Prolapse and vaginal birth

I'm 5 weeks pregnant with #3 and I have a uterine prolapse, cystocele and rectocele, all considered moderate.

I went to my GP today to get a referral etc and she was adamant that I would have to have a c/section because of it. I birthed my daughter vaginally (damage was caused by birth #1) and I do believe the prolapses have become slightly worse but I don't have any problems associated with them at all. Of course I expect them to become worse during this pregnancy.

I was just wondering if anyone else with similar issues has had a c/section. Was it your choice, were you persuaded? And what info were you given?

Thank you for any replies.

*sigh* I know I'm a newbie nobody but I was really hoping someone here would have some experience with this :(

Sorry - I've only had 2 c-sections so I can't help. Hopefully someone will see this and pop their head in and be helpful!

Welcome to BB anyway :hug:

I have never seen a uterine prolapse, cystocele and rectocele. Can I assume a cyctocele is where the bladder prolapses into the vagina and rectocele is the bowel prolapsing into the vagina? And as for the uterine prolapse is that where the whole uterus is prolapsing downwards or does it actually sort of turn inside out (called an inverted uterus) I am only asking to make sure my understanding is clear before offering any advise.

The ladies I have seen as a midwife that have had a prior prolapse during birth itself and have required immediate repair (as its causes heamorrage) have had c/s for subsequent pregnancies. Ladies that I have seen have prior surgery for hernia's of the vagina/bowel, fistulas etc have also had c/s with subsequent births so there is no risk of birth undoing the surgery that has previously being done however if you have not had surgery to repair the uterine prolapse, cystocele and rectocele I would assume there would be no reason to need a c/s for your future births especially if you have had a birth since unless it was your wish to have a c/s.

If what you have is what I am thinking (I might have it totally wrong) where the vaginal walls are weakened from your first birth and have caused the bladder and bowel to prolapse into the vagina then I think it would be perfectly safe to have a vaginal birth provided they have not being operated on and there has not being a fistula (opening from vagina into the bowel or bladder). I imagine if it were a problem then you would have being advised not to birth vaginally after your first baby though. This is all over the place and I hope I havent confused you. I just didnt like to see that your post had not being answered.

How did you find out you had all that?? Did it come up on a scan or could you just feel it?? I've been to a women's physio about all that because I was worried about the amount of swelling I've had since week 8, but no-one has insisted I get further examined? I am now 30 weeks and the swelling is still there and I feel like the baby could fall out any minute! Very frustrating telling doctors this information and them not doing anything! I assume it would come up in a scan if there were issues, but I'm just a bit nervous. I would go c-section if I were you but I guess it's weighing up the recovery from that operation compared to the alternative and the ability to care for your newborn after a c-section with regards to bending, feeding etc.

can you start on some Pelvic Floor Exercises? Strengthening the pelvic floor has been known to help right mild/moderate cases of uterine prolapse. It is especially a good idea during pregnancy if you are at risk, so I would certainly start now.

I am not sure on the c-s though. I would be asking a separate doctor for their opinion on VB with untreated prolapse and what the risk factors are. Someone without a vested interest already.

I had a mild triple prolapse with dd (crappy conective tissue, love my genetics:rolleyes:). No one suggested a cs for my second dd's birth. Generally prolapse happens during pregnancy not during labour therfore I cant see how a vaginal delivery could make it worse or why you would need a cs. I would get a second opinion. Speak to your midwie or see a gynae or obstertrician.

I saw a pelvic floor physiotherapist after dd1 and she did wonders for my pelvic floor, I really urge you to see one it made such a difference. Unortunately as we age damage to the pelvic floor becomes more noticable so improving the strength of your pf now will help later. My pelvic floor is better ater my second pregnancy compared to after the first. There are private pf physios and I know my local public hospital has one, get your gp to write a referral. Good luck

I too had a mild prolaspe with my first pregnancy/birth, had to see a pelvic floor pysio which made a huge improvement....I birthed my second child without any issues...they say alot of the damage to your pelvic floor is from your first and fourth pregnancy/birth...


Seek a second opinion...seems strange that they would suggest a c/s if it's not causing any issues now, during pregnancy...As it was GP suggesting it and not a specialist I wouldn't take it to seriously.

Good Luck wishing you a H & H pregnancy...

By the way my pelvic floor muscles are now better than they have ever been before and that is all through practicing pelvic floor excercises with physio guidance and strengthing techniques...so there may be help for you too

i have a moderate cystocele prolapse which first occurred halfway during my pregnancy last year. It occasionally flared up during my pregnancy, and we made the decision to have a natural birth. I had one - with failed suction and forceps. Bubs was only 7lb 7oz but it wasn't particularly straightforward (with episiotomy also).

Following DS's birth I've been seeing a phsyio who specialises in women's pelvic floor stuff and we've done heaps of work to strengthen my pelvic floor as much as possible. 9 months on she has just confirmed that I've sustained some nerve damage to one side of my PFM and has recommended that i have a c-s for the next baby. Her rationale being... you need a nice strong PFM to hold up your prolapse. As she said, if i had a small baby & nice uncomplicated birth, it should make no difference to my prolapse. However, if it isn't an easy birth (i.e. like last tiem) I run the risk of more nerve damage ofthe PFM, thus meaning the prolapse is harder to manage. And the resulting consequences could be a PITA for many years to come.

I wonder if you are in a similar situation given you have all three prolapses? I'm toying with the thought of getting a second opinion, and will discuss it further once I'm pregnant. So saying, this physio is a very anti-surgery lady and tbh, this recommendation surprised the hell out of me.... but on reflection I can see why she is suggesting it.

GL with your PG and working out the best thing for you to do (oh and aren't prolapses just a nuisance!!!)

I can't answer your question, but I would strongly suggest that you see a gynaecologist or obstetrician and get their expert opinion. Preferably one that is pro vaginal birth. I would not go by a GP's opinion when it comes to a specialised problem like yours. Nothing against GP's, but they can't possibly be experts on everything.

Sasa

Hi.....

I developed a prolapse about 2 months after having my first baby but it seemed to improve quite noticably by the time he was 6 months old by which time I was 4 weeks pregnant with my second baby. I mentioned it to my Ob at my 8 week check with my second baby and he examined me and said it was no big deal and I went on to deliver naturally.

My second baby is now 5 months old and the prolapse came back during the pregnancy (probably worse than the first time because it also had the weight of the baby to carry) but again, it has improved significantly and dont even notice it most days ....

In summary, my Ob didnt think it was a major deal and I delivered normally with no problems at all.

i would recommend getting checked out by a physio who specialises in the area - if you're in Aus you can look at the Australian Physiotherapy Association website and look up physios in your area who specialise in women's health/continence. In my experience, obs generally are focussed on getting bub out & the immediate health of everyone. Physio's have much more experience with managing the longer-term consequences of damage in this area and will factor that in to your recommendation.

I agree that GP's don't know as much about the area - I've heard of on GP saying the only option was surgery for a mild prolapse, which seems crazy, considering I can manage a moderate prolapse and certainly don't need surgery. Your treatment options for prolapse are also different during pregnancy as opposed to after, and a physio can help you with that. Plus as Deltadawn said, prolapses typically do improve. You just want to be informed so you don't risk causing permanent damage - also depends on whether you want more kids after this one too.

GL!

Thank you all so much for responding to this thread even though I disappeared! Unfortunatley, a week after I posted I lost my little bean :( The information you gave is very appreciated though and if we are lucky enough to fall pregnant again I will revisit it. Thank you all so much again :)

So sorry for you loss!! :hug: