A couple of questions!

Body: 

Hi, I'm new to the forum but possibly surprisingly I'm not new to prolapse.
I found my first sign of prolapse 4 years ago after I gave birth to my second child. Hers was a "perfect" home birth and ironically it was after her birth that I prolapsed, not after my first birth which was very traumatic with protracted pushing and epidural.

Anyway, back then rectocele was my biggest problem, cystocele was barely there.
I went through all the emotions back then so this time I feel like I'm much more able to cope with what has come after baby number 3.

It's much worse than after baby number 2, but I remain hopeful.
Birth #3 was also a textbook and easy home birth. It still baffles me why I would prolapse after these easy births and not the very difficult one, but I guess it just goes to show that birth is not really the issue, it must be other factors.
Adding to this is the fact that both times my prolapse was discovered a few weeks post partum, not straight after birth.

Right now I have what I would self diagnose as a stage 2 or 3 cystocele. I still have the rectocele, but honestly it doesn't bother me at all. Funny how 4 years ago it devastated me, now I'd be happy to have it for the rest of my life if I could just improve this cystocele.
The cystocele severity varies from day to day, morning to evening, even to the point where it will be horribly protruding one minute and literally 2 mins later it feels like it's tucked back in. And yes, I will admit I am obsessive with it. This I continue to work on.

I have a few questions for the forum, if I may.

Q1. When I do WW posture (which I must say feels "right" and feminine with regard to my pelvic organs) and relax my lower belly and pull my chest up, I have trouble breathing comfortably. It's very hard to take a breath in. Is this normal for someone who is 8 wks PP and new to the posture? Or am I doing something wrong?

Q2. For the last 18 months yoga and pilates have been a big part of my life, I have never felt stronger or healthier, physically or mentally, than when I practice regularly. I found my pelvic floor muscles were strong and my rectocele was virtually non-existent. However I acknowledge that this is just as likely to be other factors as it is to be the exercises I was doing. Time being the biggest factor.
It upsets me greatly to hear that yoga/pilates it is not only unhelpful for prolapse but also aggravates it. I am currently trying to decide whether to start classes again. Is there any way to practice these things while stabilising my prolapse?
I can live with a lot of these changes, moving from jeans (my staple wardrobe item) to skirts/loose pants, posture etc. But giving up one of the greatest joys in my life is going to be very difficult and it is the group classes that I enjoy most of all.

Q3. I have been taking colloidal silica for the PP period, currently 8 wks PP. Has anyone had success with that?

Q4. I am finding that descriptions/pictures/videos of the WW posture and fire breathing, nauli are hard to come by. Can anyone point me towards anything that can help me get this right. I understand there are DVDs and books but TBH I would be very disappointed if I bought them and was still left wondering how to do these techniques. Can anyone reassure me that I will find thorough explanations/videos if I purchase these items?

Q5. Should I still do pelvic floor squeezes or should I abandon them altogether? Is there room for doing all sorts of things or should I be sticking with one "system"?
I'm not sure whether to seek assistance from a gyno/physio or just try to mange this myself.

Right now I am coming to terms with this. I have good times and bad, of course all hinged around what my bladder is doing right at that moment in time. I notice I have more discharge at the moment, healthy discharge, but I wonder if my body is trying to compensate for so much of my vaginal tissue being exposed to the outside air.

I hope for improvement but I also know that a slight improvement/stablilisation is the best I am going to get.

Thankyou for reading xx

I am here only a couple months longer than you. Welcome to a wonderful place! As for your first question, I have experienced that as well and I thank you for posting that question. I feel that a lot and don't even know why I didn't ask the question. this is what I think about it though (and I think about it a lot)--in WW posture, we are stretching the abs lengthwise and maybe we are not used to the tautness in that direction. When we inhale there will be interabdominal pressure from the breath. Maybe we were used to chest breathing and now doing the belly breathing, we are feeling that. I am looking forward to hearing back from the others on that one. For your second question, my take on it is this. Get comfortable with WW posture, order the DVDs, start your own practice with Christine as your guide. When you have built the proper strength and the proper knowledge, you might be able to return to your yoga class (I have too many doubts about the pilates though) and when you return, you must only do the positions with WW posture, always mindful of what you should and shouldn't be doing. My belief is that what we must be mindful of, all women should be mindful of. There are no real "women's" yoga and pilates classes in my area or any area that I am aware of. But when you really know what you are doing, you might be able to talk to your teacher and still join in on the class with all of your "womens" knowledge guiding you. Yesterday I watched for the first time the "Third Wheel". It is so inspirational, so clear and so inspiring. Buy it! You will see the Firebreathing and the Nauli. I have purchased all the DVDs and rotate them a bit as I am learning and building the proper strength and knowledge. I cannot answer the Q5, but I believe that if you want to practice the Kegel, it should only be in WW posture. I think you will hear back from others more experienced on that one. Congratulations on your beautiful births and your babies! Welcome to this wonderful forum and my very best wishes to you!

