Pregnancy After Prolapse?!

Apr 04, 2024

This is a question I’ve received a lot in DMs and wanted to give a thorough explanation on.

Prolapse can feel scary when you first navigate it (I know first hand 🙋🏻‍♀️) but understanding the facts can help make the unknown much easier to navigate.

First let’s define prolapse & then get to the details on prolapse and pregnancy.

Prolapse: when 1 or more pelvic organs drops from their position into the vaginal canal. There are 4 stages based on how far down and into the vaginal canal the organs “fall”.

Stage 1: organ into upper part of vagina
Stage 2: organ into low part of vagina
Stage 3: organ bulges outside of vagina
Stage 4: organ completely out of vagina

Stages 1-3 can all be managed very well with conservative treatment, stage 4 requires surgical intervention.

Managing prolapse: overall goal is managing intra abdominal pressure, IAP, through activation of pelvic floor and core together with breath.

Prolapse & pregnancy:

Continued strength of hips glutes and core to support the pelvis and pelvic floor as your center of gravity changes through pregnancy. Some of my favorites here: Click Here!
Hug the baby- you can still perform core strength in exercise AND use this technique before getting out of bed, out of a deep chair, or picking up your toddler to manage IAP Click Here!
There is limited research on prolapse and pregnancy but what does exist supports the idea that typically the first delivery is most impactful and those after don’t seem to complicate existing prolapse much.
Less support of the pelvic floor and prolapse is related to things like: tearing during delivery, episiotomy, large fetal head, long push phase (> 2 hours) OR quick push phase (< 30 min).

👉🏻 With knowledge of this, improving delivery with positions and breathing can be an important consideration. Of course we only have so much control over what happens during birth, but learning to breathe baby down and use positions that open the pelvis and allow the sacrum to move are helpful nonetheless to minimize further pelvic floor issues 👈🏻

If you’ve used a pessary you may find times you benefit from using during pregnancy as well.
Stack the ribs over the pelvis in sitting and standing: the pregnancy waddle and belly out front pushes a lot of pressure forward to belly and pelvic floor. Getting your hips underneath you distributes pressure evenly across the pelvic floor.

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Cheering you on ♥️
- Caroline Packard, DPT