Uterine 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.
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
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 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.
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 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.
ABOUT 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.