Part 1: Is this normal?
“You’re not supposed to look!” said my cousin, wide-eyed, when I told her how I began to understand that I had a problem.
Because, you know, women can’t handle the truth of our own bodies, right?
Still, during my first shower after birth, washing away the sweat and blood, I had felt a totally new landscape between my legs, and I had looked. My vaginal opening was still stretched to the size of a lemon, but what gave me pause was that it was completely covered by a wall of slick pink, tissue that looked to me like it should be internal.
Yet there was a newborn out there, hours old, and breastfeeding to master, and I was being regularly checked for hemorrhage, so I figured they’d catch it if it was abnormal.
Weeks passed, the swelling subsided, the opening shrank, but the pink tissue did not go back in. It was uncomfortable with every step I took. It felt like something was falling out of my vagina.
I told the midwife at my six week checkup, but to my astonishment, as I lay on my back, she said she could see nothing wrong. I was cleared to return to work. Still, almost as a precaution, she referred me to the clinic specializing in postpartum recovery.
Her reaction made me wonder if I was making something out of nothing. I called my mother, and completely mortified, awkwardly asked her if she had the same sensation of something falling out. She said she had, and it had taken a long time to go away.
In my internet reading around 2 months postpartum, one of the ideas that worried me was that by continuing to breastfeed, I wouldn’t have enough estrogen to rebuild the loose muscles that caused my prolapse.
This turned out not to be true when I raised it with the doctor. Either the muscles are there to be rebuilt or they’re not. So feed your baby however you see fit — you won’t be putting your own health at risk, at least as far as prolapse goes. Breastfeeding was great for my baby and for me, and I was very glad I didn’t have to make a choice between my health and my baby’s.
Around 12 weeks postpartum, I finally got into the rather popular recovery clinic. They diagnosed me with a collapsed vaginal wall and offered physical therapy.
Prolapse comes in many flavors. Your uterus can try to fall out, or even your rectum. For me, I’m fairly certain it’s my bladder falling into my vagina, known as cystocele prolapse. They haven’t actually told me. To be fair, I haven’t demanded that they give it a term beyond what is written on my record, something about a weak anterior vaginal wall.
At the time, the hope was that the muscles that should be standing between and holding up my vagina and bladder, the levator ani (which men rely on too), were merely stretched to hell and could recover with exercise.
So I started physical therapy.
It takes a special sort of person to want to work in the pelvic region, dealing with damaged nerves, damaged muscles, and urinary and fecal incontinence. It’s up-close-and-personal. They use gloved hands to stretch out too-tight muscles (a stick for inside the vagina), and they see leakage of all types.
For me, with the muscles at the front of my pelvic floor gone, those in back had gone into a spasm, like a rubber band that used to be stretched but had snapped back. My PT used ultrasound to heat and loosen the muscles, enabling them to relax again. She pushed into them with her fingers, fighting the tension. She did these things every week for about three months. Only then could I rebuild strength — you can’t contract a muscle that is already contracted.
The hope was that, with the back muscles loosened, the front ones would no longer be forced into a stretch. But as we loosened and strengthened the back muscles, there was no progress in the front. We didn’t yet know that these muscles were gone.
The exercises started with simple core exercises like raising the pelvis into a bridge position, with something between my knees to stabilize my hips. She corrected my hip alignment and taught me to do it myself. She had me sitting on a racquetball to help loosen the back muscles and stretching the opening of my vagina to prevent the scar tissue from impeding flexibility on one side.
It was not easy to get used to the idea of hooking a finger inside the opening of my vagina and holding it in a stretch for two minutes. I was squeamish about my own body. I didn’t do it for the first week at least. Then, I accepted that if she could do it to someone else, I could do it to myself. If I wanted to get better, I’d have to let go of that hangup. So I started doing the stretch in bed before sleep, reading to pass the time.
After two months, the PT had me order Roll For Control. Only after I’d been doing the exercises for weeks did she realize that she meant for me to order the core video instead. I did not find Roll for Control to be especially helpful.
When kegels began, it was three sets of ten10-second holds and three sets of 10 one- or two-second holds. At first, there was no response from any of my muscles, but then the back muscles and what was left of the front muscle began to work again. This way of doing kegels was OK, but not as effective as a regimen I would discover later.
When I began to have meaningful muscle response again, she started me on hypopressives, an exercise that involves trying to breath in after emptying your lungs and closing your windpipe. I thought they had helped, but now I believe what I was really noticing was the effect of the pessary (more on that later).
Before discovering the DVD mix-up, I stumbled upon Hab-It, which at about $20 on Amazon seemed to be worth a shot. This turned out to be the most helpful set of exercises for me, particularly the way the kegels are so effective and manageable to keep up with.
When the physical therapist was confident that my scar was not pulling and my muscles were out of spasm, I was discharged from physical therapy.
I was still prolapsed though. Reading on the internet, you’d think that exercises could fix it if you just worked hard enough. But we’re not all that lucky. Which is why I was relieved when the doctor finally made her diagnosis, and I could stop blaming myself.
Posts in this series:
Prologue
Part 1: Is this normal?
Part 2: Sometimes you won’t get better
Part 3: Menstruation
Part 4: Pregnant with prolapse
Birth plans and prevention
