WTF
During my six weeks postpartum, I noticed a pressure in my vagina, especially at the end of the day and/or after any light exercise (cleaning, walking…). It wasn’t the sensation, “I need to pee,” but rather something pressing internally on my pelvic floor. It wasn’t painful, but it was uncomfortable. I had thoughts of concern, but just assumed that it was part of the healing process.
As instructed by my momma friends, I waited to look at my vagina until the morning of my six-week check up, I grabbed a mirror and had a peak. WTF?! To say I panicked is an understatement.
At my appointment, when my doc came in, I immediately said, “L, there is something majorly wrong.” She laughed. “Oh Lauren, I am sure you are fine. It is totally normal for things to be different down there after having a baby… [begins exam]… Oh, that is your bladder. It has fallen a bit, otherwise known as a bladder prolapse.” WTF?! I think my doctor was just as surprised as me as she responded, “Hmmm, you didn’t push for very long [Leon was actually considered an expedited delivery] and it is your first baby. Does bladder prolapse run in your family?” Yep, it sure does. My doctor said that the good news is that there are several degrees of prolapse and mine is right in the middle, so it could have been much worse. The best part is that I can reverse my symptoms with physical therapy, so my doctor wrote a script.
I got in the car and I sobbed. I was scared. I felt broken. I felt like my body failed me or I failed my body. What did I do wrong? I am a fitness professional. I teach Yoga for snicker’s sake and am all about working the pelvic floor. This is embarrassing. I thought I did everything right in my pregnancy and delivery. And, how will I ever feel sexy again?
I was suppose to go run errands, but drove immediately home. I needed to hold my baby and remind myself of the beautiful gift my body gave me.
Here is my physical therapist and I on my graduation day.
It Isn’t Normal to Pee Your Pants
I was excited and also incredibly scared for my first physical therapy appointment. My therapist was absolutely amazing though, and immediately made me feel comfortable (Kelly Cross at ATI Women’s Health in Tinley Park, Illinois. Go meet her!) She assured me that I was capable to reverse my symptoms, which is just what I needed to hear. She said that our goal was to bulk up the muscles in the pelvic floor, which will compensate for damaged joints and ligaments and help lift up the bladder.
At this time, urine leakage wasn’t a concern. I never tested the water though. I always crossed my legs while laughing, coughing, and sneezing. I was always home with a baby on my boob, so I never was put in a position where I needed to search for a bathroom. And lord knows, I wasn’t going on a run or doing jumping jacks.
During this initial appointment though, we did discuss urine leakage and it was eye opening. I just assumed if you have children and/or as you age, it was normal to leak a little urine. You wear a panty liner and move on with your life. I was wrong. Although it is very common, it isn’t “normal” for the average healthy body. It means you have a deeper issue that needs to be addressed. The good news? Pelvic floor physical therapy works! There is enough research out there to prove it and doctors with this specific specialty are becoming more popular. If you dedicate yourself to the exercises, you can strengthen your pelvic floor enough to not have leakage issues.
Creating a New, Temporary Identity
My PT laid out the game plan - stretch the muscles and then build strength. Other do’s and don’ts:
No lifting heavy objects, including weights.
Don’t strain with bowl movements (one of the worst things you can do). Be sure to be getting enough fiber.
Put the pause on high intensity exercise until we bulk up the muscle.
Wait, no high intensity exercise? (Another WTF moment) I hadn’t tried it since Leon was born, but I was expecting to go back to teaching Zumba and other high intensity classes within the next couple weeks. Teaching classes where I can run around like a wild woman IS MY JAM. IT IS ME. When I heard this instruction, I felt like someone was taking a limb off my body and removing part of my identity. How can I be me without it? When I told the news to my group fitness boss, I sobbed. Again, time to go stare at my miracle.
After I mourned the loss of one of my favorite hobbies, passions, and jobs, I needed a game plan to move on. I love practicing and teaching yoga just as much as aerobic dance and since this type of movement was safe for me to do (I still needed to modify some things), I took this as an opportunity to grow as a professional in this area. I began teaching Mommy & Me Yoga and Prenatal Yoga. This kept my mind focused on what I could still do verses what I was “not” able to do. In addition, after 12 weeks of PT, I was able to do/teach low impact dance including Zumba Gold. See, look at all the things I CAN do!
I also focused on the big picture. The doctor said that if I stick to my exercises consistently, in about 8 months, I should be able to do all the things I was doing prior. In the big scheme of things, 8 months is nothing. I am lucky. Some people experience injuries that don’t allow them to return to the life they had prior. I stayed grateful and counted my blessings.
Lengthen Before Strengthen
I assumed that since I pushed a 7lb human through a tiny hole, my pelvic floor muscles were stretched plenty, so let’s jump right into Kegels and tighten ‘er back up. That wasn’t the case though. My PT reminded me of the battle my pelvic floor endured and said that my muscles reacted by tightening (a normal response when experiencing pain or negative emotions), so first we need to get the muscles calm and relaxed. You can’t properly contract a muscle that is already in its contracted state. We need to lengthen in order to get a proper contraction. Before jumping into Kegels, we focused on stretching the pelvic floor and surrounding muscles, deep breathing, and contracting the deep abdominal muscles, which are very important for pelvic floor health.
Sex with a Prolapse
Remember how I just said that my pelvic floor freaked out after childbirth and clenched up? Everyone told me that sex after baby was going to feel like a loose handshake. It was quite the opposite for me. Queue Madonna’s song “Like A Virgin.” My therapist and I talked about sex frequently and these were my takeaways:
Use lubrication and try different types.
Go slowly and be sure to take deep breaths and relax.
With a prolapse, the bladder will create a resistance at first, but it will eventually move over.
Try all different positions. Keep experimenting until you find what works best.