Hi Odelia! I'm Amy, the Whole Woman office lady. I just wanted to reiterate what Nightingale said about The Third Wheel being great for Nauli and fire breathing. The posture is pretty well defined in the First Aid for Prolapse DVD. I am happy to talk to you about anything product related at my email [email protected] or you can call 505 314 1455.

I speak to many women who master what is safe for their POP and then share that information with the instructors of their group class. Like any sport, be straightforward with your coach, or yogi in this case, and let them know about your concerns and the positions you will NOT be doing in class. That way they wont come behind you and try to tuck your tailbone in. :) When it comes to exercise, everything with WW and POP breaks down to angles. You are safe at anything 90 degrees or less in relation to your torso and legs. Your Danger Zone is between 90 and 180 degrees. These angles place too much stress and unstablility on the pelvic organs and area. So basically no Boat Pose, and many of the "ab specific" exercises found in pilates. As a woman, your "core" is unique and you should do exercises designed for your body.

I hope that that helps.

If you need any thing else, I am am your girl.

Hi Odelia

Following up on Survival's answer.

Firstly, you are only 8 weeks pp, and what you say is true. Postpartum POP normally makes its presence felt a few weeks after birth, rather than straight away. We don't know why.

It will take a full two years for your body to revert postpregnancy. For a woman who has a baby every two years or so she never actually reaches that time before she is pregnant again. Two years after your last baby you will be back to base again, though I think there was still subtle firming up in my pelvic area for a couple of years after that. The worst time for pp POP seems to be the first 3 to 6 months. After that your prolapses will start to improve. All you can do is support your pelvic organs with appropriate WW posture to ensure that with all the work needed with littlies you do not damage your pelvic support system more. You just need to be very patient, as many women on these Forums will tell you.

The other mystery for you is why you didn't experience POP after your first and difficult birth. When you became pregnant the first time your body was all young and taut. The second and third times your body went into the pregnancy already a bit stretched, so it is understandable that further stretching can happen in an already stretched soft tissue system. I had similar experiences with my three babies.

Re exercise, your Pilates has probably taught you to hold your tummy in, and your brain probably wants to get it back to that state. To be able to do this you need a very, very strong pelvic floor.

The female torso is designed to distend. During pregnancy as your uterus swells all the organs of your abdomen have to move around, up and outwards at the front and sides, even out the back of your ribs, in order for your body to still contain them. Your rib cage changes shape and expands. Your ligaments loosen so that joints can expand their movement. Your belly grows forwards and stretches the transverse, both sets of obliques and the rectus abdominus muscles to the max. During birth your pelvic floor muscles all need to stretch to the max to let the baby out. This is in addition to letting stool and urine out. They are not designed to keep things in. These pelvic floor muscles are designed to periodically let things out, then retract back to normal size.

If your tummy is tucked it will straighten your lumbar spine curvature and your tailbone will drop. Your bladder and uterus are pushed backwards and end up on top of the vagina. Your anus ends up at the bottom of the torso and all your intestines will push down on your rectum, squashing down on top of it. This is how prolapse happens. These are facts. Have a think about what I have described.

Is it any wonder that your rectum too pushes into your vaginal space? With all this downward pressure is it any wonder that you need to do pelvic floor exercises to give your pelvic floor muscles higher tone, so they don't sag under the weight?

MsNightingale alluded to belly breathing. Our main breathing muscle is our respiratory diaphragm. It is a big thin, domed muscle fastened to the underside of the rib cage and breastbone at the front, right around to the bottom of the ribs and down onto the lumbar spine. It makes you breathe by contracting down and forwards because of its shape (higher at the front). This naturally expands your tummy above your waist, then below your waist right down to your pubic bones as you inhale further. When your tummy is tucked flat it cannot expand in this way it is designed to operate and you are forced, like a woman wearing a corset, to breathe with the muscles between your ribs and your shoulders. All the intraabdominal pressure created by breathing has to be absorbed by your rigid rib cage or has to go down and is 'extruded' out of your pelvic outlet, with some elastic resistance from your pelvic floor.

