How to Manage Uterine Prolapse after Childbirth

uterine prolapse after childbirthUterine prolapse after childbirth usually comes as a shock and great disappointment to the unsuspecting new mum.

When the initial shock of a prolapse diagnosis subsides some women can feel quite devastated and needlessly ashamed of the change in their body.

These Pelvic Floor Physiotherapy exercises and techniques can assist women with mild to moderate uterine prolapse reduce their symptoms, improve prolapse support and overcome associated feelings of isolation and helplessness.

Read on now to learn how to maximise your prolapse recovery with exercises and techniques that:

(A) Improve uterine prolapse support
(B) Reduce uterine prolapse strain

Risk Factors with Uterine Prolapse after Childbirth

Women with uterine prolapse after pregnancy and childbirth are at increased risk of pelvic floor dysfunction owing to their:

  • Decreased pelvic floor strength and support after pregnancy and childbirth
  • Weakened pelvic floor muscles during breast feeding
  • Loading of the pelvic floor with body weight gained during pregnancy (abdominal fat)
  • Inappropriate exercise routines and unrealistic expectations weight loss expectations
  • Increased physical work overloading their pelvic floor supports
  • Physical fatigue weakening their pelvic floor supports

Women can improve their pelvic floor recovery and minimise the risks to their prolapse by addressing manageable risk factors with the following strategies.

(A) How to Improve Uterine Prolapse Support

Pelvic Floor Exercises

Pelvic floor exercises can be challenging to adhere to after childbirth – don’t ever feel guilty about being unable to do that amount of exercise you would like to, many new mums have difficulty finding the time and energy to complete as much as they’d like to.

The benefits of pelvic floor exercises with prolapse are clear:

  • Decreased prolapse symptoms (e.g. dragging, bulging) in women with mild to moderate prolapse
  • Increased pelvic floor strength and support
  • Lifting the pelvic floor (and prolapse) to sit higher within the pelvis

After childbirth follow the advice of your gynaecologist, midwife or physiotherapist regarding when to commence your exercises – this can vary since women who experience pelvic floor trauma and marked tearing of the perineum during delivery may be required to avoid pelvic floor exercises during initial healing of the pelvic floor tissues. Ideally women should progress to doing 3 sets of up to 8-12 repetitions of repeated pelvic floor exercises aiming to maintain each pelvic floor contraction for up to 10 seconds. Pelvic floor exercises can be performed by new mums when resting lying down, sitting nursing and feeding, progressing to standing. Seize every opportunity you get to do your pelvic floor exercise – it all adds up over time. It’s not going to happen overnight and perseverence is important, it can take 5-6 months of regular daily pelvic floor exercises to recover pelvic floor strength.

Support Pessary

Pessaries can provide symptom relief and may enhance the effectiveness of  pelvic floor exercises for uterine prolapse management. Pessaries can provide numerous potential benefits for new mums with prolapse when fitted with a well fitting support pessary:

  • Decreased prolapse symptoms especially with fatigue towards the end of a day
  • Increased effectiveness of pelvic floor exercises by lifting the weight of prolapsed tissues
  • Improved ability to exercise without symptoms
  • Discreet and ability to remain sexually active with pessary in place.

You may choose to speak with your gynaecologist about your suitability for support pessary if you are troubled by uterine prolapse symptoms after childbirth.

(B) How to Reduce Uterine Prolapse Strain

Safe Lifting

Heavy or repeated lifting increases the load on the pelvic floor, increasing the likelihood of strain and weakness thereby worsening prolapse problems. Looking after a new baby and young children involves plenty of lifting. These lifting strategies can help you reduce the associated load on your pelvic floor and prolapse:

  • Lift with correct lifting techniques (lunge rather than squat)
  • Try to minimise heavy lifting and seek assistance where possible
  • Try to avoid or minimise repeated lifting where possible
  • Use a pram rather than carrying young children for long periods of time
  • Sit or lay down rather than standing for prolonged periods of time when nursing or carrying young children
  • Feeding lying down can help to reduce the load off the pelvic floor
  • Encourage older children to climb into position rather than lift where safe and appropriate

Pelvic Floor Safe Exercise Inside Out book and DVD

Pelvic floor safe exercise is essential for all new mums and for women with uterine prolapse it is imperative to protect the pelvic floor. Appropriate exercise will help you to avoid overloading your pelvic floor while improving your general strength and fitness after pregnancy. Exercise can help new mums to regain strength and fitness, manage body weight, improve mood and energy levels and cope with the emotional demands of motherhood.

