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Pelvic Organ Prolapse After Delivery

Normal Female Pelvic Anatomy. Source: Healthwise

What is Pelvic Organ Prolapse?

In Pelvic Organ Prolapse or Genital Prolapse, organs in your pelvis – uterus, rectum, vagina, urethra – sag below their normal level. Any of the following may occur:

  • Your uterus prolapses into (sags down into) your vagina
  • Your uterus and vagina both prolapse outside your body, past the vulva
  • Your vagina prolapses outside your body, past the vulva
  • The wall of your rectum prolapses into your vagina
  • Your urethra prolapses into your vagina

This may occur following trauma during vaginal delivery. In a traumatic delivery, there may be damage to the nerves or damage to mechanical structures including muscles and ligaments, which help to hold these organs in place, in normal conditions. Also the higher a woman’s parity (that is, the number of times she bears children), the more at risk she is of having a genital prolapse.

Symptoms & Signs of Pelvic Organ Prolapse

When there’s a prolapse, a woman may notice a mass protruding from the vagina or anus, worsened on straining or lying down, and any of the following symptoms:

  • Stress incontinence: urine leaks out when the bladder is strained by laughing, sneezing, coughing, etc.
  • Sudden urge to urinate
  • Constantly feeling the urge to defecate

A prolapse could hinder a woman’s sexual activity.

How to Prevent Pelvic Organ Prolapse in Pregnancy

Genital Prolapse can be prevented in the antepartum, intrapartum and postpartum period in several ways:

  • Maintain a healthy weight.
  • Do Pelvic Floor Exercises to strengthen the pelvic floor. When it is done sufficiently before delivery, it helps your baby to pass through the birth canal painlessly with minimal trauma. When done in the postpartum period, it also helps in reducing the risk of prolapse.
  • Avoid strenuous activities and weight-lifting while pregnant.
  • Avoid straining to defecate. Eat a high-fiber diet. Increase intake of fluids.
  • During labor, do not strain or ‘push’ before you are told to do so by the doctors or midwives. Ensure you go to an approved hospital or maternity center for delivery.
  • After delivery, ensure to lie in the knee-chest position  to help your uterus recover to its normal position. To do this, on a flat surface, lie on your chest. Rest your head on the side and you may support it with your  forearms. Then bring your knees forward towards your chest, hang your hips up and part your thighs slightly. Your body weight must rest on your knees and chest.
  • Start moving early after delivery
  • Space your births adequately: It is recommended that a woman should give an interval of at least 18 months between one delivery and the next pregnancy, so her body can adequately recover

Treatment of Pelvic Organ Prolapse

If a woman develops a genital prolapse, it’s best to consult a gynecologist to determine which form of treatment is right for her.

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