Prolapse after Childbirth: What it is and How To Treat it

Prolapse can be a challenging problem for new moms after childbirth. Childbirth is not the only cause, but it tends to be the most common. Despite its prevalence, it catches many by surprise.

This article will go over these topics related to prolapse:

  • What is it?
  • What causes it?
  • Are there common symptoms?
  • How can you manage and treat it?
Pelvic Floor Organs

What is Prolapse?

Prolapse occurs when one or more of the pelvic organs (bladder, uterus, and/or bowel) move downward into the walls of the vagina. This happens when there is weakness or a lack of support by the pelvic floor muscles. Pregnancy and labor and delivery put a lot of pressure on the pelvic floor muscles. This can make them weak. As the pelvic floor recovers after childbirth, symptoms of prolapse can improve. However, any prolapse could indicate future potential future problems.

There are three main types of prolapse that occur after childbirth:

  • Uterine Prolapse- this is the prolapse of the cervix and uterus into the vagina
  • Bladder Prolapse (Cystocele)- this is the bladder prolapsing into the front wall of the vagina
  • Bowel Prolapse (Rectocele)- this is the rectum prolapsing into the back wall of the vagina

These can occur individually or separate from each other.

What Causes Prolapse?

There are a variety of things that contribute to prolapse. For instance, hormonal changes during pregnancy increase the mobility and laxity of ligaments. This can affect the supporting structures of the pelvic floor. The weight of the baby on top of a more lax pelvic floor puts strain and stress on the muscles. Therefore, the muscles tend to move downward from their normal position.

Vaginal delivery does have a slightly higher risk of prolapse than cesarean, however, this does not mean a cesarean is preventative. With that being said, vaginal delivery stretches the muscles of the pelvic floor and cause tearing of the muscles. Depending on the degree of tearing, muscles and/or nerves can be damaged which can contribute

The following factors increase the chances of prolapse with pregnancy and childbirth:

  • Traumatic delivery/ instrument- assisted delivery (forceps/ vacuum)
  • Large birth weight baby
  • Chronic constipation and straining
  • Multiparity (having more than one baby)
  • Being obese or overweight
  • pelvic floor weakness
  • Chronic Coughing


It may be noticeable immediately after childbirth. However, symptoms may also present themselves later on. Symptoms could include any of the following:

  • Bulging sensation in the vagina
  • Dragging/ heaviness in the pelvis
  • Low back pain or abdominal pain
  • Visible bulge of tissue from the vagina
  • Pain with intercourse
  • Difficulty with tampons
  • Difficulty with bowel movements or urination

Typically, these symptoms are worse as the day progresses or with more standing and/or lifting.

How to Treat and Manage

Taking care of your pelvic floor after childbirth is important regardless of symptoms. Check-out this post to find things to avoid in order to prevent prolapse. Outside of basic hygiene and care after childbirth, the following are some additional things to consider if you're managing prolapse.

  • Rest- avoid prolonged standing or lifting in the early days after a vaginal delivery
  • Ice- ice or padsicles can help decrease swelling that can help promote healing after vaginal delivery.
  • Elevation- laying on your back with a pillow under the hips allows gravity to assist prolapsed organs back into place.
  • Pessaries- Pessaries are support devices that act as a barrier and lift for the pr0lapsed organs. Oftentimes, pessaries are most effective with pelvic floor therapy in addition.
  • Manage constipation- Constipation and straining put excess pressure on the pelvic floor and can actually worsen prolapse. Take care to eat fiber and drink water as well as elevate the feet. This will allow you to have bowel movements without straining.
  • Pelvic floor exercise- Kegels are often prescribed to manage prolapse. However, it's best to check with a pelvic floor therapist about whether your muscles are too tight or weak so that you can start in the right place with exercise.
  • Posture- Maintain a neutral posture throughout the day to avoid increased pressure on the pelvic floor.
  • Breath- Don't hold your breath with exercise, pooping, or lifting.

Prolapse is definitely a challenging thing to add on top of a newborn baby. However, doing preventative activities and reaching out to a pelvic floor physical therapist will help. It can certainly be prevented, treated, and managed!

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