  • Choose low impact cardiovascular exercises (e.g. walking, swimming, and cycling)
  • Choose pelvic floor safe strength training positions and techniques
  • Avoid unsafe abdominal exercises – these exercises will not flatten the abdomen and can force the weakened pelvic floor downwards, thereby increasing the likelihood of pelvic floor strain and weakness.

Inside Out book and workout DVD provide women with a pelvic floor safe strength workout routine and pelvic floor training regime – ideal for new mums seeking to exercise safely and get back into shape with uterine prolapse problems.

Manage Body Weight

Managing your body weight and losing excess weight if you are overweight is important for uterine prolapse management. Abdominal fat increases the load on the pelvic floor and prolapse, in other words it weighs down your prolapse. Abdominal body fat is the fat that is stored in and around the abdominal organs and is also known as visceral fat.

A combination of appropriate diet, cardiovascular and strength training exercises will help you to reduce abdominal fat loading your prolapse. High intensity exercise is the most effective form of weight loss exercise and can be performed using low impact pelvic floor safe exercises. The ‘Lifesprints’ high low intensity exercise program is a great form cardiovascular exercise shown to effectively reduce abdominal fat in women when performed over 3 months of 3x weekly 20 minute sessions per week.

Bowel Management bowel emptying video

Managing your bowels well to avoid straining and constipation is vital for long-term uterine prolapse management. Manage your bowels using the correct bowel movement position and technique for bowel emptying shown in this bowel movement video. Never strain to empty your bowels as a rule. Eat well to maintain a soft well formed stool that is most appropriate for bowel emptying. If you are troubled by constipation speak with your doctor or pelvic floor physiotherapist about appropriate bowel management techniques.

Chronic Cough Management

Coughing causes repeated forceful loading of the pelvic floor and is a known risk factor for prolapse. If you have a uterine prolapse and a chronic cough speak with your doctor regarding medication to assist you manage your cough. ‘The Knack’ is an exercise technique involving a pre-contraction of the pelvic floor muscles to resist the downward forces of coughing (and sneezing). Use ‘The Knack’ exercise technique with every cough to reduce the downward impact of coughing on your prolapse.

Rest

Rest and put your feet up whenever you have the opportunity to do so to relieve your pelvic floor and reduce physical fatigue. Lying down reduces the load on the pelvic floor when compared with sitting and standing. Rest allows the pelvic floor tissues to repair after childbirth. Resting also reduces the strain on the pelvic floor muscles which decreases the likelihood of pelvic floor muscle fatigue and increased prolapse symptoms during the course of the day. When the pelvic floor muscles are repeatedly stretched and strained they become progressively weaker and less capable of supporting your uterine prolapse.

So while a diagnosis of uterine prolapse can at first be distressing, it is definitely not the beginning of the end no matter how dire things might seem at the time. These uterine prolapse management strategies will help you towards prolapse recovery after childbirth so that you can feel confident about your body and empowered to exercise and lead an active life. Consultation with a pelvic floor physiotherapist can assist you manage and overcome problems associated with uterine prolapse after childbirth.

prolapse exercisesABOUT THE AUTHOR, Michelle Kenway

Michelle Kenway is a Pelvic Floor Physiotherapist and author of Prolapse Exercises Inside Out.

Prolapse Exercises is a complete exercise guide for women with prolapse and after prolapse surgery seeking to exercise safely and protect their pelvic floor.

Comments

  1. Samantha says:

    Michelle, I am so glad that you have put this information out there for new mums. None of this was available for me after I had my child 9 years ago at 21. In fact, it was assumed by professionals that I could not have a prolapse after just 1 child. This led to me having to fight for 9 years to be taken seriously. At the end of last year I was finally diagnosed with having a large rectocele.

