“The Women’s Health Initiative found that more than 34% of women in the U.S. with a uterus had significant cystocele (bladder prolapse). The figure of 50% of all women who have given birth (experiencing some form of prolapse) is published widely in gynecologic literature. These statistics show that prolapse occurs far more often than any other women’s health disorder.” – Christine Kent
Let’s put it right out there: I have a postpartum bladder prolapse. Three vaginal births and a 14 inch head coming down the birth canal last month did the trick. A month-long chronic cough also helped pave the way back in January. Don’t get me wrong: Life is good, nonetheless. I’m one of the lucky women with no symptoms and a positive prognosis for healing. And, there have been challenges. The chronic, debilitating cough. The whole family sick again right after birth (including my four-day old newborn). Then there was the stomach bug (mine) in postpartum week three. Then there was another cold this past week (week four). Oh, and of course there was the high blood pressure news delivered up by my midwife alongside the newly acquired retroverted (tipped) uterus revelation. (Perhaps that is why those afterbirth pains were so excruciating?) Oh, and yes, the bladder prolapse. Did I mention the bladder prolapse?
Wow. Did you say prolapse? Yes: “a slipping forward or down of one of the parts or organs of the body.” (Although it actually isn’t a falling forward but rather a falling backwards). WHAT? There was dismay. Confusion. Distress. Even despair. I cried. Was my body failing me? There was worry. My husband tried to reassure me (based on the midwives’ assessment) that prolapse after a third birth is ‘normal.’ (But really, death and disease are ‘normal’ too and that doesn’t make it any easier, right?). Luckily, my midwife handed up sound advice: “Worrying is the worst thing you can do. You are sending negative energy to the very part of the body you are trying to heal.”
But wait: Why hadn’t I heard of this? Why was nobody talking about this? I vaguely recall hearing of prolapse occurring in older women. But 50% of all postpartum women? Me? According to the NAFC, one in five women will go through prolapse surgery in her lifetime. One in five?! NAFC also estimates that the number of women undergoing surgery to treat pelvic organ prolapse will increase by 48 percent between 2010 and 2050. Furthermore, 27 percent will have repeat surgery. And so it appears I’ve stumbled upon a quintessential women’s issue. A motherhood issue.
The emotions accompanying the reality of this experience swing all over the map. Two things I know as a constant truth: This is hard. And, this merits practice. This is about my body, our bodies. This is about shedding light on what wants to remain in the dark: personally and culturally. This is the very literal expression of depth, right here in the organs at the base of the body. First, there is the uncomfortable process of acceptance. Then, there is the confusion about what to do. There is the conflicting information. The surprising revelations. “Kegels are the only thing that will make it better,” my midwife says. But wait! The kegel actually might not work? In fact, it can make prolapse worse? But wait! What do you mean the field of gynaecology is based on a faulty 500-year-old understanding of female anatomy? Wait! Squatting regularly like our ancestors did helps? Oh, and carrying heavy loads on our heads like indigenous women serves the feminine lumbar spinal curve which keeps organs in their proper place? Oh, sitting on couches can make our pelvic muscles weak?
After several weeks of mulling, inner work, research and a trip to a physical therapist, I come away with several insights that I hope will serve the women and mothers reading:
1. Knowing our own bodies is essential. This shift in my body has elucidated how little I really know, and how much I take for granted. Each woman’s body is different. We need to find out for ourselves what is true of our own experiences. Believing everything we are told about our bodies doesn’t always serve us. Cultural patterns of disconnection and dissociation from the base of our bodies fuels bodily complications.
2. It is important to tend to the deeper emotions embedded in bodily experience. Our bodies are home to long-held psycho-emotional patterns and habits, either our own or inherited genetically. Birth too comes with its own imprints and associated bodily ‘traumas,’ even for peaceful, non-complicated births. Prolapse has pointed me to the ways in which my own body has been adversely affected as a result of my three births: pelvic bones out of alignment, tailbone tipped to the side, tissues rubbery from stress…
3. Self-reliance and trying to “hold it all together” is a bust. Tucking the tailbone, sucking in the stomach muscles, overly contracting the pelvic floor and trying to “hold it all together” doesn’t work. One vein of research addressing prolapse points me to the practice of softening the belly, deepening the breath, loosening the tailbone, and reconnecting with the natural feminine curve of the lumbar spine. Apparently the force of our deep breath coupled with good posture serves to maintain the proper position of our organs. As Christine Kent says, “Part of the graceful curvature that makes us women is the pronounced curvature of our lumbar or lower back spine. It is this curvature that allows our organs to stay to the front.” Instead of trying to “pull in,” stay “strong,” or “hold it together,” we can instead let the belly relax (postpartum pooch and all), be okay with ‘softness,’ and let go of trying to overly control situations in our lives. We can practice a relaxed trust in the female body’s natural alignment, even when that alignment is out of balance and things are asunder.
4. “Letting go” is key. My physical therapist tells me to ditch the kegels. “You don’t need more strength here. If you contract the pelvic floor muscles too much you will shorten them and eventually weaken them.” And – you guessed it: this can tip our organs out of place. “What you need is release.” We need to remember lengthening, letting go, releasing and relaxing, just as much as we are told to practice the contracting strengthening exercises. (Of course!) Kara sums it up well: “It’s easy to see how we heard Dr. Kegel telling us to squeeze, but we ignored that bit about releasing…who among us has an easy time “letting go?” That, right there, is what childbirth is all about: letting our body open up and let go. Open up and let go? Huh, what? No, letting go just doesn’t come naturally to us in our society. We can clench and squeeze and get nice and tightly wound, but ask us to let go?…The exercise of letting go is always a good one to practice in any aspect of life.”
The experience has ultimately led me to ask essential questions about my body and my broader existence. What is true of my own body and experience? What habits need tending so that I can be healthy into my later years? What do I need? Where do I need more support? Where do I need more strength? What is out of alignment? Where do I need to let go?
Once again, motherhood and birth deliver life-altering challenges that ultimately move me to new perspectives and make it impossible to ignore or dismiss the deeper layers of my human condition.