Pelvic Organ Prolapse After Birth

Pelvic organ prolapse occurs when organs such as the bladder, uterus or bowel shift down toward the vagina. After birth, you may notice a feeling of fullness or downward pressure in the vagina, or a bulge you can feel. These symptoms may change over the course of the day, after standing for a long time or with physical activity. A physiotherapy assessment looks at your symptoms, your birth history and how they relate to your daily activities, and examines the strength, relaxation and coordination of your breathing, abdominal wall and pelvic floor muscles. Depending on your symptoms and goals, the physiotherapy plan includes pelvic floor training, pressure management, biofeedback and a gradual return to daily activities.

Book an Appointment

Tuğçe Atalay

Pelvic Organ Prolapse After Birth: Symptoms and Physiotherapy Assessment

Pressure and a Dragging Sensation in the Pelvis After Birth

In pelvic organ prolapse, the bladder, uterus or bowel may lose support and descend toward the vagina. After birth, you may notice fullness or pressure in the vagina, a dragging-down sensation, or a bulge you can feel at the vaginal opening.

How Can Prolapse Symptoms After Birth Affect Daily Life?

For some people, the feeling of pressure increases after standing for long periods or later in the day. Changes may also occur when urinating, emptying the bowels or during sex. Symptom severity varies from person to person; the type or degree of prolapse cannot be determined from sensations alone.

Assessment and Support with Pelvic Floor Physiotherapy

A physiotherapy assessment looks at your symptoms, your birth history, and the contraction, relaxation and endurance of your pelvic floor muscles. Based on the findings, exercises, breathing work and adjustments to daily activities are planned. NICE recommends considering supervised pelvic floor muscle training for women with symptoms.

Would you like information or an appointment?

Book an Appointment

Common and Treatable

In a study following 300 first-time pregnant women, pelvic organ prolapse detected on examination at different follow-up points was found in 0 to 10 of every 100 women.

"At the end of the day, I feel a downward pressure in my vagina."

"I noticed a bulge I can feel at the vaginal opening."

"Since giving birth, the way I empty my bladder or bowels has changed."

Reimers C, Staer-Jensen J, Siafarikas F, et al. Change in pelvic organ support during pregnancy and the first year postpartum: a longitudinal study. BJOG. 2016;123(5):821–829.

Pelvic Organ Prolapse After Birth FAQ

Can vaginal pressure or a dragging sensation after birth be a sign of prolapse?

This sensation can occur with pelvic organ prolapse, but on its own it is not enough for a diagnosis. The healing of tissues after birth or other pelvic floor problems can cause similar sensations.

Does pelvic organ prolapse appear right after giving birth?

Symptoms may be noticed shortly after birth or become more noticeable over time. Besides when they began, what makes them worse and how they affect your daily life are also important in the assessment.

What happens in a physiotherapy assessment for prolapse symptoms?

First, we talk about your birth and health history, when the feeling of pressure gets worse, and your bladder and bowel function. Then we assess the strength, relaxation and coordination of your pelvic floor muscles.

If I feel prolapse symptoms, should I stop exercising?

You don't need to stop all exercise; however, which movements suit you depends on your symptoms. If vaginal pressure, heaviness or a bulging sensation increases during activity, talk to your physiotherapist or doctor to review the type and intensity of your exercise.

What should I do if I notice a bulge at the vaginal opening?

A doctor's examination is needed to find out what the bulge is. If you also have difficulty urinating or emptying your bowels, be sure to mention it. Treatment options for prolapse symptoms are planned based on your symptoms and examination findings; in some cases, your doctor may also consider options such as a vaginal support device (pessary).