Why would you want to do this to your pelvic floor?

Instead, use your shoulder and chest muscles to lift your chest. This will stretch your abdominal muscles until they are firm like a ship's sail in the wind. You now have a much greater, elastic area of your abdominal wall to absorb intraabdominal pressure from breathing. As you inhale and lift your chest your lumbar spine will be drawn forwards into the centre of your body by the contraction of the diaphragm where it joins the lumbar spine. Your pelvis will tilt forwards and your bladder and uterus move forwards off the vagina, and onto your pubic bones. Your pubic symphysis actually moves down and back at the same time by this tilting mechanism, requiring your abdominal muscles to stretch even further!

The pelvic floor is no longer holding anything up. It is just a stablising wall at the back of your body, stabilising your bladder and uterus, which are now hiding *under* your lumbar spinal curve, away from the effects of intraabdominal pressure, which is absorbed and deflected by your sail/belly, the same way as a seagull flying straight into a sail would go boomph, and deform the sail briefly.

The geometry of your whole musculoskeletal system and fascia system is specifically designed to work like this, with each part reinforcing the other. Why would you want to make it work otherwise? To have a flat tummy, and do mens' exercises so you can have a flat tummy like a man? Why do you want to have a flat tummy, when you can have a gently curved tummy that does its functional job of absorbing forces in firm, curved sausage shape, and looks so much more feminine? BTW, in this WW posture configuration the tummy above your waist will be the furthest out in front of you. Your belly will not be floppy and will not protrude. While you are still feeling postpartum you might not see or feel very firm, but with time you will see and feel it happening.

Feel the landmarks on your body with your fingers. Have a play in front of the mirror and see how they move when you change your posture. Grab an anatomical atlas from the Library and see how your body works.

That's enough for now. Yoga and Kegels later. I hope I have turned your lightbulb on. :-)

Louise

Thanks for the replies :)
Just in response to Louise - I don't want a flat tummy and I don't want to do "mens exercises" but I do want the enjoyment of group classes, the enjoyment of taking those hours out for myself (I have 3 young children), the feeling of strong legs and bottom, the feeling of strong arms and no back pain, the uplift to the mind and soul upon finishing the class, the social aspect......
I have never wanted a six pack and am lucky enough to be naturally slender, so it has nothing to do with wanting a flat tummy, just to clarify. I feel as though the assumption that vanity motivates me! Not the case at all.

Dear Odelia and Ms Nightingale

Breathing from the relaxed lower belly is called diaphragm breathing. The irony is, if you concentrate too much on your diaphragm while doing it, you can’t do it. The way is to relax the lower belly as you are doing and just concentrate on breathing from the lower belly. The belly going out as you inhale and coming in as you exhale. I found doing it slowly to start with paved the way. It doesn't hurt to push belly out with the inhale but I leave it to come in on its own in the exhale.

Best wishes, Fab.

Hi Odelia

Thanks for the clarification on this. Didn't mean to offend. Sometimes women just pick up that six pack is 'good', and cannot see why it is not.

Yes, physical strength is awesome! To be able to do a workout with ease that was a struggle a few months earlier is a great buzz. Exercising in a group is good social stuff too, with social contact that comes with the additional common reason for being there, being to get a stronger body, and you all work on it together.

You just have to pick the right group. This is why I gave the detail explanation about how WW posture allows the body to 'multitask', one part of the body reinforcing the mechanism of another part. It is just amazing. Pilates can work against the body's natural design, and work against Whole Woman principles.

If you know what your body is trying to do, then you are in a much better position to be able to amend your Pilates exercises so that they don't work counterintuitively for pelvic organ support, and ensure that you don't miss out on strengthening the right muscles in the right way that WW Yoga DVDs show you, for purposes of POP management.

You never know. Christine may one day do a DVD called Wholelates, to demonstrate how you can do this. This is not a promise, but I hope she will see this post and rise to the occasion of responding. :-D

Fab - thankyou for that explanation and reassurance :)
Louise - That would be fantastic! But what would be even better is if this could go world wide and my gym started running wholates classes...lol. I'm not the kind to use DVDs at home, I know I would never do it myself due to lack of motivation, plus I'd have my kids jumping all over me :/
Unfortunately the classes I was doing were based on the core being the mid section and I can see and understand how that is totally counterproductive to my POP. It clicked for me right away. I am now just mourning the loss of something that was a huge positive in my life.

Odelia, you have the rest of your life to get WW techniques perfected. Your kids won't be little forever, believe me!