pelvic health, postpartum, Prolapse

Pregnancy After Prolapse – The 4th Trimester

Some of you may be thinking – ‘uh, Kirsten, you know pregnancy is only 3 trimesters right? Like… that’s where TRImester comes from?’

Yes, yes, I know. But, recently there’s been a movement to recognize the importance of the first 3 months after birth in both the development of baby and recovery of a new mom. These first 90-ish days are so so crucial when it comes to rehab and recovery from birth for mom, regardless of the mode through which her baby arrived. There is so much healing happening in the early days, it is so important that we don’t take advantage of that time.

Going into this birth I knew this and was prepared for it. I read The First Forty Days when I was pregnant and responded by filling my freezer with delicious homemade soups and easy to prepare meals, knowing those first days are so. damn. hard. I wanted to set myself up for the best possible 4th trimester I could. As Brianna Battles would say, control what you can, and I did just that. I made bone broth and froze it in individual portions and stocked up on canned goods and frozen vegetables so in those hard days i would have nutritious food that could fuel my healing and my day to day life. I also invested in placenta encapsulation, which I know doesn’t have a lot of scientific evidence to support it, but there also hasn’t really been ANY research on it. It hasn’t been proven OR disproven and I’d been told many positive anecdotal stories about it’s benefits, so I gave it a go. I think the most important thing I did to prepare was to ask for help. Early on in my pregnancy I planted the seed with my mother in law that we would like her (and my father in law too) to come and help us when the baby arrived. Of course she was ecstatic at the idea and was able to come stay with us for nearly 3 weeks. We were so lucky that baby arrived on the first night she was here!

I must admit, those first few days after birth I was nervous. I was a bit of a wreck after my son was born, both physically and mentally. I felt like I was sitting on a bleeding baseball due to all of the swelling and the expected lochia, and I was an anxious mess. I did very little self care in those early days and instead was so concerned with keeping up with my regular life in addition to having a newborn and recovering from childbirth. I pushed myself to go grocery shopping and to stores to buy nursing bras and take the baby with me and sweep the floors and clean the bathrooms… It was all too much! But I learned from that and took it with me into this postpartum period.

Even though this birth was so much easier than my first, it was still birth. Birth is physical trauma, regardless of how quick and easy it seems, and it demands respect and recovery. I was lucky to have a homebirth because after she was born, I was able to get into my bed and not leave it for 36ish hours, with the exception of going to the bathroom. All I did for the first day or two was sleep, care for baby, and text my husband downstairs to bring me food or whatever else I needed. Once I felt up to it, I started having regular epsom salt baths with postpartum healing herbs to help relieve some of the swelling in my perineum as well as regularly using frozen pads to soothe in between.

That first week, obviously, everything felt heavy & raw, but that is normal right after you squeeze an 8lb human out of you in the span of 2 hours! With my son, this heavy feeling scared the crap out of me, and I responded by constantly clenching my pelvic floor in hopes of lifting it all back up. What I didn’t realize was the heaviness was caused by all of the swelling, and no amount of clenching was going to fix that, only time and patience. Instead, I focused on keeping things relaxed (do you sense a theme here between this and birth?) and allowing my body to respond intuitively, all while limiting the demands I placed on it. I tried my very best to not pick up my 30lb toddler, especially in that first week, knowing how vulnerable everything was. I also limited the amount of time I spent on my feet, by having others do the cooking and general housework, and when I did participate in some cooking, I dragged a stool into the kitchen to sit on. None of this would have been possible without the help provided by my in-laws who stayed with us for the first few weeks.

Within a couple weeks I started feel more normal. Almost too normal. I had zero prolapse symptoms at all. Even the stress incontinence I had in pregnancy resolved! I can now understand how some women jump right back into heavy exercise right away because I totally felt ‘ready’. After my first birth, I was sore for weeks, I didn’t get this whole ‘let’s go workout right away’ thing… Now I get it! I am so glad I had the knowledge to take it easy and slow and not get too excited about exercise so early postpartum. I focused on rehab-type movement and continued with the pelvic floor exercises prescribed by my PFPT in pregnancy. Most of this was movements done while laying on the floor to minimize the strain on my core muscles while they healed and my internal organs settled back into place. I did a few weeks of this until progressing to some upright movements, still without any weights and moving really slowly to focus on form and breathing and ensuring my PF was firing with each rep.

An interesting thing that happened around 8 weeks postpartum. I was doing my PF exercises in an odd position, and I felt the front portion fire for the first time since I gave birth. It’s not that I had been working on that for weeks, I just didn’t even know it wasn’t firing, until it did. This was a major lightbulb moment for me. It took me eight weeks to reconnect with that particular portion of my core. Eight weeks. What would have happened if I had jumped back into high impact or heavy lifting before that time? Would that part of my PF have fired to respond to the task? Or would it have remained ‘turned off’ resulting in a major vulnerability in my core function? If I didn’t even know how to do proper PF contractions, as taught to me by my PFPT, how would I have even known I was missing that piece?

This is why I advocate for every woman to see a PFPT! They can assess these tissues and make sure you are connecting with them all, and ensure they are functioning well before you jump into intense exercise. I didn’t get to see my PFPT until I was nearly 10 weeks postpartum (and I booked my appointment within days of birth! She’s just that in demand!). I was feeling great going into see her, I honestly had no symptoms. She was so awesome, she kept laughing and saying ‘you’re too good for me!‘ and ‘why are you here?‘ with a smirk because everything was functioning so well. She gave me some advanced core exercises to work towards and felt confident, that though my prolapse has returned, I should be able to heal it again like I did previously.

Since then I have started up a new strength training program, and am taking things very slowly but hope to get back to a full lifting program eventually. I am in no rush. The weights and the gym will always be there, and if I do things right now, then my body will be able to support whatever I need it to do, in the future.

That is what postpartum training is all about. It’s about accepting the now, rehabbing appropriately, and building strength slowly and intentionally so that we can keep that strength and function for years to come. Because I don’t know about you, but for me? I don’t care if I can post a video of me pulling a huge deadlift, or running a marathon, or skipping 800 times in 15 minutes tomorrow if it means that I won’t be able to hold my bladder when I’m 80. I want to function just as well 40 years from now as I do today, and taking care of myself now is how it’s going to happen.

Pregnancy After Prolapse (3)

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