Navigating the shame and empowerment

POP at 28 / Story at 34

I am a 34-year-old kiwi physiotherapist, and have always been active with netball, mountain biking, whitewater kayaking, and adventure racing. I have three children who were born when I was 26, 28 and 33. They were all fairly good sizes and my deliveries were natural, with no complications, and extremely fast (just a few minutes of pushing). After my first baby I started walking immediately and started some occasional running and social basketball from when she was about 8 weeks old, with no problems.

After my second baby, I became aware that things didn’t feel right when he was a few days old – a walk to the end of the driveway made me feel heavy in my pelvic area and I realised I had a prolapse. I saw my GP who wasn’t particularly helpful, and worked hard at pelvic floor strengthening which I designed using my physiotherapy knowledge. After about eight months I did return to everything that I enjoy including netball and long runs (3–4 hours). I found it hard to tell anyone that I had a prolapse – as if being fit, active and a physiotherapist should have protected me, and I felt embarrassed even though I knew how common it was.

We deliberated for a long time about whether to have a third child, and one of my concerns was what impact it would have on my pelvic floor and prolapse. When I did become pregnant, I decided to see a highly reputable pelvic physiotherapist while still pregnant, and after delivery. She was amazing in her ability to accurately assess me and empower me by being clear about the things I could do to lessen the likelihood of prolapse again, and to take care of myself before and after delivery. 

I did experience prolapse symptoms again which was disappointing and pretty tough for a couple of months – not being able to walk for exercise and mental wellbeing for that initial post natal period was really hard. I was able to ride my bike on easy trails, but obviously couldn’t do this with baby so my opportunities were limited to when my husband was home. I can remember feeling uncomfortable walking just a few blocks to school pick up when my baby was about a month old, and this was pretty disheartening. 

However with the pelvic physiotherapist’s guidance I felt in control and was able to return to the active things I love within 5–6 months. I have been really careful to limit my activities if I feel any pelvic discomfort, heaviness or have any leakage – which fortunately now is very rare. I now recommend to all my friends to see a pelvic physiotherapist (which we almost all have to pay for privately in New Zealand) routinely, but especially if anything feels not quite right.

I think the things that contributed to my prolapse were probably the size of my second two babies, not allowing time for my body to recover between my first two children, starting back with impact activities too early, and probably just a bit of bad luck. I was fortunate that because of my profession I was able to identify what it was and I knew how common it was. Even so, I didn’t seek the right advice after my second baby! Cost was a barrier – it’s quite hard to access free pelvic physiotherapy when we need it.

It was great to learn with my third baby how much control we can have over the situation with the right advice (which is absolutely worth paying for, but would be amazing if it could be funded in the future!).
The guidance I was given about how much and how long to rest for after delivery, the most effective way to do exercises individualised for me, and extra supports such as a pessary meant that my second prolapse experience was a bit frustrating for a while but never out of my control. I didn’t have the same guidance or open conversations with my friends with ‘prolapse round one’, and it was much more worrying and shameful. 

I am fortunate that my prolapse experiences have been on the mild end of things, that I’ve had great support and I have managed to return to all that I love.