Will prolapse worsen with future pregnancies?

Well Juls, I take my hat off to you!

How many times did you say you had another baby after the OB told you it would get worse with each baby? Have you not answered your own question?

It is not really possible to test this hypothysis because you can't set up a trial with one group of women who go on to have more babies and another group that go on to 'undo' their existing babies. The other difficulty is that POP changes from day to day, even during the day, and definitely during the monthly cycle. When would you measure it, and who would measure it? This assessment business is all so rubbery; designed for surgeons who need quantitative methods of deciding which procedures will work 'best', and assessing scores against the likely complications once they are in there. It is all about probabilities for them, whereas for the individual woman it is about her one body, and her track record, and her attitude.

Yes, grand multigravidae will probably end up with POP of some sort, but most of us will end up with a degree of POP anyway. There is always the chance that you will have a difficult birth with subsequent babies. Having babies is a bit like that. One of our very experienced mothers did have a nightmare birth of her fourth(?) baby after three successful homebirths. I would be lying to say anything else.

I personally think that the first birth is the most likely to cause damage, for several reasons. Firstly the mother's tissues have never stretched before. Secondly the mother doesn't have a track record to give her or the OB faith that she can confidently birth vaginally. The first birth always seems to be a nervous Mum, and fraught with scalpel-wielding staff eager to 'ease' the baby's way into the world.

I think six babies has probably done all the 'damage' that is going to be done. As you say, the your pelvic region is designed for birthing babies vaginally. ;-) Have faith in it.

Louise

Hi Juls,

Thank you so much for posting. Your story warmed my heart so very much - I would like to designate you Whole Woman of the Year!!

What exactly would change? Each time a baby passes through your birth canal in a natural way (not on your back and tethered to the bed with IVs!) both your bladder and rectum are moved out of the way and into their normal positions. The enlargement of the pelvis is involuted through natural postpartum posture and movement.

I don't believe "damage" is ever the right term to use for prolapse that results from a natural birth. Not that maternal injury isn't a very real and common phenomenon that exists in the obstetric setting. Yet, words like damage, defect and dysfunction - ubiquitously applied to prolapsed women - should be discarded. It is time.

Please keep us posted as your family grows. You sound like a true Earth Mother.

Christine

Hi Juls

It would be lovely if you would offer encouragement to other Moms.

I am an only child, and found my own three children a bit of a handful when they were young. Mothers of four children in my community always used to tell me that three was the hardest because you don't have any older children to shoulder the need for many hands, hugs and TLC. You inspire me. We managed, and I don't regret any of it.

I think your very real story demonstrates so much about being aware of your body and having the confidence to be in charge of it; also about not getting hung up on the here now, and accepting that time does a lot, and that as a postpartum Mom your body will revert in its own time. After we have done something a few times we tend to have faith in the evidence. For a woman who has had one or two pregnancies and births, there simply have not been enough successful longer term outcomes to convince her that she will be OK.

It is the same when we are living with POP. The first few temporary setbacks we have often result in tears and heartbreak, but the more of these setbacks we overcome, the more familiar we are with the subsequent recovery, and we eventually realise that every temporary setback will have a happy ending with the proper response on our behalf.

It just takes practice.

Louise

Wouldn't a good,natural birth, followed by a good postpartum in fact 'remold' thepelvis and pelvic organs into, perhaps, better position than they were in before, from a previous poor birth/pp?

Some Japanese saying that alemama mentioned is floating around my mind- something about only a good postpartum being able to 'undue' a bad postpartum.

or did I totally twist that out of context and misunderstand it...

I have thought the very same thing, Chicka, but we haven't proved it yet! I am hoping BadMirror will weight in on this...

I can tell you that from my experience, prolapse has worsened for a time after each pregnancy- and then improved to the point of not even noticing it after a while. I have had 5 pregnancies and births. My prolapse is no more noticeable now at 6 months postpartum than it was after my second birth at this same time.
So, the trick then, is to expect it to bulge a bit more when pregnant and postpartum and then it won't do a number on your head.

As to symptoms worsening during menopause because of having more kids after the 6 you have already- all I can say is I seriously doubt it :) If anything, you will have the simple beautiful transition into menopause that women who are open to pregnancy and birth at any time experience. One where you have your last baby, nurse a few years and then all of the sudden realize, gee, I'm not having periods anymore.

As far as the re-injure comment: I don't think of it this way at all. The body is made to birth a baby- it does not injure the body to do so. Yes you will have relaxin in your system, yes your ligaments will be more lax and stretched out, yes you will have less muscular support due to the pregnancy- but this is all easily shaped back up after the baby is older. No big deal. Just the body doing it's thing.