    • Michelle Kenway says:

      Hi Samantha
      If it helps at all I beleieve that you’re not alone in having this experience with prolapse after childbirth. I am not sure which country you are writing from however in many places there is little to no support for women with prolapse after childbirth. In Australian cities many of the large hospitals now have Physios visiting new mums and helping them with their prolapse issues. I think this is very important in helping new mums deal with their new roles as mothers, their body image and very importantly avoiding problems like post-natal depression.

      Thank you for your comments Samantha – they will undoubtedly help other women to feel less alone and this is indeed a gift for someone else.
      Wishing you all the best
      Michelle

  2. HI I wish I knew about your site 5 yrs ago when I thought I had a “growth” after my 1st child. After seeing a GP I was not really given any info about the situation and was left untreated until I had to seek treatment for adenomyosis (witch made my uterus larger and bulky), then I became pregnant with my 2nd and after waiting to see a few different specialist with not much info still being passed along it became severe prolapse affecting by bladder and ability to void.
    Now am 39and I had a hysterectomy from a prolapse 12 weeks ago. I have a 2yr old (still in diapers) and a 5yr old.
    When I had my check up with my surgeon at 8weeks…(i don’t see her again for 1yr) I was then told that I can’t lift up more than 10lbs – forever!! I was so shocked and honestly have been very depressed about this as I feel that I can’t be a great mom with my kids and I am having trouble getting my little one to do anything now as he knows I can’t pick him up.

    This was something that I had not been aware of prior to my check up and surgery and I wish that I would have put off the surgery for 1 or 2 yr so that I could be there for my little guy.

    My question for you is if I do lift what will happen, and how long before I will need surgery again…I just feel like I need to do more for him, be able to carry him when he gets hurt and refuse to walk, and I need to pick him up to toilet train him as well.
    Every where I read is not to lift heavy objects but to me 10lbs is not heavy. I used to often carry my 40lbs 5yr old and move massive things in storage area. What is it that determined the weight limit set by my DR?

    I also have a stand up paddle board business and I want/need to be able to SUP, is this something that you think that I would be able to do? I saw on your sight paddling but i’m not sure about standup if that was different.

    Biking uphill is that ok? pushing a stroller ok? I have and SI joint and low back problem from a car crash 14yrs ago and pilaties really helped stretch it out. Is that always something that is not advisable, or after a few yrs or can I do it limited?

    Sorry I have so many questions I just feel so frustrated and sad

    • Michelle Kenway says:

      Hi Kat
      Thanks so much for your comment, I understand your frustration and I feel for you reading your story.

      Kat your specialist will base her lifting recommendation upon her understanding of your pelvic floor and your surgery and her advice should be heeded or at least ask her if you need clarification.

      Having said this when it comes to safe lifting after prolapse surgery I do have some problem understanding what research the magic number 10 is based upon and how it can be the same for all women without having strength tested that woman and her pelvic floor. I think some women who are young and strong will be able to lift 10 lb without straining whereas others who lack general strength and lack pelvic floor strength will have no chance. In Australia the magic number if often 10 kg (or 22.0462lb) so where does that leave us? Confused to say the least. What we do know is that heavy lifting does increase the load on the pelvic floor. I would also add to this abdominal weight will also load the pelvic floor and is a consideration after prolapse surgery.

      So how can I help you?
      1. Here is some information on safe lifting techniques with a prolapse, this should help you care for your baby
      2. There is no way of predicting if or when you will require more prolapse surgery
      3. Stand up paddling will use your abdominal muscles – the intensity will depend upon how hard you drive your paddle/speed of paddling and ideally you want to keep the intensity of core abdominal muscle exercises low if you are at risk of repeat prolapse (which owing to previous surgery you are)
      3. Biking uphill – use light gears and stay seated in the saddle to avoid straining
      4. General Pilates is not ideal for the ‘at risk’ pelvic floor unless the instructor knows how to modify the intensity of the core abdominal exercises
      5. Here is some information on Pilates and pelvic floor dysfunction that will explain more

      I really hope this answers your questions Kat, let me know if I can assist with any further information
      Best wishes
      Michelle