Talk to me about pelvic floor damage and what you did to address it.

[Anonymous]

I had vaginal surgery to repair a bladder and bowel prolapse resulting from pelvic floor damage.

I had to be sure I was done having kids. Recovery was just like childbirth (6 weeks, lots of bleeding), but without the cute and lovely newborn to go with it. Took six weeks for things to settle and to feel comfortable exercising. I’m about 5 years out now and it’s the best decision I ever made.

Try Cherie Marfori at Inova - she’s the very best pelvic floor surgeon in this area.

[Anonymous]

Surgery. See a specialist to discuss options.

[Anonymous]

Anonymous wrote:I had vaginal surgery to repair a bladder and bowel prolapse resulting from pelvic floor damage.

I had to be sure I was done having kids. Recovery was just like childbirth (6 weeks, lots of bleeding), but without the cute and lovely newborn to go with it. Took six weeks for things to settle and to feel comfortable exercising. I’m about 5 years out now and it’s the best decision I ever made.

Try Cherie Marfori at Inova - she’s the very best pelvic floor surgeon in this area.

Thanks for response..could you please share a little about your birth experience, what caused so much damage? Thanks

[Anonymous]

Anonymous wrote:OP, i had two c-sections and i still needed Pelvic PT to fix issues.

It's not just pushing and labor that can mess up your pelvic floor --being pregnant changes the way we hold our muscles (we are clenching for months), and c-sections often leave scarring that interferes with your muscle movement. For me, the scar was interfering with both my ab muscles and my pelvic floor muscles. my PT was able to loosen and break the scar tissue and I had to do exercises every day to retrain the muscles to work properly. I'm actually still going.

Don't want to scare you, but I really believe every single woman who gives birth should have access to pelvic PT! none of us come out of it unscathed, and PT's are VERY helpful.

follow the vagina whisperer on Instagram.

100% agree everyone should see a PT. I plan to see one and trying to learn what not to do so avoid potential damage. Childbearing is traumatic!

[Anonymous]

Anonymous wrote:I had vaginal surgery to repair a bladder and bowel prolapse resulting from pelvic floor damage.

I had to be sure I was done having kids. Recovery was just like childbirth (6 weeks, lots of bleeding), but without the cute and lovely newborn to go with it. Took six weeks for things to settle and to feel comfortable exercising. I’m about 5 years out now and it’s the best decision I ever made.

Try Cherie Marfori at Inova - she’s the very best pelvic floor surgeon in this area.

Do you know what surgery you had exactly, eg colporrhaphy (eg posterior or anterior repair), sacrocolpopexy, or something else? Did a colorectal surgeon do the bowel part or did Marfori do all of it? I had considered seeing her but she is not a urogynecologist and my OB wanted me to see a trained urogyn.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I had vaginal surgery to repair a bladder and bowel prolapse resulting from pelvic floor damage.

I had to be sure I was done having kids. Recovery was just like childbirth (6 weeks, lots of bleeding), but without the cute and lovely newborn to go with it. Took six weeks for things to settle and to feel comfortable exercising. I’m about 5 years out now and it’s the best decision I ever made.

Try Cherie Marfori at Inova - she’s the very best pelvic floor surgeon in this area.

Do you know what surgery you had exactly, eg colporrhaphy (eg posterior or anterior repair), sacrocolpopexy, or something else? Did a colorectal surgeon do the bowel part or did Marfori do all of it? I had considered seeing her but she is not a urogynecologist and my OB wanted me to see a trained urogyn.

It was a colporrhaphy. She did the whole thing. I have actually had multiple surgeries and procedures with Marfori, for a variety of things. I trust her with my life - quite literally.

My problems were caused by a very difficult first labor. No meds, slow to progress, many hours of pushing. Then I had a very large second baby, who essentially sat on my damaged pelvic floor for nine months.

I had surgery when my youngest was 3. It has solved all my problems.

[Anonymous]

Sorry to randomly jump in here, but as another longtime patient of Cherie Marfori's, I can wholeheartedly second the recommendation to talk to her. She's one of the leading gynecologic surgeons in the country, and a delight to work with. She's well connected to other specialists in the region, so if she's not the right surgeon for you and you do need a uro-gyn instead, she would be able to link you to the right specialist.

