Vaginal Prolapse: Post Pregnancy Experience w/ Sara Johnson

Sara Johnson & her beautiful son, Archer.

Being a mother has always been the ultimate end goal for me and what I wanted in order to live a fulfilling life. It was an emotional blow that becoming pregnant did come come easily for me; but I was fortunate enough to have my first child through IVF.

The pregnancy was uneventful until around 7 months when I developed preeclampsia and left undiagnosed was very close to losing my life and the life of my daughter.  Fortunately, an emergency c section at 33 weeks gestation and everything turned out ok for us. I always had a bit of disappointment and shame that my body did not “work” the way it was supposed to, and that science had to help me do what I was designed to do.  

I didn’t think having children naturally was possible, so 7 months later when I found out I was pregnant with my son I was so proud and in awe of my body. I felt empowered and proud to be a woman. I was told by doctors that I should have a repeat C section as this would be “safest”. I didn’t question that until something in my gut was telling me that my body was incredible and capable of conceiving and carrying a child, so surely it could birth a child naturally.  

When I was 32 weeks pregnant I decided that I wanted to explore having a VBAC (vaginal birth after cesarian). I did my research and hired a doula.  I was told by my OBGYNs that I would only be allowed for a trial VBAC if I labored naturally before my delivery date. That was not okay with me.
I doctor shopped and switched OBGYNs at 39 weeks pregnant. My new OBGYN was supportive of my plan of natural labor and vaginal birth, even past the due date.  

The Big Day

41 weeks and 1 day my water broke while watching TV in bed. My plan was to labor at home; however, there was meconium (feces) in my water and I was advised to go to the hospital. I was only 2cm dilated and my labor was not progressing.  Eventually I was induced with Pitocin and 10 hours later I told the nurse that “I feel something in my vagina.”When they checked, to their surprise, my son’s hand was in the vaginal canal.  It’s very rare, but my son was attempting to come out limb first. At this point my doctor asked for permission to place the limb back into place, and was successful at doing so. At this time, I was advised to push. I pushed during my contractions in sets of 3s. I must have done 5 or 6 sets and my beautiful son came out in less than 10 minutes.  

I was incredibly happy; my body worked! It functioned and delivered my child the way nature intended. I was successful.  

About an hour later, the excruciating pain kicked in. The pain was in places I never imagined having pain. It felt like I gave birth through my tail bone, my anus, and vagina. Was this normal? I’m thinking this is normal and will pass in a few weeks. I can’t even lay on the hospital bed comfortably; I cannot even find a position to put my body in that does not cause mind blowing pain.  And at the same time, I am breastfeeding my son constantly.  It was awful.  

24 hours on the dot after he was born we were discharged. Standing hurt. Moving hurt.  Walking hurt. I waddled into our bed and had many sleepless nights breastfeeding my son around the clock while everything “down there” hurt. Initially I thought the discomfort was normal and would pass.  But by the end of the first week it got worse. 

There was this incredibly heaviness coming out from my vagina. It felt like a 10 pound dumbbell was hanging from the inside of my vagina. This could not be normal. I started to worry. I turned to google and discovered I had the worst possible thing I could have ever imagined: prolapse. My freaking organs were falling into, and out, of my vagina. 

I called my OBGYN and at 3 weeks PP he diagnosed me with cystocele (bladder prolapse). From 3 weeks PP to 8 weeks PP it was a blur of non stop crying, hours of googling, and making apps with as many experts as possible. How could this have happened? My body, once again, failed me.  It could not complete the birthing process without causing an injury. How soul crushing. Why me?

Does This Heal On Its Own?

Sometimes when a woman gets prolapse after birth, within the first 2 months or so it will heal and/or reduce in grade. However, generally if you have prolapse several months postpartum, it is a not known to “heal” or change shape or appearance; the goal with prolapse would be to reduce symptoms through time, exercise and modifying things such as breathing.  Also, over time, the sensation may reduce due to simply getting used to it and your brain not identifying it as a negative sensation. With that being said, there are many people out there who say their prolapse was “cured” through some way: PT, exercise, hypopressive breathing, posture, emotional healing, etc. However, this is not the norm.

Now at nearly 4 months PP I have navigated the world of having prolapse and it’s incredibly overwhelming. For one, there isn’t a lot of help for pelvic organ prolapse (POP). OBYNs are not trained enough about it and underplay it a lot. My OBGYNs advise was “go home and do kegels and it should go away in 2 months”. Well, 2 months later, and it didn’t change. I started calling around to get into pelvic floor physical therapists; they all were booking out 1-3 months. I was so frustrated and scared and didn’t know what to do. I literally stayed on bedrest for nearly 8 weeks. The first two PTs that I saw minimized my symptoms and gave me exercises to do. 

