Postpartum, the period of time, after giving birth (one year), can be tough for any mother with sleep deprivation, pain, hormonal shifts, the risk of depression, not to mention the tiny new life to care for. What happens when a mother returns to the work place and is still suffering from issues? A very common complaint and a potentially embarrassing health problem is pelvic prolapse.
WHAT IS A PELVIC PROLAPSE?
The pelvic floor is something possibly not even considered, unless partaking in a Pilates class, until pregnancy, and these words float around as common as womb and vagina. What is the pelvic floor and why is it so important? The pelvic floor is a maze of integrated muscles, tissues, and ligaments that stretch over the pelvic muscles and support the nearby organs.
The supported organs are:
Like a large trampoline supporting a mass on top, if there is a weakness or a tear, then any physical stress could lead to a potential health issue.
There are specific gaps in the pelvic floor for the vagina, anal passage, and urethra to pass through, and these may overly stretch whilst pregnant. The weight of the baby puts extra pressure on these muscles, and the muscles are slackened due to hormones. Child birth strains this area of the body, which could lead to a pelvic prolapse. Common causes of a pelvic prolapse include: a long labor, the use of instruments during the birth like forceps, vacuum extraction, and giving birth to large babies or multiples. Due to many pressures on the pelvic floor, there are a number of side affects.
Side Affects Include:
- Stress incontinence (leaking urine)
- Fecal incontinence (this is not common but can happen)
- Wrenching feeling due to the bowel, bladder, vagina and womb pushing against the wall of the vagina.
- Back ache
- Incomplete emptying of the bladder, leading to bladder and urinary infections.
- Sexual intercourse issues due to penetration discomfort and decreased sensation
COPING WITH A PELVIC PROLAPSE IN THE WORKPLACE
Many women return to work after childbirth and need to know their health is in check and an embarrassing scenario does not catch them off guard. Depending on how bad a pelvic prolapse is depends on the individual. If the case is milder, a doctor may suggest certain exercises, also known as Kegels, to do throughout the day, to strengthen the pelvic floor. These exercises involve strengthening the pelvic floor openings by lifting and squeezing them. It is essential to get advice from a professional in order to have the correct technique with these particular exercises. These maneuvers will help improve bladder and bowel control and decrease the prolapse symptoms. These exercises will not work instantly and will require consistent repetition.
Steps to prevent an embarrassing situation may include:
- Visit the bathroom every two hours
- Wear a sanitary pad and change often
- Underwear for pelvic prolapse
- Limit lifting heavy weights
- A heavy patient must lose the extra pounds
- Limit caffeine and alcohol, which are both irritants to the bladder
- Drink water often
- Wear flat shoes (wearing high heels may put pressure on your core and therefore the pelvic floor, increasing the need to use the bathroom)
- Wear dark colored pants
If the urinary leakage is persistent, a doctor may suggest a pessary, which is a small silicone ring, placed in the vagina in the morning and removed at night. This ring supports the areas which are affected by the prolapse. Working mothers may find this particularly helpful during a busy day when getting to the bathroom often is not always feasible. The pessary is not for everyone so discussing this with a doctor is important. It may take up to a year to recover from a milder version of a pelvic prolapse, but having a more severe case will not heal without help.
IS SURGERY AN OPTION?
Returning to work after child birth can be exhausting and with the added stress of a pelvic prolapse, it may leave some mothers anxious too. There are of course all the positives of returning to work: financial independence, socialization, and career development. However, what happens if the pelvic prolapse is so severe, it limits activity at work? Having a desk job with restricted movement is an easier way to control this health issue, but not all women have a desk job. What if the job demands constant meetings, running errands, or even physical activity? Many people consider having an operation to support and realign the pelvic organs. The operation depends on: which organs have been affected in the prolapse, the age of the woman, whether she wishes to have more children, and if she desires to keep her uterus. There are numerous risks involved in these operations and research is still being carried out into limiting them.
The potential dangers are:
- Infection in the operation site
- Bleeding from the large blood vessels around the uterus. This may require additional surgery to control the bleeding.
- Organs around the pelvis may be damaged such as the bladder, bowel, uterus.
- Pain is common after the operation
- Difficulty emptying bladder, which is usually resolved after a few weeks.
WHAT TO DO
It is imperative to discuss and plan the operation with a specialist. Make sure the surgeon is not just treating the symptoms, but also the actual cause. If requiring a sacrocolpopexy (attaching a synthetic mesh to the top of the vagina and fastening it to the sacrum, pulling the vagina into its normal position), be educated, this particular procedure has been banned in places like Scotland, due to the synthetic mesh possibly breaking away from the structure, resulting in foreign material in the body. According to a study in the Journal of the American Medical Association, this procedure fails for every one in three women. Before rushing into surgery, look at the options, ask questions, and be aware. Armed with knowledge and choices, returning to work without the anxiety or embarrassing health issues may soon become a reality.