Managing prolapse during subsequent preganancy

[Morgan Menchaca]

Hi Tasha,

I’m a mother of one with a second on the way (I’m 23 weeks pregnant). During the birth of my daughter, who was born in July 2016, I suffered a third degree tear with my first that resulted in a cystocele and mild uterine prolapse. Your program has been immensely helpful for me, both physically and mentally/emotionally as I’ve adjusted to my new normal. Everything has been going fine up until a few weeks ago, when I started noticing my pelvic floor aching at the end of the day.

I have found a good deal on the website and “Ask Tasha” about pregnancy and exercise – I think I’m pretty clear on those parameters. I found your pregnancy exercise program, and I’m continuing with the Hab-it DVD, with some minor adjustments.

My questions are about the day-to-day – posture and such. I have a desk job. Should I try to work standing as much as I can, or should I avoid that? When I’m sitting at work, I already try to sit on my tripod as much as possible. Should I be contracting my abdomen while sitting and/or standing to relieve some of the pressure on my pelvic floor? Do you recommend using a maternity belt or band to help support my growing belly, or triathlon shorts to support my pelvic floor? How often should I take breaks to “re-set”? What about a pessary?

On the flip-side, are there particular postures or habits that could be especially damaging to my pelvic floor while pregnant? If I’m sitting back on the couch, is that angle doing damage I don’t even feel? What about sitting back or slouching in my desk chair? (As much as I try to avoid these positions, I find I wind up back in them again and again, especially when I’m tired – which is all the time now!)

I know you can’t diagnose everything perfectly from this note, but some general best-practices advice about the day-to-day of being pregnant with prolapse (all the stuff other than exercise) would be greatly appreciated. Thank you so much for the work that you do, and for being so responsive to those of us who rely on your work to recover from childbirth injury.

[Tasha]

Shoot Morgan, tough recommendations on this one. Your pelvic floor is telling you that it needs some relief from the pressure. You will best relieve pressure by laying down periodically throughout your day or going to a hands and knees position – which I know is tough if you are working. Think of frequent position changes from sitting to standing to sneaking into a break room for 5 minutes where you can lay down or get on your hands and knees for 2-3 minutes.

I would say yes to triathalon shorts to help support the perineum expecially if any varicosities are developing that can lead to the aching.

Do not over contract your belly or lift your pelvic floor – just position yourself with soft knees, slight tail bone lift, and your chest up. Breathe with chest elevation and expansion.

Be sure to sit and relax on that couch and don’t over think it! You deserve those times to chill and left everything relax – this is good for blood flow and rest of all muscles. I don’t recommend it for 4 hours but I have no problem with you sinking into the couch for an hour or so at night!

Tasha

[Valerie]

Hello! I am 3 months postpartum diagnosed with a grade 2 bladder prolapse (after my 1st child in 2014). Would it be unwise to go for a 3rd kid one year from now? Could a 3rd pregnancy/childbirth cause the prolapse to evolve to a grade 3?

[Tasha]

Valerie,
With every pregnancy and delivery there are great risks, but my personal observations have shown that most damage to tissue is done on the first pregnancy and delivery. This is not a guarantee, but I would never base my family planning on the fear of my prolapse. You are in the right place – you have found all the information you need to properly rehab your body, hold neutral spine posture, and exercise good habits moving forward, so I would encourage you to move forward with your family planning without fear!

Tasha

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