Prolapse after birth

Pelvic organ prolapse happens when the muscles and ligaments in your pelvic floor become weak or damaged. This causes one or more of the organs in your pelvis to slip out of place and bulge into the vagina.

The organs affected may include the:

• uterus (womb)
• top of the vagina
• bladder
• bowels

While pelvic organ prolapse isn't life-threatening, it may cause discomfort, pain, and impact your quality of life.

There are different types of pelvic organ prolapse. It's important to have any prolapse checked by your doctor.

Pelvic organs can bulge into different parts of the vaginal wall:

• into the front wall of the vagina
• through the back vaginal wall

Sometimes, more than one of the pelvic organs may bulge into your vagina at the same time.

You may not notice symptoms of prolapse at first. Sometimes, it's only found during a routine check-up like a pap smear test. When symptoms appear, they can range from mild to more serious.

Common symptoms may include:

• seeing a bulge at the vaginal opening
• a feeling of pressure or heaviness, as if something is falling out
• lower back pain
• discomfort during sex (Opens in new tab)
• soreness or bleeding if the prolapse comes out

Bladder or bowel issues may include:

• difficulty emptying the bladder (weeing) or passing stools (pooing)
• urinary (wee) or faecal (poo) incontinence
• urinary tract infections (Opens in new tab) that keep coming back

Symptoms may worsen throughout the day or after standing, but often improve when you rest.

Prolapse is most often caused by pregnancy and childbirth. Your first vaginal birth can increase your risk of prolapse by 4 times.

When your baby moves through the vagina during birth, it can stretch and tear the tissues and muscles supporting your pelvic organs, particularly if you had an assisted birth with forceps or your baby was larger. The more vaginal births you have, the higher your risk of prolapse.

Prolapse can run in families and is also more common:

• after menopause (Opens in new tab)
• after a hysterectomy (Opens in new tab) (surgical removal of the uterus)
• if you live with obesity (Opens in new tab)

Prolapse can also happen to females who haven't experienced childbirth. Other causes may include persistent coughing, heavy lifting, and chronic constipation with straining.

Prolapse happens because of weakened or damaged pelvic tissues and muscles, so it's important to keep these muscles strong. Just like other muscles in your body, you can strengthen your pelvic floor muscles with exercises.

It's a good idea to have your exercise techniques checked by a pelvic floor physiotherapist. They can make sure you're doing them correctly. This can play a big role in preventing prolapse.

If you notice any symptoms of prolapse, speak to your doctor. They can guide you through the next steps and refer you to a specialist such as a gynaecologist for treatment.

Prolapse is usually diagnosed with a physical exam and by reviewing your symptoms. Sometimes, imaging tests like an ultrasound or MRI scan (Opens in new tab) are used to better understand the severity and location of the prolapse.

Find out more about your rights when having a vaginal examination.

There are several ways to manage prolapse based on your symptoms and preferences.

Physiotherapy

A pelvic floor physiotherapist will guide you through exercises to strengthen your muscles. They will teach you about bladder and bowel health and create a personalised exercise plan.

Pessaries

A pessary is a small silicone device placed in your vagina to support your pelvic organs. It is a non-surgical option and will be fitted by your doctor or physiotherapist.

Surgical options

Surgery may be needed for more severe prolapse or when other treatment doesn't work.

Discuss your options with your gynaecologist to find the best treatment for your situation.

Living with prolapse means making small changes to help manage your symptoms. It's a common condition and you're not alone. Starting with regular pelvic floor exercises can make a big difference and reduce your need for surgery.

Safe physical activity

Exercise is important for your wellbeing, especially after having a baby. If you're diagnosed with prolapse, it's important to learn how to exercise safely. Work with a pelvic floor physiotherapist and consider finding a personal trainer who specialises in postpartum care.

Pelvic organ prolapse can lead to discomfort, as well as issues with urination, bowel movements, or sexual function. This may impact your daily life. There can also be complications after surgery.

Sexual disfunction

It's common to feel self-conscious about changes to your body, which can affect intimacy. While prolapse doesn't worsen with sex, concerns may lead to avoiding it.

Pelvic floor exercises and open communication with your partner can help.

Try these tips:

• Take time for arousal.
• Relax your pelvic area.
• Use lubricant or non-latex condoms.

Surgery

Surgery for prolapse can lead to complications like infection or the prolapse returning after surgery.

It's important to talk to your doctor about these risks to make the best decision for your health.

Prolapse can affect future pregnancies, but it's possible to have a healthy pregnancy. During pregnancy, prolapse symptoms may worsen due to increased pressure on the pelvic floor. You may experience more discomfort.

If you are thinking about pregnancy, talk to your doctor or a pelvic floor specialist for support. They can help you make informed decisions, so you feel confident managing prolapse during future pregnancies.

Speak to your doctor, midwife or obstetrician about your symptoms or any questions you have.

Visit Birth Trauma Australia (Opens in new tab) for information and support, including their peer2peer support (Opens in new tab) programs. They also offer information on:

• pelvic floor muscle damage
• pelvic organ prolapse (POP)
• birth trauma

Continence Health Australia (Opens in new tab) offers confidential information and support to people with bowel and bladder problems. Call the helpline on 1800 33 00 66 between 8am and 8pm (AEST), Monday to Friday excluding national public holidays.

Visit PANDA (Opens in new tab) (Perinatal Anxiety & Depression Australia) for information and support after a traumatic birth. You can call the PANDA national helpline on 1300 726 306 (Mon to Sat, 9am to 7.30pm AEST).