The journey of childbirth brings immense joy, but it also leads to significant physical changes, especially in the pelvic region. One condition that many new mothers aren’t told about is vaginal prolapse, when pelvic organs shift downward into the vagina due to weakened muscles and tissues. Although common, it’s often overlooked or misunderstood, leaving women feeling confused or isolated. Raising awareness about the signs of prolapse, its risk factors and available treatments can help women feel more informed, supported, and confident in their recovery after birth.
What Is Vaginal Prolapse?
Vaginal prolapse occurs when the pelvic organs (such as the bladder, uterus, or rectum) descend into or outside the vaginal canal. The cause is usually a weakened pelvic floor, the group of muscles and connective tissue that hold the pelvic organs in place.
Women may feel a heaviness or pressure in the pelvis, or a noticeable bulge at or near the vaginal opening. It’s one form of pelvic organ prolapse (POP), which includes:
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Uterine prolapse (uterus dropping into the vagina)
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Cystocele (bladder prolapse)
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Rectocele (rectum bulging into the vaginal wall)
Causes and Risk Factors
Several risk factors contribute to vaginal prolapse:
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Vaginal Birth: After birth, prolapse can occur when the pelvic floor muscles and tissues are weakened or stretched during childbirth. This becomes a leading risk factor, especially with prolonged labour, forceps delivery, or large babies. Research indicates that vaginal childbirth significantly increases the risk of pelvic floor disorders 5-10 years postpartum compared to caesarean childbirth. [1]
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Ageing & Menopause: Decreasing estrogen and collagen reduce pelvic tissue strength, making tissues more susceptible to weakening with age.
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Obesity: Adds pressure to pelvic organs. A study highlights obesity as an independent risk factor for POP, with weight loss potentially improving symptoms [2].
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Chronic Cough or Constipation: Each cough increases pressure inside the abdomen, which in turn pushes down on the pelvic floor. This repeated straining can damage pelvic structures.
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Heavy Lifting: Regularly lifting heavy items puts extra pressure on the pelvic floor muscles and tissues, potentially weakening them and causing pelvic organs to descend.
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Genetic Predisposition: A study found that a family history of prolapse increases the risk of its presence and recurrence. [3]
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Pelvic Surgery: Surgeries like hysterectomy can change pelvic alignment and support, potentially contributing to vaginal vault prolapse.
Understanding these risk factors can help women make proactive decisions to protect their pelvic floor health.
Symptoms of Vaginal Prolapse
Vaginal prolapse symptoms can be physical, emotional, or both. Recognising the signs of prolapse is the first step in getting help. It's important to note that the correlation between symptoms and the degree of prolapse can vary; some women with significant prolapse may have few symptoms, while others with mild prolapse experience significant discomfort [2].
Physical Symptoms:
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A feeling of pressure or heaviness in the vagina or pelvis
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A visible or palpable bulge in or outside the vagina
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Urinary incontinence or incomplete bladder emptying
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Constipation or straining during bowel movements
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Pain or discomfort during intercourse
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A dragging or aching feeling in the lower back
Mental and Emotional Symptoms:
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Anxiety or sadness related to body changes or function
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Reduced participation in exercise, sex, or social activities
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Concerns about appearance and body image
Stages of Vaginal Prolapse
The severity of vaginal prolapse is measured using the POP-Q (Pelvic Organ Prolapse Quantification) system and is categorised into four stages:
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Stage 1: Mild descent, organ is above the vaginal opening. Few or no symptoms.
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Stage 2: Organ descends to the vaginal opening. A bulge may be visible or felt.
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Stage 3: Organ partially protrudes outside the vagina. More discomfort and functional problems.
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Stage 4: Organ completely protrudes outside the vagina (complete prolapse or procidentia). Often requires surgery.
How Is It Diagnosed?
Diagnosis typically begins with a pelvic examination. During the exam, your doctor will:
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Inspect the vaginal canal visually
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Ask you to bear down (like having a bowel movement)
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Use a speculum or perform a manual exam to assess organ position
Additional tests may include:
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Bladder Function Tests: If urinary issues are present, these tests assess bladder and urethral function.
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Ultrasound or MRI: For complex cases or surgical planning, these imaging tests provide a clearer view of pelvic organs.
Is It Treatable?
Yes. Vaginal prolapse after birth is highly treatable with appropriate medical care. The choice of treatment depends on the severity, symptoms, and patient preferences.
Non-Surgical Treatment Options
These approaches can relieve mild to moderate prolapse symptoms and may prevent progression:
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SRC Restore Support Mini Shorts: These compression garments offer pelvic floor support using medical-grade fabric. They’re ideal for postpartum recovery, particularly in active or working mothers, by providing external compression and aiding muscle recovery.
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Pelvic Floor Exercises (Kegels): Strengthen the muscles that support the bladder and uterus. A pelvic physiotherapist can guide you through proper technique and a personalised exercise program.
