Knowing how the first labour and birth came to affect my life, unavoidably I wondered whether or not I should go for a c-section this time. In fact lots of people around me assumed I would. And some encouraged me to consider it – at least amongst friends and family. Most professionals around me instead seemed to suggest that it wasn’t the birth that would affect the prolapse, it was the pregnancy itself. Especially as the second labour would most probably be faster and easier. Most probably. Statistically that is. No one would be able to say for sure, and I didn’t expect anyone would of course (even if it certainly would help to have someone giving me ‘The right answer’)!!!! 

To begin with I just went with the flow. The weeks ticked by, I was tired and nauseous, my toddler kept me busy and my belly grew….and at first labour seemed so far away and I didn’t think much of it. But when I sat down in the doctor’s office and suddenly burst into tears when something regarding giving birth came up, that was when I realised I had a lot of emotions around this topic, more than I had in fact understood myself..

So I allowed myself to try and figure things out. I wanted to weigh my options against one another and try to understand what different scenarios could mean, and also what they would actually mean to me. I talked about it with my midwife, physio, obstetrician, family and friends. Considering my history I would be ‘okayed’ quite easily for a caesarian. So that wasn’t a problem… but yes, statistically this birth ‘should’ be easier. And as long as it was straight forward – my prolapse wouldn’t necessarily get worse. Apparently? A caesarian instead would come with its own risks. Apart from being a stomach surgery and everything that entails in terms of infection risk, bleedings, not being able to lift for several weeks after…. but my personal worry about a c-section would be the fact of laying on my back. And this had nothing to do with the prolapse, but my coccyx. The first time around my tailbone pain was so much intensified partly due to laying on my back for too long and this time I was determined to avoid that position to all costs..

I was not against c-section. But my heart wanted a natural birth. I think in a way I wanted to get some sort of revenge and just do it awesome this time. Without that epidural. Without forceps.

But was a caesarean the more sensible thing to do in my situation? What if it was too risky for my prolapse (and maybe also for the coccyx) to give birth vaginally again. After all I also had to think about my family, they needed me fit enough afterwards to get on with our life! 

So what was the right choice?

In the the first part of the pregnancy I used my pessary just as normal. (By the way, how did that happen? I’m referring to a blue silicon cube I insert every day ‘down there’ as something normal? Now that’s something I wouldn’t have guessed about my life a few years ago…). Anyway it helped a lot, especially as the prolapse felt A LOT worse in the first trimester. And my then 2.5 year old kept me busy, which meant I didn’t have many chances to sit down and relax. I consulted with the gynaecology nurse and asked her for how long I should continue using the cube, and she said that it was entirely up to me. That it was perfectly safe, and that theoretically I could use it throughout the whole pregnancy if I wanted to, BUT that I would most likely find it more and more difficult to put it in and out as the belly would grow. Which made lots of sense… And she said that whenever I decided to stop it shouldn’t be a big problem for the prolapse itself, it was more of an issue in my head: I was by now so dependent on the cube in my day to day life.

And she was right, I was really getting nervous about removing it. I would normally only go a few hours tops without it and would never leave the house like that. My bladder would fall out!! But the initial worsening of my symptoms thankfully only lasted for a few weeks and a little bit into the second trimester the prolapse actually felt a bit better. Having heard of this phenomenon it was a point in the pregnancy I was hoping I would reach, but would never believe until I experienced it. Amazing!

I was still stressed about taking away the cube though, so I decided to do it gradually. I went half a day without it. First day off the cube completely was a day I spent at home. And I increased the time without it day by day…. Around 16-17 weeks I stopped using the cube completely.

My prolapse was now unsupported but a little better (temporarily, most likely) – and I was nearly half way through my second pregnancy!

So what about running? How should I be thinking this time around? Knowing the end result of my first pregnancy and birth the sensible thing to do was probably to give running a rest and make sure to avoid further damage as much as possible? But all the work I had put in up until this point.. I felt as if it would all have been for nothing if I didn’t keep going. And maybe it would actually be good for my pelvic floor to keep ‘teaching’ it that kind of stress/impact…? But there was a chance this was only wishful thinking…

And of course the result of this second pregnancy was still a blank page. Regardless of if I ran or not now, there was a risk that after this birth my prolapse and pelvic floor were going to be in a state where running would be out of the picture completely. Forever. (Dark thoughts)

So the question was, keep going and enjoy running as long as it lasts? Just in case I won’t get the chance anymore later!? Or take a step back to limit any (potential) further damage?

The reality was that because my prolapse symptoms worsened so much in the first trimester, it came quite natural to take a step back with the running. Waking up in the morning with that heaviness down there made it impossible to enjoy it anyway. Both physically and mentally. I did a few 1-2 kilometer jogs over the first weeks – just for the sake of it I guess. For my cardiovascular fitness I would have to rely on spin classes again.

