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It didn’t take long before I understood that the pelvic floor had taken a massive toll from the birth of my second baby. I knew my body so much better now and a bit more about what to expect (and what not to) after giving birth. 

But I also knew that even if the prolapse felt very low initially after the birth it didn’t necessarily mean it was a long term worsening. So I stayed positive. I didn’t want to ruin the good emotional feelings from the birth experience and I really wanted to just enjoy the moment. I tried to put any thoughts about my pelvic floor to one side for the time being, there would be time later to deal with my physical side of things..

Of course it wasn’t entirely easy to ignore my body, especially because that cough I suffered before labour kept lingering. And of course kept affecting the pelvic floor and my stitches.. Soon enough I ended up on antibiotics because of a diagnosed chest infection. At least that meant I could finally start to recover from that bit.

Midwife J came to do my Day 3 checkup at home. She straight away identified that my cervix was positioned too low to be considered normal at this point and referred me to women’s health physiotherapy. And that would be to the same physio I had seen lots both before and after my previous baby. 

However, there is really not enough of these type of professionals out there, and I assume there are not enough fundings for this area, women postpartum are basically not very much prioritised. This means that those few that work with women’s health get very, stretched. To give you an idea: I had my baby end of May, the referral to physio was sent through in the very early days of June. I got my physio appointment the 22nd of October…

Lucky for me that this was my second baby and I had done so much pelvic floor physiotherapy in the past so I kind of knew a lot of what I needed to do. Plus I had the cube to go back to eventually. But for a first time mother who may have no idea at all, and might be experiencing prolapse issues or other pelvic floor problems – imaging having to wait for that long to get any kind of help!!!? 

In my next post I will tell you what my GP said at my 6-week postpartum checkup. 

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My second baby decided to come out two days before due date, and she came fast (as opposed to my first..!) 

The overall experience was pretty amazing. Emotionally it was beautiful and positive all the way through. I think it had to do with my own approach to it all but also the way we were taken care of by the hospital staff. Things were on our side from the beginning for most parts and I felt supported. For example – we tried the Birth Centre first, as my preference was to give birth there. (Last time I had been transferred to labour ward when complications arose). I was examined there and had the positive news that I was already open a few centimetres and things were progressing. But soon enough I was told I wouldn’t be able to stay there because of my history/complicated first birth. The midwife and her student however were friendly, supportive and assured me I could still have a natural birth on labour ward. 

I also had a very good approach to this change of plans myself, and took the news well. I knew there was a risk I’d be declined the Birth Centre (the midwife I’d seen during the pregnancy had told me exactly this – to try and go there and see if the midwife on shift would accept me or not). So we didn’t despair. And how right they were, I did have a natural birth even if I was on labour ward! With another amazing midwife. 

And pain! In terms of pain level it was something totally different from the first time around. I understood that the levels of pain I reached last time maybe in fact were not as normal as I had thought. It probably partly had to do with the unfavourable position my baby was in, and for a very long time. That time, I kept wondering how it was possible that it was SO painful, as I several times truly thought I wouldn’t make it through alive…. and on some level that time I knew it wasn’t quite right. But I kept telling myself that surely it must be, it’s probably just me. Probably just me having a lower pain threshold than I thought I had and therefore simply wasn’t able to give birth like one of those super women…. 

Now, after giving birth a second time I understand that it can be very different. Of course I am aware of the theory that my body had by then gone through it once before and therefore it would maybe feel different etc – but nonetheless I was absolutely chocked when I understood the baby was ready to come out. I couldn’t believe we had reached that point already, surely I had so much more pain yet to experience?! I was by then only using gas and air for pain relief and in all honesty I probably didn’t even need it… 

So I guess I got that ‘revenge’ I had hoped for. A very positive labour. A birth where I felt in control and my body did what it was meant to do, without complications on the way.  The first few hours post labour I was in a state of happiness, a bit in chock over how quick and ‘easy’ it had been and of course I was in the obligatory postnatal hormonal-suddenly-living-in-a-bubble kind of state. I referred to the birth as ‘Incredible’ when asked by a midwife on the postnatal ward. She laughed and said that most women don’t describe it like that. I was over the moon!

But. (of course there is a but!)

Had this labour actually been too fast for my pelvic floor?

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Ten days before due date I caught a cough. It was a really bad one that meant I couldn’t lie down without entering horrible cough attacks. I was full term in my pregnancy and inevitably exhausted already, and with that cough I was getting even more deprived of my sleep. And of course the worst part was how it affected the pelvic floor! Anyone with a weak pelvic floor or suffering stress incontinence or prolapse knows what I am talking about. The pelvic floor does not agree with coughing, sneezing etc… and with a 39 week pregnancy belly on that – well I wouldn’t wish that on my worst enemy .

I wanted to prepare myself for the upcoming labour in a positive way, resting myself up and getting ready. Prior to this I had entered a more calm state of mind and just wanted to go through labour and have a positive experience. Instead I didn’t sleep much at all and nearly coughed the bladder out of my body some nights – I was literally holding between my legs during the worst cough attacks to try and support the prolapse. At one point I coughed so much that I strained a muscle in my lower back. So there I was, a few days before due date (and who knew when the baby would decide to come out?!) and I could barely walk because of pain in my back. I was tired, I was coughing, my belly was big. I panicked. Broke down in tears one evening. I wasn’t ready to give birth yet. Not like this. 

Thankfully, my mum had decided to come over and stay with us for some time at the end of my pregnancy for support. As I also had my nearly 3 year old to look after this was very much needed and appreciated, especially considering the state I was in. 

What would I have done without her?

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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?

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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!

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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…

 

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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!

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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…

 

 

 

 

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