I love so much the simplicity of being open to life, adding to the family and taking things as they come. That's what we've done for the last 9 years. If we kept that up, that would mean at least 8 more kids and I'm not up for a family of 13 children (assuming I don't get pregnant after 46, I don't have any twins, I have a child every two years on average and they all live). I look around our table and I feel this contentment- this feeling of everyone present and accounted for and it makes me happy.
I'll live through you, so pop in and tell us all about your sweet new babes from time to time!

I can't see that the actual pregs and deliveries will make anything worse, but (forgive me if you think this comment is out of order), but you do need to think about how you will care for yourself in and amongst the HUGE physical job of caring for your current as well as future children. My second preg seems to have slightly improved my prolapse, but the reality of having small children means I just don't have the time to do everything I would like to do (and should be doing) to take care of myself and rehabilitate my pelvis.

I will second the nomination of wholewoman of the year! I wish I were up for a large family like you are growing. we've been blessed with five children (youngest two born after I found the prolapse and I am no worse off for it). I have absolutely zero concerns about future pg's negatively affecting my prolapse, my concerns about more babies have to do with my emotional health. I think I cannot survive another round of ppd and nightfeedings.
like everything else, that's a highly variable thing, I know lots of women who have 8+ children and are calm and relaxed and well cared for. I say if you can swing it emotionally, dont let the fear of 'future damage' stop you.
I cant imagine you'd ever regret having more babies. like alemama said, sometimes I look around the table and feel so full to the brim with blessings.

Wow, Granolamom, do you really know people with 8+ kids?! (genuinely surprised). Can't say I know anyone from my generation with more than 3. I am going to spit it out and say large families do niggle me a little. Of course it is a thoroughly personal issue and I have no desire to dictate any other person's reproductive desires or opportunities, but in the interest of debate and genuine personal curiosity, what is it about having loads (say 5 or more) of children? I look at my two and I feel immensely grateful for my good luck, and can't help but think 'be thankful for what you have' and 'quit while you're ahead'. I feel comfortable with the fact that I am only replacing myself and my husband in this very crowded world.

In the absence of any religious 'calling' to have many children (or of course religious belief that prohibits the use of contraception), what are the arguments for very large families?

How about: there's no reliable birth control short of abstinence and menopause. what surprises me isn't women who grow large families, it's women who manage to have only one or two babies- when and if they so choose-during their entire reproductive time period.

I had to laugh out loud at a great many of the statements you made here cynical :)
Glad for a laugh. I love that 5 kids seems like loads to some people. I have heard 5 called a gaggle and that cracked me up too.
My good friend was once asked this question by a store manager. Actually, he went so far as to tell her that she had too many kids. She told him that when one of her *too many* kids cured the cancer he was dying from one day he might change his mind about that.

When people ask me why, I just say that I'm balancing out the stupids. Think about it, if only the intelligent, environmentally conscious people stopped having many children, who are your children's peers going to be? What type of people will be the majority? Really, give it some thought.

My 5 well loved, intelligent, kind, thoughtful, environmentally conscious children are here. They will one day be scientists, doctors, naturalists, teachers, philosophers, lovers, movers and shakers. You are welcome!
Besides, they're cheeper by the dozen.

Well, I bet that 95% of the time, it is religion. I can name 5 major religions off the top of my head that celebrate the large family. I gather you are European, cynical? Yeah, large family not so popular there, for quite some time. I think Italy actually had negative population growth last year. As an American, I site a cultural love of the large family in this country that exists beyond religion. We've got it good, got the space, and a certain nostalgia for the joy of loving a lot of siblings. I'm from a family of 2, but my husband has 4 brothers. His aunt has 9 or so (not religious at all btw). My mom's from a family of 4 kids, my grandpa was the youngest of 13. I'd say about 30% of the people I know are from families of 4, 5, 8, and even 12 children. I know at least 3 people from families of 12. I think ours is a culture that idealizes childhood and likes to share when we have plenty. As long as you don't use public funds to support your family, whose business is it? Our famous family of 19 kids is entirely self supported. I think it is a pioneer kind of thing, at least here out west. Big spaces, big families. Heck, I'd like 4 if my age and economics allow :-)

Hmmm... not sure i buy into any of those arguments (alemama's). Chances are our children will all be average, and there's nothing wrong with that either. I'm definitely not kidding myself that I doing the world any great service by having children. It's enough for me that my husband and I wanted them and we adore them, but I can't see how having more would enrich my life any further, but that's just me. And I definitely don't want one of those enormous cars/ mini buses to transport us all around in!