So when I put the running shoes on the shelf in pregnancy 2 I did it with a sincere hope that there will still be running in my future…

We were lucky and I became pregnant relatively quickly and I was curious (maybe more nervous?) about how my body would react to this. I didn’t have to wait long and already in the very first weeks the prolapse gave me a clear reminder of its presence down there. The heavy bulging and chafing sensation which I lately would only feel at the end of a particularly tough day for the Pelvic Floor – I now felt first thing in the morning!

The pessimist inside me wondered how I would cope with this for 9 months whilst progressively getting bigger and heavier.

The optimist had learnt however that often prolapse symptoms could improve somewhat in the second trimester, and I tried to cling onto that idea as I counted the days and weeks….

The realist in me though knew that even if the symptoms would improve in the middle of the pregnancy, surely it would only be temporary. Having the weight from the baby pushing down on the pelvic floor at the end of a pregnancy, realistically it could only go one way for the prolapse issue. And on top of that the labour and birth itself!

A pregnancy filled with emotions, thoughts and concerns had begun.

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I loved breastfeeding! It was such an emotional and bonding experience between me and my son, and it came so much more natural to me than I had ever imagined before becoming a mother. Sure, it was complicated to get started properly because of soreness and getting the flow right and the joy of mastitis hit me a couple of times in the beginning. Also, because of my injured tailbone I could only breastfeed when I was lying down, which made it all quite inconvenient. But for the relationship with my son I absolutely loved it – and so did he!

So when I was told that the prolapse might see an improvement when I stopped breastfeeding I stood in front of a difficult decision. I was back on that battle where the personal me wanted to try everything to get my own body back to some sort of normality… but as a mother I really didn’t want to stop breastfeeding! The discussion came up every time I went for a ’prolapse checkup’ and I came from the appointment confused and a little sad. When to stop breastfeeding was not a decision I wanted to make in this way. I wanted to be able to continue as long as my little one needed/wanted it without having any other reason making me decide to stop. And on top of it, I didn’t know that stopping would for sure help, it was just a ’might’. I guess it was also for that reason that each time the question came up, I ended up putting it behind me, and I let the mother win this battle.

I therefore continued breastfeeding with no consideration of the prolapse and stopped when my son was 17 months old. I saw no significant difference in the prolapse symptoms after. And I feel very pleased that I listened to my heart on this one.

But what are your experiences? I am not sure if this breastfeeding thing is something scientifially proven or not. But I believe it is due to hormonal reasons – something about that the estrogen levels are lower when you breastfeed making the vaginal tissues weaker, so when you stop and your cycle and estrogen levels are back to normal it may have a positive effect on the tissues and pelvic floor strength – but please do not quote me on this. I am in fact very curious about hearing YOUR experiences on the topic?! Has anyone had a prolapse improvement after stopping breastfeeding? Or do you have any other thoughts (or knowledge!) on this? Please share!

Before having children I think I imagined that I would want my second one about 2 years after the first. Then, that seemed reasonable to me.

Once I was a mother and I knew the toll the pregnancy and birth had taken on my body the months soon became a year and more and I was still not ready to have another baby. Maybe it was the physiotherapist’s word ringing in the back of my mind: ‘Ideally give your body two years of rest post-partum before getting pregnant again’. Like that I would give my body a chance to naturally heal up from the pregnancy and birth and go into another one as strong as possible.

But sometimes I played with the thought of having a second one sooner. Maybe I should think the opposite way instead? What I mean is: going for the next child closer to the first and ‘get it over with’ and then take care of my body damage and potential treatment options afterwards? Because no matter what, I seemed to understand that if I wanted to go down a surgical route for the prolapse then I would have to have all the children I want before. The reason being that there might be no point in doing surgery to correct things when another pregnancy might just mess it up and it needs to be redone anyway. So maybe, if I instead I have all the children I plan to have in a shorter amount of time and then deal with the problems afterwards – at least  that would mean less years passing by in total, I would just decrease the recovery between each pregnancy. And I could sooner focus on getting my body back and hopefully become a runner again?! To be honest, the sensible part of me never really thought this seemed like the way to do things, but I have to admit it sometimes was an intriguing thought.

When I asked the women’s health gynaecology nurse about the matter she said she would rather recommend me to do the running I wish to do Now, before getting pregnant again. To try to reach a few goals now that I was ‘anyway back to running a little bit’. She is such a sweet person and I know she always tries her best but unfortunately she has no understanding of that the running I have managed to do so far postpartum is nowhere near any goals I would actually be happy to set. And even worse, I knew what she was trying to say between the lines….

Another pregnancy and birth might just make things so much worse and I won’t have the chance at all later on…

I thought I would post an English translation of my story which was published on the blog Baking Babies a few weeks ago. The original text was in Swedish (and can be found here) and I have had several requests for a translation.