Pelvic Floor Therapist

However, they were helpful in giving me confidence in how to move safely in order to not make my symptoms worse. The PT apt consisted of a physical exam to see the prolapse and inserting their fingers into my vagina to test my Kegel strength. Every PT will do different things. My first PT was more focused on teaching me exercises to strengthen my transverse abdominals and would make sure I would do those exercises correctly during our sessions. She also utilized biofeedback to see if my pelvic floor was being activated during activity and relaxing when not active. To do that, she put sensors around the vagina/anus that sensed if the muscles were working. For me, doing bio feedback was helpful b/c it showed that my pelvic floor was correctly engaging and relaxing during activity and gave me the confidence to become more active (this was done around 5 weeks PP). 

The current PT I have has focused on the muscles that make up my pelvic floor; in my situation, they are tense/tight and she believes it contributes to me being symptomatic (essentially, if the muscles are tight they constrict and can increase the downward pressure and bulge). Also, the tightness causes a muscle aches/pain around my vagina/anus area. To help relax those muscles, she finds the parts of the pelvic floor both externally and internally and massages them in a way that releases them. I have found her therapy to be incredibly helpful in reducing symptoms. You can also strengthen your pelvic floor through kegels; a PT will be able to help you identify if you are doing them correctly and how strong you are doing them. It’s rated on a 5 point scale (5 being the strongest), and I am generally at a 3. They rate you by inserting a finger into your vagina and asking you to do a kegel. They teach to kegel by starting to squeeze from your anus to your urethra.  The standard “prescription” is to do 3 sets of 10 daily.  B/c my muscles are tight, doing kegels would not be helpful, so I don’t do them.

Through my hours of research on the internet, I also found the most helpful resource: POP UP. It’s an entire website and blog dedicated to POP education and exercise by a personal trainer who has POP and a PT. I did hours of research on what happened to my body and started doing the exercises daily.  I felt connected to a community of young women who were blind-sighted by POP. In the medical community POP is something that happens only to “older women”; but, this is not true. Lots of younger women are suffering from it but are not taken seriously or heard by their doctors.  

Surgery

Another option for me would be to get surgery. If I decided to get surgery, I would want to go to a Urogynecologist; but there are not many of them. In all of the United States, there are fewer than 3,000. In the Phoenix area, there are 3 major practices. I did a ton of research and there is one doctor who gets rave reviews and people claim is the best. I called to get an apt. with her back in Jan and could not get in until the end of April. While waiting to get into her, I went to another one that did not get good reviews but I could see right away.  

A Urogynecologist appointment consists of having a speculum inserted while you “bare down” while they take measurements. The first Urogynecologist confirmed I had cystocele but downplayed it and said “I usually only work on older ladies” and informed me there was nothing he could do. The second Urogynecologist informed me that I had urethra prolapse, bladder prolapse, and rectal prolapse. She told me that surgery could improve my symptoms and would not include any type of mesh. She was compassionate, caring, and validated me. Surgery would consist of making an incision in the anterior and posterior wall of the vagina to get to the connective tissue to cut it and stitch it back together (essentially tightening it so that it would lift the organs back into their place). However, surgery isn’t an option until 6-9 months PP as the body needs to heal as much as it can on its own.

Surgery will also be incredibly painful with a 6 week recovery time and very strict orders of not lifting anything (very hard to do while breastfeeding and living with 3 children); surgery would also mean I could not have any more children. 

In all of my networking and reaching out, I met an influencer on instagram (@twothentwins) who happens to live in Gilbert and had the surgery by the amazing Urogynecologist. She’s been an amazing support and feels the surgery was definitely a success and improved her quality of life. Connecting with her has given me a lot of hope that I don’t have to live with POP and that I have options. 

Living With POP

Now, here I am, 4 months PP on May 13th, and I am unsure of what I plan to do.  I’m back to living my life normally and have resumed all activities (excluding running).  I no longer feel heaviness or that things are falling out of my vagina. I feel a very annoying presence of something sitting at the opening of my vagina (like a tampon) and pain in the vulva. About one month ago I found the most incredible PT who believes I have a tight pelvic floor that is causing a lot of my discomfort. My weekly apts with her consist of giving me an internal and external vaginal massage to relax the pelvic floor.  I look forward to those apts because she understands me, what I am going through, and supports me and my journey.  

Sex With POP

My husband and I have resumed having sex and it’s enjoyable and not painful. POP has given me the opportunity to really understand and connect with my vagina in ways I never would have. I am more aware of what is going on down there; before I was not sure what the inside of my vagina looked like; now I am extremely aware.  I do not think it looks gross, and I am not ashamed of it. I realize now that it still did its job and it delivered my beautiful boy; it just got a little injured during the process.  

Some Words From MedAmour

We are so grateful Sara shared her experience with us, as this is all too common in motherhood. If you too are dealing with prolapse, we recommend finding a PFT that truly understands your needs and wants to meet your goals and expectations. We work closely with Pelvic Floor Therapists, providing resources like kegel devices, lubricants, and dilators to help ease symptoms of many common pelvic floor issues. Have you experienced this too? Send your story to hello@medamour.com to talk more!

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