Bringing a new life into the world is an incredible journey… but it can come with its own set of challenges. One of the common yet often unspoken issues faced by many women postpartum is pelvic organ prolapse. This condition can significantly impact a woman’s quality of life, but with the right information and support, it can absolutely be managed effectively. Here, we’ll delve into what prolapse is, why it happens postpartum, and what helps!

What is Pelvic Organ Prolapse?

Pelvic organ prolapse (POP) occurs when the pelvic floor muscles and tissues can no longer support the pelvic organs (bladder, uterus, rectum) adequately, causing them to drop (prolapse) from their normal position. This can lead to various symptoms, including:

A feeling of heaviness or pressure in the pelvic area
Bulging in the vagina
Discomfort during sexual intercourse
Urinary or fecal incontinence
Difficulty with bowel movements
A feeling of vulnerability as if things are unsupported in there

If you are experiencing any of the above symptoms come visit me in person, or go see your local PFPT because we can absolutely help.

*please I beg you not to google image prolapse — the internet is a grim place so I found you a depiction that is not so… visceral.

These are the different types of prolapse. Keep in mind that there are 4 different levels of severity.
**Grade 1:** tissue is moving slightly towards the opening ***most common and not that different more normal baseline**
**Grade 2:** tissue is descending 1cm above or below the hymen * **also most common**
**Grade 3:** tissue is descending more than 1cm below the hymen (but not totally out) ***likely requires surgery**
**Grade 4:** tissue is .. totally out. **VERY RARE but defs requires surgery.**

Quick Facts About Prolapse?

Did you know 50% of people over 50% have some form of prolapse regardless of having had a baby?
Did you know that over 30% of new moms feel like they have a prolapse even up to 6 months PP?
Did you know that even if you have a prolapse you can still get back to doing all your favourite physical (and sexual) activities without making it worse?

IT MATTERS MORE WHAT YOUR PROLAPSE FEELS LIKE THAN WHAT IT LOOKS LIKE (so long as it’s not hanging out of the body.

So Why Does Prolapse Happen?

The reality is, prolapse can happen to anyone. It can happen during pregnancy, during delivery, it can happen even if you haven’t had a baby! It occurs typically when there is prolonged excessive increase in pressure that bears down on the pelvic floor, creating laxity in the internal connective tissue. Obviously, pushing a baby through your vagina is a risk factor for prolapse but so are a few other factors:

Vaginal Interventions During Delivery: birthing a baby vaginally stretches your pelvic floor muscles THREE TIMES their resting length. That is an extremely compromising position for those muscles to be in while you’re also bearing down with as much force as you possible, with or without forceps. Unfortunately, the research shows that extended pushing (over 45mins), and forceps deliveries can increase injury to the pelvic floor muscles and increase the odds of developing a prolapse.
Hormonal Changes: Pregnancy and childbirth involve significant hormonal changes that can affect the elasticity and strength of pelvic tissues. When there is more laxity, your pelvic organs can rest lower than usual causing the feeling heaviness. This is also important to consider when we go through menopause because estrogen helps to keep tissue plump and supportive!
Genetics: As with other connective tissue disorders, these have a tendency to increase your likeliness of also having stretchy connective tissue so it might be worthwhile asking other family members how their pelvic organs feel after birth ;)
Chronic/Repetitive Excess Pressure: research shows that individuals who have heavy manual labour jobs, do really HEAVY weight lifting (and aren’t properly managing pressure), or who have chronic coughs or constipation are at higher risk of developing prolapse.
Multiple Pregnancies: Women who have had multiple pregnancies, specifically vaginal deliveries, especially with instrumental deliveries or episiotomies… well you get it. ❤️

What are some tips to help improve prolapse symptoms

Let’s answer this question Frankly from the inside out.

Sign up for Frank Postpartum - Duh
Go to Pelvic Floor Physio! We can help assess, and identify which pieces you should work on to better support your symptoms. PFPT can also introduce you to the weird and wonderful world of pessaries if needed.
Regain your pelvic floor strength & endurance so that it can support and uplift your organs. There is so much evidence supporting pelvic floor muscle training as the best treatment to help reduce prolapse symptoms. In some cases PFMT can even reduce your prolapse laxity. It’s important to keep in mind however that the laxity causing all that movements is in the connective tissue — not the muscle. We can strengthen the muscles to do a better job at supporting your organs, however the laxity in the connective tissue does not change. Think of this as like — your boobs are saggy, and you can do chest exercises to improve the perkiness — a little — but we can’t actually change the sag ya know?
Let your pelvic floor go! After long and loaded days or after physical activity, things can feel heavy and naturally your pelvic floor (or worry) can become really stiff and tight. In order to absorb pressure and do its job best, the pelvic floor needs flexibility. Here’s a quick follow along option to try.
Rebuild your core strength so that it can support your pelvic floor better contain intra abdominal pressure. It’s amazing to see how much bladder heaviness improves as a client does the work to improve their lower deep core strength.
Maintain good mobility through your glutes & thoracic spine. Tight muscles restricts your pelvic floor’s ability to absorb and contain pressure. Try out this Frank mobility workouts
Learn how to manage pressure postpartum. Especially during your first year postpartum (and during pregnancy!) using your exhale when a movement or task is hardest will not only help your pelvic floor and core do it’s job, but it will also move the pressure out your mouth vs. bear down on your pelvic floor. Here’s a little summary of the pressure canister
Slowly & progressively load your body postpartum. your core & pelvic floor are MEANT to contain pressure, but after pregnancy and muscle strain from birth, these muscles need to slowly rebuild their strength & capacity. You’ll notice that if you overdo it one day, you’ll feel heavier down there or more discomfort.

The Frank Golden Rule: You’re in the sweet spot for your body if you can properly breathe through a movement, you feel tired at the end and maybe notice a little heaviness / fatigue but these symptoms resolve shortly after finishing the task and don’t linger into the next day.

So all in all - prolapse DOES gets better and is definitely something that you can live with an be completely unaware of. But it can take time to rebuild all the pieces that will get your prolapse feeling happy. With a little patience, a lot of Frank and some guidance from a pelvic floor physio, your prolapse concerns can be a thing of the past.

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Rachelle Bonneville

Let’s Be Frank About: Prolapse