Down and Out – Identifying Pelvic Organ Prolapse

When you give birth you are expecting a baby to come out and then the placenta but not many moms are expecting their bladder or uterus to come out – most don’t even know this is possible.

Pregnancy and childbirth are risk factors for a condition known as pelvic organ prolapse. In simple terms a prolapse is the progressive descent of the internal organs (the bladder, the rectum and the uterus). They move down and eventually out of the vagina which is considered a 4th stage prolapse. Stage 1 and 2 are quite often asymptomatic so women don’t even know they have a problem until that problem progresses to a stage 3 when the organ is at the vaginal opening and may even bulge out periodically on exertion. Early stage prolapse is often reversible and very manageable, however once the prolapse progresses to a stage 3 or 4 it becomes life altering, and may require surgery – surgery that can in turn cause other challenges. Prevention and early detection are key when it comes to pelvic organ prolapse.

Early stage prolapse as mentioned earlier can be asymptomatic or it may present with the following symptoms:

  • Back pain
  • Pelvic pain
  • A feeling of heaviness in the lower abdomen
  • Pulling sensations in the abdomen and/or pelvis
  • Discomfort with sex
  • Incontinence

As the descent of the organs continues symptoms may progress to:

  • Feeling like you are sitting on a ball
  • Feeling like something is falling out
  • Heaviness that gets worse as the day progresses
  • A bulging sensation at the vagina

Early detection is key and it is vital that you see a pelvic floor physiotherapist ideally during your pregnancy and at 6 weeks postpartum for a full assessment. Your therapist can examine the pelvic floor and the internal organs to see if they are where they should be and the muscles have the strength and endurance to support them. With that knowledge you will then know the best restorative exercises to do, what activities to avoid and what steps to take to help prevent the condition from getting any worse.

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Kim Vopni
Kim Vopni The Fitness Doula – Author of Prepare To Push™ - What Your Pelvic Floor and Abdomen Want You To Know About Pregnancy And Birth, Owner of Pelvienne Wellness Inc, and Co-Founder of Bellies Inc. Kim is a mom of 2 boys and is a Certified fitness professional who also trained as a doula. She combines the support aspect of a doula with the principles of fitness to help her pregnant clients ‘Prepare To Push’ while postpartum she helps her clients optimize healing and regain their core confidence for motherhood. She has taken specialized training in 2 pelvic floor fitness programs - the Pfilates Method and the Hypopressive Method. In 2009 she created a women’s health event called Kegels and Cocktails (that is now running across Canada and into the USA) designed to empower and educate women on the importance of pelvic health. You can find her on-line at and on facebook @PelvienneWellness and @BelliesInc and on twitter @FitnessDoula and @BelliesInc Kim is also a contributing writer for the Globe and Mail's online Health section.
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