Really, having children is, in my opinion something we do for ourselves and our family. I don't think it has to be about any more than that. But I still don't understand why 6 is better than 4 or 10 better than 8... I'm not trying to be inflammatory, but I'm not sure why the desire to have loads of kids warrants two Whole Woman of the Year nominations :-)

Yep, I'm not American. Not entirely European either, but I live in the UK nowadays, where there is free health care and a welfare state (but this is not an argument I was trying to make, much more interested in the personal side of things...but you're right, we don't have as much space, and, perhaps more significantly our society in general is far more secular).

Never said I wanted to dictate how many children people should have, just fascinated by why some people keep going...

I kinda agree with Cynical on the topic of huge families. That being said, I think Juls does get the award for proving that prolapse needn't interfere with reproduction!

Come dear Whole Women! Yes, the population bomb is a very real and present danger, but let us celebrate the increasingly rare woman who births naturally and recovers from prolapse as many times as she desires in an ever more polluted, radioactive and sterile world! Something tells me we won’t be crowded for long...

Love your work, Christine, but I can't help but think your last post came across a tad patronisingly. I'm all for celebrating reproductive freedom and courage, but that doesn't mean we can't have a civilised and healthy debate about all the other issues, in addition to prolapse, that affect how many children those of us blessed with fertility can and should have.

yes, I really know families with 8+ kids! my sister has more than 8. two of my childhood friends were from large families (13 and 15 kids respectively). two of my childhood friends are currently expecting their 7th each. the woman who taught me to sew has 21 kids (2 sets of twins). another friend of mine is one of 9. a neighbor of ours has 9.
and this is just off the top of my head. I could probably think of more if I tried harder.

I'm pretty religious (although bc is not prohibited) so there is a value of the inherent holiness of life, the preciousness of each life, and of each potential life. I know some people view having (many) children as a selfish act, but we view it as selfless.
what argument for large families? well, my answer would be each life is a gift to the rest of humanity. I hope and pray that I raise each of my children to add something to society, to bring happiness and joy to others, to make this world a better place. and each one of my children has his own beauty and strengths, I cannot imagine my family without each one so I imagine that the world will benefit from each one. everybody brings something to the table :)

I am immensely grateful for what I have, and when given more I feel that someone up in heaven must think I deserve more. as far as quit while I'm ahead, you never know when you're ahead.

oh cynical, come on. I just loved her post, her energy, her vibrancy and joy of life.
6 is not better than 4 nor 10 better than 8. but a woman who loves growing her family and maintains a balanced attitude about her body while doing it, to me, epitomizes wholewoman philosophy. my opinion only, not a WW spokeswoman here.

granolamom said "I'm pretty religious (although bc is not prohibited) so there is a value of the inherent holiness of life, the preciousness of each life, and of each potential life."

On the religious scale I would not fall under *pretty religious* but this statement is very true for me :)

Have you all ever read Kahlil Gibran? He's an amazing poet and philosopher. He has a poem called On Children.
Below is the first bit of it:
On Children
Kahlil Gibran
Your children are not your children.
They are the sons and daughters of Life's longing for itself.
They come through you but not from you,
And though they are with you yet they belong not to you.

Cynical, I can not for one second imagine having children so that I could have play things. There is something so much stronger going on here- a biological imperative perhaps you would call it. Life's longing for itself sounds prettier though.

You've got your hands full
You sure must be busy
Look, you have a basketball team
How do you feed all those children

I love when people make these comments. And Juls, I'd probably chat you up in the grocery line ;)

but the one that I HATE! is when some man looks at me with my kids and says something suggestive like: you've been busy or you know how it happens right ?(suggesting that I have no clue sex could cause pregnancy). All said with eyebrow raising.
I hate it mostly because since I'm with my children I can not say something inappropriate right back at him.

Cynical, my dh wants a short bus so bad I think he'd have 15 kids just to get the bus (just teasing- sorta). I would not want to have to get a special car- I'd do it, sure. But I know what you mean. They are big. and there is no short bus in my future (well unless he converts one for camping or something).

LOL, because I only have 2 kids, and people say 2 out of those 4 statements to me! Short bus .... LOLOLOL!

alemama, I think you shared a bit of that a long time ago here, I looked it up and have uttered that phrase 'lifes longing for itself' or the 'they come through you but not from you' on an almost daily basis.
so thanks again for sharing it :)