Will my prolapse get worse if I have another baby?

The short answer?
Probably not

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I think the better question should be, "What's worse for my prolapse: C-section or vaginal birth?"

The truth is, a C-section disconnects your abdominal muscles, which can  lead to greater pelvic floor weakness.

I know us mama’s need  the short version, so I'm quickly going to explain the role of your pelvic floor during birth.

When your in labour your pelvic floor needs to lengthen and stretch to allow your baby through. It’s essentially a little hammock in the lower part of your pelvis and keeps everything in it’s place (including your baby). During pregnancy it is carrying a lot of extra weight and then if you labour it begins to lengthen to prepare for your baby’s passage and when you've had your vaginal birth or at least pushed for a while, then it’s going to be stretched to it’s maximum to allow your baby earthside.

In the weeks and months after birth it slowly regains it’s strength and tries to return to it original position. Most likely, your pelvic floor is not going to be exactly the same pre-pregnancy, but most women don’t experience a serious change to their everyday life. For those that do, there is a lot that can come with it. It can be less serious, like the need to manage how you sneeze and engage your muscles to prevent wee leaking. For other’s it’s living in a state of constant worry that you won’t make it to the toilet and having very limited to no control.

Getting Pregnant with Prolapse

When women are on the latter side of this spectrum it's easy to imagine what it would be like to find out your pregnant and worry about whether a vaginal birth is going to make your life after birth even harder? That being said, you might still desire one.

I’ll start by saying that as a doula, I work with many women who have very different births, postpartum bodies and experiences. I also am constantly liasing and recommending different professionals to help the women I serve. This is why everything I say should certainly be clarified with a women’s health physio to assess your personal circumstances as this blog post information is general in nature.

So back to the original question. Will a vaginal birth make my prolapse worse? The answer lies in the contrast with your alternate birth option: Caesarean Section

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There is some misinformation out there that when you have a caesarean section your pelvic floor is left unhindered. This is a myth. 

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Your pelvic floor relies on your abdominal muscle activation for it's function. So, if you have one weakness where your pelvic floor holds your bowel and bladder, then by adding another weakness you are actually making it harder to heal.

On the other hand, although your pelvic floor will need to lengthen and open (resulting in weakness) after a vaginal birth, it will probably not be worse because you will still naturally regain your strength again as the weeks go on.

Furthermore, you would most likely be more open to starting your strengthening exercises, avoiding specific activity you may not have known to last time around and may have already engaged a women’s heath physio. Go you!
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I know it’s probably a shock that compared to a caesarean birth, a vaginal one might be the better option. Another shock may be that your doctor could possibly disagree.

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This is because there is no real education on the pelvic floor and how it works when it comes to obstetrics. They don't diagnose pelvic floor trauma and you are not routinely checked for any weakness at your 6 week postnatal review. Not to mention that most of these OB’s are men who have not needed to deal personally with this serious issue that can cause a mother serious trauma.

Should you have a c-section if you have prolapse or a vaginal birth?

Whether you want to opt for a vaginal birth or even if you are going to book in your elective caesarean, I would implore you to take a few steps.

1. Get in touch with a women’s health physio (if you haven’t already)
2. Read my blog post on five ways you can improve your strength now for a stronger and more confident you (with prolapse).
3. Start BirthTools™ so you can begin planning your positive birth and utilise all our videos and resources on recovering in the postpartum and returning to exercise.

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Every BirthTools™ course comes with multiple videos to help you after birth. Here's a sneak peek...

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