vaginal vs cesarean birth

...and someday these studies will take into account the tremendous reversal accomplished by returning to natural female posture over the course of the first postpartum year. :)

I'm thinking about another pregnancy within the next few months. I will strongly consider a c-section - mostly b/c I've been struggling with pelvic floor myalgia ever since my daughter's birth 16 months ago. I don't know what I would do if I had no pain associated with my injury, though. I think it would be a big decision for me. I wish there was someone else on this forum that had elected a c-section after discovering uterine prolapse. I'd be really interested in hearing about it.
kath333

Hi Kath

I can see that you are thinking about another vaginal birth with some trepidation, before you even have a pregnancy. It is obviously bothering you a lot.

Have you ever found a definitive cause for the myalgia?
Or is it just the association with vaginal birth?
Have you experienced any change in the pain you have been experiencing all this time since the birth?
And have you had any sort of therapy to alleviate it?
How have you gone with WW posture?
Did it make any difference?
Firebreathing?
Nauli?
Has somebody led you to believe that CS will prevent it from worsening?
Or that another vaginal birth will worsen it?

Sorry for all the questions but I am just trying to put together what has happened up until now.

Louise

Hey Louise,
I have not found a definitive cause for the myalgia....which has been extremely frustrating. My hospital note from the birth states that I tore bilaterally (internally) down to endopelvic fascia/fat. I also had an unrepaired tear to my perieum. The OB that did the delivery said that I didn't tear through any muscle....I have no idea how this is possible. I'm fairly certain that I had a bilateral avulsion of part of my muscle. My urogynecolgist agrees...although we haven't done any ultrasounds that would prove that to be true. I was suspecting that the pain is related to nerve dysfunction....and I'm sure it is to some extent. But basically I think that my muscles are just PISSED off b/c they were so incredibly injured. I also think that the prolapse makes it worse b/c my muscles are tightening up under the pressure of my uterus.
Some days are better than others, but in general the pain has not improved since the birth. The prolapse has also not improved at all. I do try to stay in the posture b/c I believe it will prevent my prolapse from getting worse. I do believe, though, that to some extent it worsens the pelvic floor tightness and pain b/c it further contracts those muscles.
I have been to three physical therapists, have tried prescription drugs (all of which have horrible side effects and can't be taken during a future pregnancy), have had injections into the muscles, and am on an anti-inflammation diet. I'm going to see an MD who is trained in chinese medicine and acupunture next month. I need to look into psychology/mind body medicine. Maybe the emotional freedom technique. I'm really trying to figure out if I should continue to spend time and energy searching for relief....I just hate the idea of giving up and living my life in pain. It seems so unhealthy to deal with pain on a daily basis. I cannot imagine birthing a baby through these tight and painful muscles. I really hate the idea of having c-section, but I believe that it will probably be the best option for me. It's amazing to reflect on how much my opinions, thoughts, and dreams have changed since experiencing this suffering. Let me know if you have any advice!
PS - on a lighter note - my 16 month old daughter is super healthy and absolutely adorable. I'm hoping that she and my 3 younger sisters will benefit from everything I have learned within the past year!
kath333

Hi Kath

Wow. You have been through a lot. I think I understand what you have described about the birth. Yes, your muscles would be pissed off. The doctors etc do seem to know what they are talking about in describing the damage. I don't fully understand it. I hope you are up with them. Maybe they are just throwing around big words and hoping that they are right?

It sounds like they are assuming that the pain is coming from the muscles and have tried everything they can to fix the muscles. I am wondering if, following the medical model, they have been looking for illness where it is manifesting itself, when it is actually coming from somewhere completely different. Referred pain?

I am wondering if you need some sort of spinal adjustment, eg chiropractic or something like that. Or the whole body Chinese thing that you refer to. I would be going for that. Related to that I am also wondering if you are actually getting into WW posture, but can only get so far because your spine is not fully flexible. I know I get lower back pain when my neck and shoulders stiffen up. This makes my lower spine less flexible so I think my WW posture is less effective.

Have I mentioned pudendal nerve neuralgia? Go to www.tipna.org to find out about it. It is caused by stretching and irritation of the pudendal nerve, which can be alleviated by lifting the perineum, which WW posture does. It is usually found in women who have had hysterectomy but I imagine that a difficult birth which has left a 'not quite right' pelvic area, or posture, could have the same effect. Just because pain happens after an event like birth doesn't necessarily mean that the vaginal birth is the cause of the pain, simply that they are associated. The trauma of the birth may have affected something else that is the cause of the pain.

If you give up looking for a cause, and give up looking for a solution you may have pain for life, or it may eventually settle down. If you keep looking you might find the cause and be able to eliminate it. Looking means that you are being proactive and positive. If you stop looking you might become passive and then negative. I really think only you can decide. But looking doesn't have to be obsessive. You just have to be aware and informed.

When I read the last paragraph it all sounds like a load of s***. Feel free to ignore it.

Louise

you want the information. Well what makes sense? You have some compromise of the structural support of your pelvis- now what would be best is to not get pregnant again. Pregnancy changes the pelvis, the support, the shape, in short everything. Choosing to get pregnant after prolapse is a choice best made knowing the risk involved. In other words your prolapse could get worse simply because of the pregnancy alone. I feel very strongly that a simple vaginal birth does not in any way create more problems for a woman with prolapse. Why would it? Your body opens and the baby is born- there is no factor involved there that would cause a prolapse. Especially in a woman who has already had one vaginal birth. Yes during the birth the pelvis flexes open to let the baby out- but it returns to it's pre-pregnant dimensions within the first 6 months or so and as long as you are supporting your healing at that time and holding your body in it's intended shape then you will have no problem. Now contrast that with major abdominal surgery that has major multiple risk factors for both mom and baby, a surgery that cuts the support to the uterus from the top and really think about it. Which situation would you rather be in?
Your best bet is another straight forward vaginal delivery in an optimal position with minimum pushing. BMSrunner you can do that for sure. You trained for your birth- you can train for your next birth. There is no doubt in my mind that a c-section does not prevent prolapse and there is no way that a c-section could prevent further prolapse in a woman who already had a prolapse.