Pelvic organ prolapse (POP) during pregnancy can lead to discomfort and potential complications. POP is a condition where the pelvic organs—such as the bladder, uterus, or rectum—descend into or beyond the vaginal canal due to weakened pelvic floor muscles and ligaments. It is most commonly associated with postpartum and menopausal women, but can occur during pregnancy.

Causes of Pelvic Prolapse During Pregnancy

Several factors contribute to the development or worsening of pelvic prolapse during pregnancy, including:

• Increased Uterine Pressure – As the uterus grows, it puts additional pressure on the pelvic floor muscles and ligaments, potentially weakening them and allowing organs to shift.
• Hormonal Changes – Pregnancy hormones, particularly relaxin and progesterone, loosen the ligaments and tissues that support the pelvic organs, increasing the risk of prolapse.
• Multiple Pregnancies or Large Baby – Women who have had multiple pregnancies, especially those carrying large babies, may experience excessive strain on their pelvic muscles.
• Previous Vaginal Deliveries – A history of vaginal births, particularly with prolonged labor or forceps-assisted deliveries, can weaken the pelvic floor and contribute to prolapse.
• Chronic Straining – Conditions like constipation or chronic coughing can exert extra stress on the pelvic muscles, worsening prolapse.
• Genetic Predisposition – Some women may have naturally weaker connective tissues, making them more prone to prolapse.

Symptoms of Pelvic Prolapse During Pregnancy

Pelvic prolapse symptoms can vary in severity, but common signs include:

• A sensation of heaviness or pressure in the pelvis
• A visible or palpable bulge in the vaginal area
• Difficulty with urination, including urinary retention or incontinence
• Bowel movement difficulties, such as constipation or incomplete emptying
• Lower back pain or discomfort
• Increased vaginal discharge
• A feeling of something “falling out” from the vagina

IMPORTANT: If any symptoms seem abnormal, uncomfortable or unusual, or if you have any doubts or questions, seek immediate medical attention. We have physicians on call 24/7 to answer any questions or concerns. If your medical condition is urgent, call 911 or go to the emergency room. You can never be too careful.

 

Diagnosis and Evaluation

A thorough examination by one of our OB/GYNs or certified nurse midwives is necessary to confirm pelvic prolapse. Diagnosis typically involves:

• Pelvic Exam – A physical assessment to evaluate the extent of prolapse.
• Ultrasound or MRI – Imaging may be used in severe cases to assess the pelvic organs.
• Patient History – Understanding previous pregnancies, deliveries, and symptoms to determine risk factors.

Management and Treatment Options

While pelvic prolapse during pregnancy can be concerning, several management strategies can help alleviate symptoms and prevent further complications:

Lifestyle and Physical Therapy

• Pelvic Floor Exercises (Kegels) – Strengthening the pelvic muscles can provide better support for the organs.
• Avoid Heavy Lifting – Reducing strain on the pelvic floor can prevent worsening symptoms.
• Managing Constipation – Eating a fiber-rich diet and staying hydrated can reduce straining during bowel movements.
• Proper Posture and Supportive Garments – Using maternity support belts may help distribute weight more evenly and relieve pressure on the pelvic floor.

Medical Interventions

• Pessary Use – A pessary, a removable device inserted into the vagina, can help support the prolapsed organ and alleviate symptoms.
• Regular Monitoring – Close follow-up with an OB/GYN ensures that symptoms do not worsen or lead to complications such as urinary retention or infections.

Delivery Considerations

Women with significant pelvic prolapse may need a tailored birth plan. In some cases, a cesarean section may be recommended if vaginal delivery poses a high risk of worsening the condition.

Postpartum Outlook

Pelvic prolapse symptoms may improve after delivery as hormone levels stabilize and the uterus returns to its normal size. However, some women may require continued pelvic floor therapy or, in severe cases, surgical intervention.

When to Seek Medical Help

If you experience severe discomfort, difficulty urinating or having bowel movements, or notice a significant bulge, consult your OB/GYN immediately. Early intervention can help manage symptoms and prevent complications.

Pelvic prolapse during pregnancy can be distressing, but with proper management, many women can have a healthy pregnancy and delivery. If you suspect prolapse or have concerns about your pelvic health, our team at Cherokee Women’s Health is here to help. Contact us today at 770.720.7733 or schedule an appointment online to learn more about maintaining pelvic health during pregnancy.