So what was this all about? I was asked to write a constructive text about how I dealt with a very tough time following childbirth, but how I managed to get through it. This was part of a theme where not just me but also a few other readers of that blog shared our stories in order to help and encourage other women that might go through a rough time. I do hope this can inspire also some of you, my own blog readers!

‘The labour and birth did not turn out at all as I had planned. And after that nothing was the same anymore. This is the story about how much the complications I got when I gave birth to my son have affected my life and still do.

   I was in so much pain. The injury I had sustained in my coccyx (tailbone) from snowboarding more than a decade earlier got extremely aggravated when I gave birth. I could’t sit without horrendous pains, or even walk. And I felt like a failed mother. How was I supposed to get through this? I live in London since twelve years and gave birth here in 2015. I had a pretty much problem free pregnancy, but instead a long and dragged out labour with various complications. After 59 exhausting hours of contractions my son finally came out with forceps, and in connection with the final stage I sustained a major haemorrhage and needed blood transfusion. The blood loss combined with that I didn’t have any sensation in my lower body from the epidural meant that I remained lying flat on my back for much longer than what was ideal for my coccyx. I had already before labour had some concerns about how my tailbone was going to cope with this task, and soon enough I was going to find out that it hadn’t very well. The pain was almost unbearable. 

   The initial period after the birth was very tough. I struggled with lots of thoughts and emotions, probably more than anyone around me ever realised. I felt like a bad mother because I was so limited physically and I couldn’t do many normal everyday things – like sit or walk. So I was lying down most of the time, and this was the only chance also for breastfeeding. We lived on the top floor with no lift, and a venture out from home was a major project. Because of the pain I felt too unstable to lift my little baby down all the steps. And what would I do when I had to breastfeed? The sight of a chair could make me panic. In the beginning I never left home without my very special sitting cushion which relieves some pressure on the tailbone. I still use it today when I sit for longer periods. I also learnt how to breastfeed my son in a standing position in a baby sling so I wouldn’t have to sit down to feed him when we were out. But it was really only when it was necessary to leave home in the beginning that we would, most of the time we simply didn’t. 

   The physical problems also affected me psychologically and I couldn’t help but feeling like a failure. A failure because I hadn’t gone through the labour and birth like the super woman I had hoped I would be. And I hadn’t bounced back to pre-pregnancy me immediately like so many other women seemed to be doing. I felt like a failure because I couldn’t feed my baby like a normal mother seated in an armchair, or even cuddle on the sofa with my son on my chest. You know, like you do. If I would just do these things anyway it only resulted in that my injury felt worse and I could anyway not enjoy it. The pain was just too intense. I was also stressed about the fact that I couldn’t enjoy the days together with my newborn to 100% because time seemed to just fly by and my baby kept growing.

   But I found help! Already from a very early stage I started seeing a Women’s Health Physiotherapist. My encounters with her were everything else but comfortable as many techniques performed were vaginal or anal. But thanks to what we did slowly things started to improve. I received exercises to do at home and lots of advice on how to ease my daily activities. It took time but finally I got over that initial and worse phase. The coccyx did not heal – and will probably never do – but the pain eventually became manageable and life could start for real again. I started to sit more, walk more, walk even more, and eventually also progressively start training again. 

   That’s when I realised how much my newfound prolapse also was going to affect my life. It was so hard to accept that. I have been a runner since as long as I can remember and both trained and competed up until I became pregnant. The running was something that had always identified me. When I was running I was home. To run was ME. What would now happen with my running? I had imagined I would regularly be out for runs with the buggy. And I had thought I would shortly after birth be setting new goals for my continued training. Nothing became like I had planned, it was like starting from scratch again. My running world fell apart.

   And on top of that, how should I be thinking with regards to any future children? The thought of another pregnancy and what further damage it could do on both the coccyx and the prolapse was indeed quite complicated. Would I ever be able to run again? At the same time there is a mother inside of me who was born in the same moment as I met my son for the first time. That mother doesn’t care about if I never will be able to run again. The mother inside of me doesn’t want anything else but focus on family and hopefully be able to give a sibling or more to my son. There is that constant battle between the Runner and the Mother inside of me that I am fighting. They are two different people but each with very strong willpower and lots of feelings and emotions. And when I dream away thinking about my ‘pre-baby-body’ and have hopeful imaginations about the running in the future I straight away feel guilty for even thinking that thought. It’s so selfish. 