[Anonymous]

Anonymous wrote:Sorry to randomly jump in here, but as another longtime patient of Cherie Marfori's, I can wholeheartedly second the recommendation to talk to her. She's one of the leading gynecologic surgeons in the country, and a delight to work with. She's well connected to other specialists in the region, so if she's not the right surgeon for you and you do need a uro-gyn instead, she would be able to link you to the right specialist.

Thank you, that’s helpful. I guess for prolapse and other PFDs I was under the impression that you’d want a urogynecologist and not an OB surgeon. In my case I’m probably going to have to have a colorectal surgeon operate on my rectocele and a urogyn do the bladder and uterus. Basically my entire pelvic floor needs to be rebuilt. But I’ve seen several urogyns and they all recommend a different surgery so I have been putting it off. What is her experience with pelvic floor disorders versus just normal OB surgeries?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Sorry to randomly jump in here, but as another longtime patient of Cherie Marfori's, I can wholeheartedly second the recommendation to talk to her. She's one of the leading gynecologic surgeons in the country, and a delight to work with. She's well connected to other specialists in the region, so if she's not the right surgeon for you and you do need a uro-gyn instead, she would be able to link you to the right specialist.

Thank you, that’s helpful. I guess for prolapse and other PFDs I was under the impression that you’d want a urogynecologist and not an OB surgeon. In my case I’m probably going to have to have a colorectal surgeon operate on my rectocele and a urogyn do the bladder and uterus. Basically my entire pelvic floor needs to be rebuilt. But I’ve seen several urogyns and they all recommend a different surgery so I have been putting it off. What is her experience with pelvic floor disorders versus just normal OB surgeries?

This is a problem I face too. What are the different options suggested?

[Anonymous]

I learned in my postpartum doula training that we’re not allowing ourselves enough rest after giving birth.

You need way more rest than you think. We’re just so used to pushing ourselves. This is the time to let others get everything you need.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Pelvic floor physical therapy for 2 years with 4 providers. Had imaging to confirm muscle damage. Consulted several urogynecologists and a colorectal surgeon. Planning to have surgery once my kids are older and I’m not lifting them.

Wow 4 years!

It was over 2 years, not 4.

Here is my advice to OP and everything I wish I had known.

1. Talk to your mom and women in your family about their births, and lasting impacts. If they have urinary incontinence, anal or flatal incontinence, bad tearing, instrumental delivery, prolapse, or vaginal laxity (eg looseness). Ask them to be brutally honest. If there are a lot of issues, proceed with caution on a vaginal birth. Eg if mom, grandma and your aunt all had prolapses the genetics are not in your favor.

2. Consider your age. If you are an older FTM (say 33 and older) and only planning one or two
Children, I think a scheduled C section is a reasonable choice. Or you can do a trial of labor but have a low threshold for going to a C section.

3. If baby is not moving down well with pushing or is in a bad position, have a C section. Do not have forceps or vacuum. Tell your doctor you don’t want those and you want them to do whatever possible to avoid an instrumental delivery and an episiotomy.

4. Do pelvic floor physical therapy before birth to work on optimizing chances for a successful vaginal birth. Also do Spinning Babies, One Strong Mama, and see a chiropractor who does Webster technique.

5. Don’t go long past your due date - the last few weeks babies can can like a half a pound a week and get huge. Get induced instead.

6. Have an epidural and get it early. Labor is insanely painful and unless you are a masochist there’s no need to experience bone crushing agony.

7. Don’t push for hours. If you are approaching 1 hour or 2 hours and it’s not getting close, go to a C section. Pushing in excess of 3 hours is really bad for your body and can cause damage to your nerves, rectum, fascia and pelvic floor - each contraction cuts off blood temporarily to the area. It’s ok for a little while but hours of this can cause irreparable damage.

8. Know you can tear in many ways beyond first, second, third, and 4th. You can tear your urethra, labia, clitoris. You can tear inside the walls of the vagina and your anal sphincter. These injuries are things you don’t hear much about but they can and do happen so make sure you see a pelvic floor physical therapist after birth regardless.

9. Know a c section is not a panacea. It can cause many issues including infection, serious blood loss, infertility, placenta issues in future pregnancies.

10. Know there is NO good way for a baby to be born. There are different choices but all have risks and benefits and what is right for you should not be a one size fits all approach but a discussion with your doctor about your unique circumstances.

