Pregnancy and Prolapse - Navigating Pregnancy with Pelvic Organ Prolapse

Pregnancy and Prolapse. IYKYK.

We understand just how difficult it can be to navigate your pregnancy with pelvic organ prolapse. You may have already noticed an increase in your symptoms and you may be wondering just how your body / pelvic floor is going to cope.

We understand the range of emotions you may be feeling about your pregnancy including fear, anxiety and confusion. There isn't enough information out there to support women who are experiencing pregnancy with prolapse. In the Empowered Motherhood Program, we hope to change that.

We hope that in this post and the videos in the EMP, we can help you to feel more informed about the best ways to move during pregnancy, how to protect your pelvic floor and how to set yourself up for optimal post-partum healing.

The Empowered Motherhood Pregnancy Program

This post is simply an overview of the advice, workouts and support we offer in the Empowered Motherhood Pregnancy Program. We would love to invite you to trial the EMP Pregnancy program where we have a series of workouts, pelvic floor exercises and expert education to help you to move safely during your pregnancy and protect your pelvic floor. We will highlight some of our recommended videos through this post so you can understand how the EMP can support you.

Pregnancy and Prolapse

It is important to understand, however, that each pregnancy and each vaginal birth will place an increased load on your pelvic floor.

However, Lyz Evans, Empowered Motherhood co-founder and Titled Women's Health Physiotherapist has supported thousands of women with prolapse through their second or third pregnancy.  In her clinical experience, she reports that often women will see an improvement in their prolapse symptoms following a second or third pregnancy. She believes that this is because they have invested in their pelvic floor health and have learned to move their bodies safely.

There is a lot you can do during your pregnancy to protect your pelvic floor and set yourself up for optimal postnatal healing which we will share in this post.

Note: An increase in symptoms does not mean your prolapse is getting worse.

It is likely that your prolapse symptoms of heaviness will increase during your pregnancy. This is due to a combination of pregnancy hormones that work to soften and lengthen the pelvic floor, an increased load on the pelvic floor and compromised movement patterns. However, an increase in symptoms (often more noticeable in the first and third trimesters) does not necessarily mean that your prolapse is getting worse.

In addition to the workouts and education videos in the EMP Pregnancy Program, we recommend working with a women's health physio during your pregnancy so that you can stay on top of your pelvic floor.

Various stages of the pregnancy can feel heavier than the others due to the growth of the uterus and positioning of the uterus. Commonly, we see women experience more symptoms at the start of their pregnancy in the first trimester and at the end of their pregnancy as the pelvic floor becomes softer and more engorged.

Tips for Managing Prolapse during Pregnancy

It is incredibly important that you stay active and as strong as possible during your pregnancy. We understand that if you are feeling fearful or anxious about your prolapse, you may naturally stop exercising. This is the last thing we want you to do.

1. Safe Exercise for Prolapse

Our EMP pregnancy workouts are designed to help you to move safely and confidently through your pregnancy. The stronger you can keep your core, pelvic floor and entire body - the more you can rely on the strength of your arms and legs to support you. If the muscles in your limbs and core start to atrophy, more load is placed on your abdomen and pelvic floor.  There are a number of ways to exercise safely with prolapse.

We recommend keeping your workouts shorter with less time spent in a standing position. Floor based workouts such as pilates as well as swimming and cycling are also recommended.

2. Pelvic Floor Daily.

Activating your pelvic floor during pregnancy daily helps to maintain a connection to your pelvic floor as well as reduce the rate that your pelvic floor weakens. In pregnancy, the Empowered Motherhood pelvic floor workouts are designed to help you to maintain endurance, maintain continence and are specifically designed to suit each trimester.

3. Posture and Breathing

Your posture and breath are intricately connected to your pelvic floor function. If you have pelvic organ prolapse, it is important that you sit and stand with good posture.

In the EMP, we have a series of postural and breathing tutorials to help you to improve your breathing mechanics and posture during pregnancy. We would also recommend doing our Thoracic Mobility workout once a week to reduce tension and compression through your thorax.

4. Juggling Older Children

If this is your second or third pregnancy, then you have the added challenge (in the nicest way possible) of having to lift, carry and support your older children. Some of pelvic-floor safe tips for caring for children include:

1. Where possible, start training toddlers or older children to become more independent. This is a slow process requiring lots of empathy and patience. Some ideas of where to start include things such as standing on a step to brush their teeth, holding your hand instead of being carried, standing on a step so you don't have to bend as far to pick them up.
2. Use your hip pivot point to pick babies up from the ground, cot or bed. This is a technique we teach in the EMP. This is a much safer way to squat with prolapse and involves pivoting from the hip joint before crouching so that there is less load through your pelvic floor and the pelvic outlet remains in a more closed position.
3. Swap the carrier for the pram. Where possible avoid extra load on your body by using the pram instead of the carrier.
4. Sit to snuggle. If your little one needs a cuddle, think 'sit to snuggle.' You can still hold and support them, but you aren't placing extra load on your pelvic floor.

5. Rest Where Possible

Prolapse symptoms can often feel worse after a day on your feet or a day filled with a lot of physical activity. If you are able to, factor in some 'horizontal time' into your day. This means getting off your feet and slightly elevating your pelvis with the support of cushions and bolsters. 

6. Avoid Constipation

In our video 'Poo Like a Pro' Lyz explains the defecation dynamics which help you to empty your bowels without straining your pelvic floor. This is a must-watch for anyone with prolapse. Chronic straining and constipation place extra load on the pelvic floor It is incredibly important to do whatever you can to avoid constipation. This includes drinking plenty of water, eating fibre rich foods and if necessary taking supplements under the guidance of your GP or other health care professional.

7. Birthing with Prolapse

In the EMP, we also cover birthing with prolapse. This video includes optimal birthing positions, pushing techniques and factors that may influence your birth preferences.

This is a question that comes up a lot in our Live Q+A sessions. How you decide to bring your baby into the world is a deeply personal choice. Our goal is to share the evidence and information you need to make an informed and empowered decision about your birth - and then to support you as best as possible as you prepare for your birth.