   But I have now come to a point where I have accepted that I have to find a balance between the two to fully enjoy life. They have to compromise with each other, this is where life has taken me. And at present the mother is the stronger one: my son is 2.5 years old and I am actually pregnant with our second child! I don’t know what it will mean for my body physically to go through another pregnancy and birth but I believe I will be more prepared this time. Prepared in the sense that I won’t have such high expectations on the recovery afterwards. I will need to give my body the time it requires to heal. Maybe this will affect my possibilities to run in the future even more? But maybe not. This is where I am now and it looks like I will be able to give a brother or sister to my son, and I feel an enormous happiness for that!

   A big help for me to move on physically was that I had the possibility to early on meet a Women’s Health Physiotherapist and that I really listened to her advice. And then it has been even more important to let my body take the time it has needed to heal and to progressively get used to training again. It was walks lasting for five minutes that became 10min, 15min etc combined with pelvic floor training, core stability and pilates and I felt stronger and stronger. First 6 months postpartum I dared to try jogging again. It was 30 horrible seconds – I thought everything down there was going to fall out from me! But 30 seconds eventually became 60, 90…. and 16 months after giving birth I had finally reached a distance of jogging 5 kilometers, without anymore worsening my prolapse symptoms. It was a win, but on a level very far away from how I had imagined things would be. But I am confident that it was thanks to the fact that I moved things along so carefully and always listened to my body and the signals it gave me, that I finally managed to start running a little again. Another important help was that I was fitted with a pessary – without this it would have been much harder to run at all. It lifts up the prolapse and decreases the uncomfortable symptoms. 

   Psychologically it has been important to accept the fact that my body has changed, and that still a couple of years postpartum in fact still is a body in recovery. I cannot expect that it can be like it used to, maybe ever. I take care of my body in the best possible way considering my current position, and like that I prepare it as much as I can for the future. A future with or without running only time will tell. 

   I think it is extremely important not to be ashamed of your birth- or pregnancy related problems. Even if you don’t think there is help available for your kind of problem, most probably there is and you are definitely not alone. We often see all the positive examples of mothers with perfect labours and women who recover immediately, but most probably we often don’t get presented the whole truth. Many choose not to talk about it and as a result we don’t realise how common it is to have problems after childbirth. A blog like bakingbabies.se is therefore worth gold both thanks to its fantastic information and to simply get an understanding of that we are not alone in this.’ 

Last week I had my story published on www.bakingbabies.se !!

It’s an amazing Swedish blog written by a women’s health physiotherapist, she talks about everything concerning pregnancy/childbirth/female health. I can highly recommend it. It’s written in Swedish though, so not all of you will be able to read it I’m afraid!

But for those who do know the language and are interested here is my story.

After I had reached my 5K target, it felt like nothing could stop me. This was somewhat ironic as a gentle jog of that distance for ‘my previous me’ wouldn’t be much to talk about. But I wasn’t my previous me anymore, and I guess I had come to a point where I had started to accept this. I felt proud about coming to this point, considering that a year earlier I questioned if I would ever run at all again. It had taken time – a whole 16 months postpartum before I was comfortable enough to do it – but my body felt ok.

And I started dreaming.

It was right in the middle of the cross country season at the time and I was still on an emailing list from my athletics club and regularly got updates about the team’s progress and upcoming races. I never admitted it to anyone but at one point I actually considered to put my name down for one of the races that very season! Even if I would run very slow I would gain some points for the team and at least I would get the chance to get out there on the cross country field….. should I just go for it and don’t care about the performance too much?? The thought was intriguing for a moment.. but it didn’t last very long.

Deep inside I just knew it wouldn’t satisfy me in the way I hoped it would. Sure, I could now do a fairly comfortbable little run but somewhere in the back of my mind I knew it would be too heartbreaking to enter a race and therefore face reality. My level of fitness/running ability was still so far away from pre-pregnancy and even if I tried to think of me as a ‘new me’ I knew it would be too hard to take it.

So I never signed up for that cross country race. 

Fast-forward a few months and I had progressed my running and fitness level a bit more. I was pleased with that my body and prolapse could take a couple of runs a week without aggravating the symptoms too much. One day in May I was running through the little forest close to ours, I think I did about 6K that time. And I started dreaming again. I counted the months leading up to a half marathon that same autumn, and calculated how much I would have to increase the distance by each month to comfortably reach that target…..and my heart started pounding faster. It seemed doable! It was as if I forgot about the fact that maybe training for a half-marathon wasn’t ideal for the prolapse, because now that I had gotten back into the running again I just wanted more. And at one point I even thought that I don’t care anymore if I worsen it, if at least I get to do another half-marathon in my life….

But was it the right time ‘already’??? If I just went for it, would all the work I had put in until then have been thrown away, if the result would be that I made my problems much worse? Was that really what I wanted for the future?

So I never signed up for that half-marathon.

But what was all that dreaming about? Could I make any of these dreams come true one day, and maybe relatively soon?

Or was my problem now on a different level, could I actually do it now but I was too afraid to even try??