Addressing Prolapse After Birth: Expert Tips for Both Partners

The diagnosis of prolapse for a new parent comes with many unexpected consequences. Not only are there bothersome, sometimes debilitating, physical symptoms, there are also significant mental and emotional challenges for the birthing parent and their partner.  In this post, Dr. Margo Kwiatkowski PT, DPT, CSCS, PCES shares some of her top tips for navigating the emotional and physical challenges that prolapse after birth presents for birthing parents and their partners.

Most symptoms of prolapse are hidden from those around us. People cannot see that you are leaking, experiencing pain, having trouble emptying your bowels, or generally feeling uncomfortable. The mental and emotional burdens of anxiety, depression, stress and fear are also invisible and misunderstood. With the birthing parent under duress, their partner can experience similar stress, anxiety, and overwhelm in trying to help their partner navigate a new and complex medical diagnosis. 

Having a new baby is one of the most stressful and joyous things a person can experience in their life. This adventure comes with feeding struggles, anxiety around the baby's health, sleepless nights, and a body that just endured nine months of pregnancy and a delivery. Let's also remember the families that do not bring a baby home with them; they are also experiencing grief. Now add an unexpected pelvic floor injury on top of it all. This is a recipe for distress.

What are some common symptoms of pelvic organ prolapse after birth?

I would venture to assume that the majority of new parents don’t know what pelvic organ prolapse (POP) is and have likely never even heard those words. A birthing person might expect some pain, bleeding, swelling and minor wound healing in the early months postpartum. 

There are additional symptoms that might accompany POP that are less often discussed and even more infrequently told to pregnant people before childbirth. These symptoms can include significant urinary incontinence, bowel incontinence, delayed wound healing, difficulty emptying the bladder or bowels, high levels of pain, unrelenting pelvic heaviness, a feeling of a bulge in the vagina, and general weakness. Vaginal deliveries are much more likely to cause these physical symptoms, but a cesarean section is not completely protective of the pelvic floor. 

Navigating the Impacts of POP and Postpartum Injuries

The unexpectedness of physical injury creates significant mental and emotional stress for the family. There is grief in not experiencing the newborn phase as one had hoped and planned. There might be financial stress as one navigates seeing specialists, purchasing support items, and going to pelvic floor physiotherapy for months. While the majority of people will experience healing from POP in the form of symptom management, it is challenging to have hope of healing when you are in the thick of the postpartum haze. 

The Emotional Toll of Prolapse on Both Partners

The physical and mental symptoms of prolapse do not only affect the person who gave birth but can extend to the daily life of the partner as well. From personal experience, my husband had to physically do everything around the house for months. I felt unable to do laundry, cook, or clean. Forget about any yard work. The mental and emotional symptoms I experienced prevented me from feeling even remotely like my former self.

I was eventually diagnosed with postpartum depression and anxiety. This further affected my husband’s wellbeing as day in and day out he was living with a shell of the person he loved. After clawing my way out of the postpartum mood disorders, my husband experienced his own version of postpartum depression. This is not uncommon to see in partners of people with a birth injury. 

A 2021 study published in the Journal of Women’s Health Physical Therapy investigated the effects of educating pregnant people about potential pelvic floor trauma and its sequelae (or secondary consequences, sometimes referred to as "PFTS") during pregnancy. The researchers evaluated the prevalence of PFTS and general distress in the fourth trimester. Their conclusion is that prenatal education can significantly reduce the risk of both PFTS and mental/emotional distress for postpartum people. This paper is foundational to our movement towards improving education in pregnancy. If we can mitigate risk of possible postpartum mood disorders with simple education, this must become standard of care.

Practical Tips for Treatment and Improving Postpartum Health

Here are some tangible treatment options and ways to improve your physical and mental/emotional health postpartum.

Physical: 

1. Find a pelvic floor therapist who is well versed in treating postpartum pelvic organ prolapse. 
2. Discuss whether a pessary might be helpful in your healing journey.
3. Invest in high-quality external support like Hem Support Wear's pelvic floor support garments. This will also help your mental health as constant symptoms are not conducive to improving your wellbeing. 

Mental/Emotional: 

1. Find a therapist who specializes in perinatal mental health.
2. Be open and honest with your support people about your needs.
3. Find ways to move your body that bring you joy and peace. This can be as simple as stretching, walking, or meditative breathing. 

Here are some tips for partners to assist their postpartum partner:

1. Recognize that they might be struggling and inquire about tangible ways you can help.
2. Know that “help” might not be something physical but instead just a shoulder to cry on, an ear to listen, or arms to hug. 
3. Educate yourself on pelvic organ prolapse so you have a better understanding of your partner’s experience. The book Educating POP Partners, written by my husband, is a great resource for someone whose partner has been diagnosed with POP. 

Strategies for Partner Wellbeing During Postpartum

For the partner’s health:

Physical: 

1. Start or continue to exercise in a way that brings you joy and helps alleviate stress. 
2. If you are unable to complete all the necessary shared duties around the house due to time or physical ability, ask for help from your support team.

Mental/Emotional:

1. Confide in a therapist, friend, family member, or spiritual leader about your own mental health.
2. Remember that your partner will not always be like this. This experience might seem endless and you are likely yearning for your partner to be themself again. This phase of life is challenging for most and there is a light on the other end of the tunnel.

Citations:

Johnson, Kimberley & Williams, Paula & Hill, Audra. (2021). The Importance of Information: Prenatal Education Surrounding Birth-Related Pelvic Floor Trauma Mitigates Symptom-Related Distress. Journal of Women's Health Physical Therapy. Publish Ahead of Print. 10.1097/JWH.0000000000000229.

About Dr. Margo Kwiatkowski, PT, DPT, CSCS, PCES

Margo Kwiatkowski is the founder of P4Moms Physical Therapy. She is a pelvic floor and orthopedic physical therapist based in Ventura, California. She had made it her life mission to educate about prolapse after experiencing the diagnosis after the birth of her first child.

Find Dr. Margo at:

• @postpartum_pop_pt
• www.p4moms.com

**Medical Disclaimer: This post is intended to provide information and resources only. This post or any of the information contained within should not be used as a substitute for professional diagnosis, treatment, or advice. Always seek the guidance of your qualified healthcare provider with any questions you may have regarding your healthcare, conditions, and recommended treatment.