Just a side note, pain with sex could be a sign that there is another issue, not just tight muscles or scar tissue, so be sure to talk to your doctor.
Postpartum Queefing
Yep, I said it. Queefing. I am assuming that everyone else is either too embarrassed to talk about it or I am the only one who had this issue, but just in case there are other queefers out there, this one is for you! I have had queefing moments in the past, but with my postpartum body, hoooollllyyyy smokes! After sex or any yoga pose where one foot left the ground, I would queef and not a little one that you can blame on your yoga mat rubbing on the floor weird. I am talking LOUD and multiple times in a row. Thank the Lord I practiced yoga in the privacy of my own home for about a month before teaching classes. I was able to figure out which poses were the culprits and avoided them like the plague. And, thank the Lord I picked an amazing husband who loves me unconditionally and instead of being grossed out, would join me in uncontrollable laughter. We would look at each other and say, “Is this real?!” We already had to uncomfortably push my bladder to the side at insertion. We already had my breast milk squirting everywhere. We already had lube spilling on the sheets. Then, just when we thought we were in the clear, my vagina plays us a tune - A tune that sounds like a child’s first tuba recital. Super swanky.
The good news is that at about 6 months postpartum and plenty of Kegels later, I felt like I turned a corner. I haven’t queefed in awhile while having sex and I am down to just 2 yoga poses (that I know of) that I stay away from. Let’s pray it gets even better. But yeah, vagina farts. Sexy.
The Path to Healing Isn’t a Constant Incline
You do the work. Symptoms subside. You make the work harder. Symptoms reappear. You keep doing the harder work and eventually your body gets stronger and symptoms subside. Repeat.
Remember, when healing any injury, there will be times when you will slightly increase the difficulty of the exercises to build your strength. When challenging the body, symptoms may reappear. It is easy to get discouraged, but stay focused. It is normal and means you are getting stronger! During these times, my therapist would give me pep talks and we would look back to where I started. I was always surprised and proud with my progress.
What I Will Do Differently with My Next Delivery
If the Lord blesses us with another baby, there are several things that I will do differently. These are things that my therapist suggested in order to avoid further/additional damage:
While pushing, don’t hold your inhalation in your belly (or in your cheeks!). I had no intention of doing this, but when the nurses were describing how to bear down, I did, and no one corrected me. I was in the moment and didn’t analyze it or think twice. Again, embarrassing as a yoga/group fitness instructor as I know it is terrible to hold your breath. During strength training, we always queue to exhale on the hardest part of the movement. Apparently, holding your breath during pushing is an old school tactic. Back in the day, that extra air in the belly was viewed as a great way to increase pressure to push the baby out. Now research tells us the opposite -- It can compromise your pelvic floor. So next time, I am exhaling as I push.
Try to not get an epidural so you can feel your muscles and contract them properly.
Do not deliver on your back. It puts unnecessary pressure on your pelvic floor and isn’t efficient. If you get the epidural, deliver the baby on your side and have your partner hold your leg up.
Check out birthing centers. The staff is typically much more in tune with the latest research on pelvic floor health.
Focus On the Symptoms Verses the Aesthetic
Towards the end of my PT treatment, I took a mirror down below and it didn’t look much different. I was bummed. I was feeling better so I just assumed it would look better. My therapist told me to focus on the symptoms and to use that as my measure of progress. Our goal is to be symptom free, whether or not the naked eye will be able to see a physical difference.
In my yoga classes, I say often, “Focus on the sensations verses the aesthetic.” For example, if you are doing a forward fold, close your eyes. It doesn’t matter if your fingers are feet away or if you can place your palm on the earth. As long as you feel the gentle stretch in the back of your body, you are exactly where you need to be today. It is all about the feels. Same with weight loss or gaining muscle. In the end, we are creating goals to feel good, to feel confident, to feel sexy. And it applies to our pelvic floor health too. :)
What the Future Holds
If I didn’t have such an active lifestyle, I would have considered myself 100% healed after 8 weeks of physical therapy. Instead, I considered myself 80% healed, which was our original goal. I continue to do my exercises 2 days a week. It takes about 40 minutes to complete all the exercises. It isn’t easy to dedicate 40 minutes, 2x a week to my exercises, especially with an infant. It really eats up my time to dedicate to other things I love like yoga, writing, cuddling with Bill, etc. I keep reminding myself of the bigger picture though. This season of my life is temporary and fleeting. If I want to carry and deliver more babies and continue to live a healthy lifestyle, my pelvic floor is very important. Right now, I am 95% healed. In a month, I hope to complete a 60-minute high intensity workout symptom free.
Yes, I Will Heal. Yes, You Will Heal.
I am walking away from all of this with an appreciation for my body. It carried and delivered a healthy and THRIVING baby boy. This body built a tiny human. Gah, I will never get over it! And this body, it can heal. Yes, it WILL heal. As long as I dedicate my time and energy, mentally and physically, to my exercises, this body has the strength and capability to conquer. As long as I continue to tell myself, “This little bump in the road is here to serve me. I can do this! My body is amazing!” I will heal. Yes, I will heal.
So if you are in the midst of this crazy season of life with an infant on your hip, if you are in any sort of pain, uncomfortable to leave the sight of a bathroom, or a queefing champ, I hope you walk away from this knowing you are not alone. I hope you feel empowered to take the necessary action to heal. I hope you talk to your doctor, a physical therapist, your friends and/or a support group to get the help you need. Most importantly, I hope you start to believe that you have the ability to heal.
**An update: By the time I wrote this blog, edited it, and posted it (apparently everything takes me way longer with an 8 month old!) I had successfully done a 60 minute high intensity workout symptom free. I did have to modify some things, but hey, I think that is pretty darn good progress!**