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Vaginal Pessaries: A removable silicone device inserted into the vagina to hold organs in place. Effective and non-invasive, pessaries are fitted by a healthcare professional and require regular cleaning and checks.
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Lifestyle Modifications:
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Maintain a healthy weight, as excess weight adds strain to the pelvic floor.
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Eat high-fibre foods and hydrate to avoid constipation and straining.
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Treat chronic coughs, which can put repetitive pressure on the pelvic floor.
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Avoid lifting heavy items or use correct lifting posture to minimise strain.
Surgical Treatment Options
Surgery may be recommended for severe prolapse (Stage 3 or 4) or when conservative methods fail. The goal is to restore pelvic organs to their normal positions and reinforce the pelvic floor.
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Colporrhaphy: Repairs to the front (bladder) or back (rectum) walls of the vagina using stitches to restore support. This is a common transvaginal approach.
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Hysterectomy: Removal of the uterus, often combined with prolapse repair if uterine prolapse is present.
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Sacrocolpopexy: Mesh is used to attach the vaginal vault to the sacrum, restoring internal organ position. This can be done laparoscopically (minimally invasive) or via an open abdominal incision.
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Colpocliesis (Vaginal Closure): A less common option for older women no longer sexually active with severe prolapse, involving surgically closing part or all of the vagina.
Recovery from surgery includes rest, pelvic physiotherapy, and avoiding strenuous activity to ensure optimal healing.
What to Avoid When You Have Vaginal Prolapse
Certain activities and habits can worsen prolapse symptoms or delay healing. Here are some of them:
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Lifting heavy objects (children, laundry baskets, weights)
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High-impact activities like running or jumping
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Straining when using the toilet
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Intense core workouts (planks, crunches) done without guidance, as they can increase intra-abdominal pressure
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Prolonged standing or pushing through pelvic discomfort
Reclaim Your Strength and Confidence Postpartum
Living with vaginal prolapse after birth doesn’t mean giving up your lifestyle. With education, early diagnosis, and the right treatment plan, many women regain comfort and control.
Embracing a holistic approach that includes understanding your body, practising pelvic floor exercises, making appropriate lifestyle modifications, and considering supportive garments can make a significant difference. Products like SRC Restore Garments can be a valuable part of the healing process, offering medical-grade support during movement, work, and daily tasks. Combined with pelvic physiotherapy and healthy lifestyle changes, they empower women to take charge of their postpartum recovery.
If you notice any symptoms of prolapse, seek help from your GP or a pelvic health specialist. There’s no need to suffer in silence. Effective, evidence-based treatments are available.
FAQs
1. How long does postpartum prolapse last?
Mild prolapse may improve within a few months with therapy and support garments. More severe cases may require ongoing management or surgical repair. It's not a condition that typically resolves entirely on its own if moderate to severe, but symptoms can be effectively managed.
2. Can I push my prolapse back up?
Temporarily, yes, but only under medical advice. Pessaries or compression garments can help, but the root cause must be addressed through muscle strengthening and lifestyle changes. Always consult a healthcare professional for guidance on safe self-management.
3. Is walking bad for postpartum prolapse?
No. Gentle walking is encouraged and promotes healing, as it's a low-impact activity. However, avoid long walks or hilly terrain and always listen to your body to prevent aggravating signs of prolapse.
4. When is a prolapse an emergency?
Seek urgent help if you experience sudden pelvic pain, bleeding, inability to urinate or pass stool, or if the prolapsed tissue is discoloured or ulcerated (indicating potential tissue strangulation).
5. What can be mistaken for prolapse?
UTIs, vaginal cysts, haemorrhoids, fibroids, or infections may mimic prolapse symptoms (e.g., pelvic pressure, discomfort). A proper pelvic exam ensures accurate diagnosis and appropriate treatment.
References:
1. Handa, V. L., Blomquist, J. L., McDermott, K. C., Friedman, S., & Munoz, A. (2011). Pelvic floor disorders 5–10 years after vaginal or cesarean childbirth. Obstetrics & Gynecology, 118(4), 777–784. https://doi.org/10.1097/AOG.0b013e31822f1e9e
2. nternational Urogynecology Journal. (n.d.). Obesity and pelvic floor disorders. Retrieved from https://link.springer.com/article/10.1007/s00192-019-04179-8
3. Samimi, P., Jones, S. H., & Giri, A. (2021, April). Family history and Pelvic Organ prolapse: A systematic review and meta-analysis. International Urogynecology Journal. https://pmc.ncbi.nlm.nih.gov/articles/PMC8086380
4. Swift, S. E., Tate, S. B., & Nicholas, J. (2003). Correlation of symptoms with degree of pelvic organ support in a general population of women: What is pelvic organ prolapse? American Journal of Obstetrics and Gynecology, 189(2), 372–377. https://doi.org/10.1067/mob.2003.98
