to the unnecessary episiotomy and birth on my back of my first child?)

we all ask that question. there've been women here who haven't even had any children. so I'm sure its a bunch of reasons.

I have no doubt in my mind that my first delivery set me up for my prolapse. flat on my back, epidural, 'purple pushing'. then, right after, a nurse cathed me and kneaded my bladder to get all the urine out. how to create a cystocele in 3 easy steps.
'course I didn't see any bulge until after my third, but I'm sure the initial damage set the stage.

an episiotomy is for life. its not over after the stitching has healed because it will never ever heal with new skin and muscle and fascia. it heals with scar tissue, which is not elastic. for some women, this doesn't seem to matter. my sister's first birth was flat on her back with an episiotomy (huge!) and then had another 4 deliveries on her back. last two were (I think) sidelying and standing. and no prolapse anywhere. so go figure.

I think all we can know is what puts you at risk, what helps prevent, what helps heal or protect. but we will never know why this happened to any of us.