11. Don’t believe the lies that you should not hear Women’s bad birth stories or that pain in labor is caused by fear. It is normal to have a fear of childbirth - historically it was a leading cause of death among young women and children. Hearing different stories gives you a more realistic idea for the realities of birth thst you don’t get from fake social media pictures of gorgeous women with blowouts and full faces of makeup right after they deliver, Childbirth is hard, painful, and sweaty and bloody work. There will be body fluids and needles. And it can be scary. But you are strong, you can do it, and having a beautiful baby is the reward for your pain and suffering.

Bumping this, it’s awesome advice. Really love the post immediately above as well.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Pelvic floor physical therapy for 2 years with 4 providers. Had imaging to confirm muscle damage. Consulted several urogynecologists and a colorectal surgeon. Planning to have surgery once my kids are older and I’m not lifting them.

Wow 4 years!

It was over 2 years, not 4.

Here is my advice to OP and everything I wish I had known.

1. Talk to your mom and women in your family about their births, and lasting impacts. If they have urinary incontinence, anal or flatal incontinence, bad tearing, instrumental delivery, prolapse, or vaginal laxity (eg looseness). Ask them to be brutally honest. If there are a lot of issues, proceed with caution on a vaginal birth. Eg if mom, grandma and your aunt all had prolapses the genetics are not in your favor.

2. Consider your age. If you are an older FTM (say 33 and older) and only planning one or two
Children, I think a scheduled C section is a reasonable choice. Or you can do a trial of labor but have a low threshold for going to a C section.

3. If baby is not moving down well with pushing or is in a bad position, have a C section. Do not have forceps or vacuum. Tell your doctor you don’t want those and you want them to do whatever possible to avoid an instrumental delivery and an episiotomy.

4. Do pelvic floor physical therapy before birth to work on optimizing chances for a successful vaginal birth. Also do Spinning Babies, One Strong Mama, and see a chiropractor who does Webster technique.

5. Don’t go long past your due date - the last few weeks babies can can like a half a pound a week and get huge. Get induced instead.

6. Have an epidural and get it early. Labor is insanely painful and unless you are a masochist there’s no need to experience bone crushing agony.

7. Don’t push for hours. If you are approaching 1 hour or 2 hours and it’s not getting close, go to a C section. Pushing in excess of 3 hours is really bad for your body and can cause damage to your nerves, rectum, fascia and pelvic floor - each contraction cuts off blood temporarily to the area. It’s ok for a little while but hours of this can cause irreparable damage.

8. Know you can tear in many ways beyond first, second, third, and 4th. You can tear your urethra, labia, clitoris. You can tear inside the walls of the vagina and your anal sphincter. These injuries are things you don’t hear much about but they can and do happen so make sure you see a pelvic floor physical therapist after birth regardless.

9. Know a c section is not a panacea. It can cause many issues including infection, serious blood loss, infertility, placenta issues in future pregnancies.

10. Know there is NO good way for a baby to be born. There are different choices but all have risks and benefits and what is right for you should not be a one size fits all approach but a discussion with your doctor about your unique circumstances.

11. Don’t believe the lies that you should not hear Women’s bad birth stories or that pain in labor is caused by fear. It is normal to have a fear of childbirth - historically it was a leading cause of death among young women and children. Hearing different stories gives you a more realistic idea for the realities of birth thst you don’t get from fake social media pictures of gorgeous women with blowouts and full faces of makeup right after they deliver, Childbirth is hard, painful, and sweaty and bloody work. There will be body fluids and needles. And it can be scary. But you are strong, you can do it, and having a beautiful baby is the reward for your pain and suffering.

Bumping this, it’s awesome advice. Really love the post immediately above as well.

Yes I agree. I would also suggest learning open glottis pushing versus closed glottis. The nurses are going to encourage you to purple-push because that's all they know (normally). There are also many positions you can get into to open your pelvis. On your back with legs up is not one of them. Epidural does complicate as many providers are not comfortable allowing movement (side-lying/peanut balls/etc) with an epidural.

[Anonymous]

Like one PP, I also had two c-sections and major pelvic floor damage. The pregnancy itself combined with scarring and nerve damage from surgery left me with incontinence, significant vaginal laxity/“looseness,” and a minor prolapse. Basically I could not engage the muscles correctly following the c-sections and it all felt pretty traumatic. I did two years of PT and things are better but not completely resolved. I feel so defeated because although I initially didn’t want c-sections I thought they would at least leave my vagina/pelvic floor intact, but definitely not the case. According to my PT, my situation is actually quite common unfortunately. I have contemplated looking into surgical options when my youngest is a bit older but I have no idea if I’m a candidate. Anyone who gives birth in any way should have PT.

