Patient Story: Navigating Prolapse, Pessaries & Second Pregnancies
I learned about pelvic organ prolapse (POP) for the first time after having my first baby. She was born in May 2020, shortly after the COVID-19 pandemic started, and a few weeks later I started having a feeling in my vagina that I had not felt before. (I did not know how to explain it at the time, but I later learned to use terms like “heaviness” and “pressure” to describe what I was feeling.)
After a few weeks postpartum, I used a handheld mirror to look and see what was going on. I saw what I would later learn was vaginal tissue bulging out of my vagina. It looked like my insides were falling out. It was alarming to say the least. I felt concerned and unsure of what was going on. Like with so many things that I do not know the answer to, I turned to Google to try to see if I could figure out what was going on. I know searching the internet can be a slippery slope, especially for health concerns, but I needed information on what might be causing the symptoms I was experiencing. Based on my research, I was pretty sure that I had pelvic organ prolapse.
I took a few pictures so I could show the midwife at my six week postpartum visit. I showed her the pictures and told her I thought I had a prolapse. She examined me in a few different positions and ultimately said that I did not have a prolapse. This was disheartening because I felt dismissed by my provider.
Thankfully, I had learned about pelvic floor physical therapy (PFPT) from my doula community and already had purchased a postpartum care package with my pelvic floor physical therapist. She confirmed that I had prolapse and helped answer my questions, which calmed my nerves. She reassured me that everything was in fact not going to fall out and reminded me that I was still very early postpartum. This was reassuring because I finally felt seen and heard.
My pelvic floor PT was a wealth of information and made me a personalized recovery plan. At every visit, she answered my questions, assessed my progress, and adjusted my plan as needed. She recommended I purchase a pelvic floor support garment to help mitigate my symptoms while I worked on giving my body time to recover and progress through my strength program.
I tried many different garments and wore them at various times to help find relief. However, I was never able to find a garment that I liked enough to consistently wear even though they provided relief that I desperately needed.
Working with pelvic floor physical therapy was an important part of my journey and I am so thankful I had one early in the process. She gave me hope and the tools to take control of my recovery and feel confident moving forward.
That is not to say it was an easy journey. There were so many days when I felt beat down and discouraged. I felt like I had a problem and like my body had failed me. I distinctly remember feeling exhausted and crying while I was holding my screaming newborn who I was having a hard time soothing because holding her and making a soothing motion was hard on my body and made my prolapse feel heavy. I remember walking short distances and having the pressure in my pelvic floor be at the top of my mind the whole time. I wondered whether this feeling would ever go away.
I struggled with questions like whether a subsequent pregnancy was an option - was it even possible, and if so, would it make things worse?
I struggled with the decision of when I should wean my baby from breastfeeding. Based on my research, I learned the shift in hormone levels that occurs while breastfeeding can contribute to feeling more prolapse symptoms, and many people experience relief from POP symptoms after they wean their babies from breastfeeding or stop pumping. There were so many heavy things that were on my mind in addition to having our first baby during a global pandemic.
I often wondered if there were things I could have done differently to prevent this from happening. My pregnancy and labor experience were what most would define as fairly routine and uneventful. Neither were particularly hard or traumatic. However, I was questioning things like whether I should have exercised more during pregnancy or whether I should have made it to the birth center more quickly because maybe I held her in too long. POP has a way of making you question things that you would not normally question. Of course I did not hold her in too long and I exercised in pregnancy the amount that felt right for my body. Looking back and wondering ‘what if’ was not healthy for me. It took time, but I got to the point where I accepted my prolapse and that I would work through it to the best of my ability.
My recovery was a slow process. I had varying levels of POP symptoms until about 15 months postpartum. Around that time I finally felt like my POP symptoms were mostly going away. It is hard to say why my symptoms mostly went away at that time, but some contributing factors are that I was in a good groove on consistently strength training, my daughter had weaned from breastfeeding at about 13 months and I was 15 months postpartum (i.e. I gave my body time). One of the things I learned during all of this is how unrealistic many expectations are regarding how quickly your body recovers after giving birth. Postpartum should be talked about in terms of months, not weeks.
I will wrap up my story by saying that I decided to try for another pregnancy and accept whatever outcome may come from that experience.
A note from Dr. Rebecca at Lady Bird PT:
Every postpartum recovery and every recovery following prolapse diagnosis looks different. We’re so grateful we got to share Lauren’s experience with you. If you’re interested in hearing a completely different prolapse experience, read Dr. Jessica Chastka’s personal experience here.
Here are some more resources for folks interested in learning more about prolapse:
Lauren was born and raised in central Texas, and she still lives in the area. She currently wears many hats as a mom of two young kiddos. She works as a strategist by day and entrepreneur by night.
She founded Hem Support Wear in 2021. Lauren learned first hand that many pelvic floor support garments missed the mark. Hem Support Wear is setting out to reimagine the pelvic floor support garment. Hem is thoughtfully designing garments that provide gentle compression to support the pelvic floor and promote wellness. She knows from first hand experience that women deserve something better, and Hem Support Wear is on a mission to provide it.
She loves to learn new things - she has made mozzarella cheese, kept bees for about six years, worked on an urban farm in Austin and mastered the art of baby wearing and gentle parenting (that one is a work in progress).
She loves to listen to podcasts or audiobooks while she is doing things like walking, making food or cleaning dishes. Her favorite podcast is How I Built This with Guy Raz. Some of her recent favorite audiobooks are Thank You for Listening by Julia Whelan, Part of Your World by Abby Jimenez and Atomic Habits by James Clear.
Hem Support Wear is setting out to reimagine the pelvic floor support garment. It is thoughtfully designing garments that provide gentle compression to support the pelvic floor and promote wellness. Women deserve something better, and Hem Support Wear is on a mission to provide it.