[Anonymous]

Anonymous wrote:Like one PP, I also had two c-sections and major pelvic floor damage. The pregnancy itself combined with scarring and nerve damage from surgery left me with incontinence, significant vaginal laxity/“looseness,” and a minor prolapse. Basically I could not engage the muscles correctly following the c-sections and it all felt pretty traumatic. I did two years of PT and things are better but not completely resolved. I feel so defeated because although I initially didn’t want c-sections I thought they would at least leave my vagina/pelvic floor intact, but definitely not the case. According to my PT, my situation is actually quite common unfortunately. I have contemplated looking into surgical options when my youngest is a bit older but I have no idea if I’m a candidate. Anyone who gives birth in any way should have PT.

My experience was the same

Duke university hospital ugh

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Pelvic floor physical therapy for 2 years with 4 providers. Had imaging to confirm muscle damage. Consulted several urogynecologists and a colorectal surgeon. Planning to have surgery once my kids are older and I’m not lifting them.

Wow 4 years!

It was over 2 years, not 4.

Here is my advice to OP and everything I wish I had known.

1. Talk to your mom and women in your family about their births, and lasting impacts. If they have urinary incontinence, anal or flatal incontinence, bad tearing, instrumental delivery, prolapse, or vaginal laxity (eg looseness). Ask them to be brutally honest. If there are a lot of issues, proceed with caution on a vaginal birth. Eg if mom, grandma and your aunt all had prolapses the genetics are not in your favor.

2. Consider your age. If you are an older FTM (say 33 and older) and only planning one or two
Children, I think a scheduled C section is a reasonable choice. Or you can do a trial of labor but have a low threshold for going to a C section.

3. If baby is not moving down well with pushing or is in a bad position, have a C section. Do not have forceps or vacuum. Tell your doctor you don’t want those and you want them to do whatever possible to avoid an instrumental delivery and an episiotomy.

4. Do pelvic floor physical therapy before birth to work on optimizing chances for a successful vaginal birth. Also do Spinning Babies, One Strong Mama, and see a chiropractor who does Webster technique.

5. Don’t go long past your due date - the last few weeks babies can can like a half a pound a week and get huge. Get induced instead.

6. Have an epidural and get it early. Labor is insanely painful and unless you are a masochist there’s no need to experience bone crushing agony.

7. Don’t push for hours. If you are approaching 1 hour or 2 hours and it’s not getting close, go to a C section. Pushing in excess of 3 hours is really bad for your body and can cause damage to your nerves, rectum, fascia and pelvic floor - each contraction cuts off blood temporarily to the area. It’s ok for a little while but hours of this can cause irreparable damage.

8. Know you can tear in many ways beyond first, second, third, and 4th. You can tear your urethra, labia, clitoris. You can tear inside the walls of the vagina and your anal sphincter. These injuries are things you don’t hear much about but they can and do happen so make sure you see a pelvic floor physical therapist after birth regardless.

9. Know a c section is not a panacea. It can cause many issues including infection, serious blood loss, infertility, placenta issues in future pregnancies.

10. Know there is NO good way for a baby to be born. There are different choices but all have risks and benefits and what is right for you should not be a one size fits all approach but a discussion with your doctor about your unique circumstances.

11. Don’t believe the lies that you should not hear Women’s bad birth stories or that pain in labor is caused by fear. It is normal to have a fear of childbirth - historically it was a leading cause of death among young women and children. Hearing different stories gives you a more realistic idea for the realities of birth thst you don’t get from fake social media pictures of gorgeous women with blowouts and full faces of makeup right after they deliver, Childbirth is hard, painful, and sweaty and bloody work. There will be body fluids and needles. And it can be scary. But you are strong, you can do it, and having a beautiful baby is the reward for your pain and suffering.

Jesus Christ I’m glad I didn’t read or do anything like this before giving birth. See my biggest takeaway from having a baby is you have ZERO CONTROL. What good does knowing all these possible horrible outcomes do? I read absolutely nothing about birth beforehand, and I’m glad. If I’d known I would end up pushing for 5 hours and be too tired to even hold my baby, I probably would not have wanted to have a baby. I honestly think it’s best not to dwell on all these things because it gives you the illusion of control and choice and makes you feel bad and responsible if things go badly. Find care providers you trust. Have a partner you trust. Be flexible. Trust medicine. Deal with decisions and negative outcomes as they come, no sooner.