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3.5 Minute

20-09-2024 Team Medicover woman-and-child

Written by Medicover Team and Medically Reviewed by Dr Akhila Lalam, Gynecologist

Uterine Prolapse After Childbirth Causes, Symptoms, and Treatment

Uterine prolapse is a condition where the uterus descends from its normal position into or outside the vaginal canal due to weakening of the pelvic floor muscles and ligaments. This condition commonly occurs after childbirth, especially following vaginal deliveries.

Understanding the causes, recognizing the symptoms early, and knowing the available treatment options can help women manage this condition effectively.

What Is Uterine Prolapse?

Uterine prolapse occurs when the uterus descends from its normal position in the pelvis into or even outside of the vaginal canal. This happens when the muscles and ligaments that support the uterus become weakened or stretched, often as a result of pregnancy and vaginal childbirth.

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Stages of Uterine Prolapse

Uterine prolapse is classified into stages based on how far the uterus has descended into or beyond the vaginal canal. The stages help determine the severity of the condition and guide treatment options:

Stage 1 (Mild Prolapse)

The uterus has dropped slightly but remains well within the vaginal canal. The cervix is still high inside the vagina, and symptoms may be minimal or absent.

Stage 2 (Moderate Prolapse)

The uterus descends further and the cervix approaches the vaginal opening. Some women may feel a bulge or pressure but it usually does not protrude outside the vagina.

Stage 3 (Advanced Prolapse)

The uterus protrudes outside the vaginal opening or is visible at the entrance of the vagina. Symptoms like discomfort, pain, and urinary problems become more noticeable.

Stage 4 (Complete Prolapse or Procidentia)

The uterus completely protrudes outside the vaginal opening. This severe stage often requires surgical treatment and can cause significant discomfort and complications.

Causes of Uterine Prolapse After Childbirth

Childbirth is one of the primary risk factors for uterine postpartum prolapse, particularly vaginal delivery, which can strain the pelvic floor muscles.

Some key causes include:

Pelvic Floor Muscle Damage: During delivery, the pelvic muscles and connective tissues stretch and sometimes tear, weakening their ability to support the uterus.
Multiple Vaginal Births: Women who have had several vaginal deliveries are at higher risk due to repeated strain on the pelvic structures.
Prolonged Labor or Difficult Delivery: Extended labor or the use of forceps/vacuum can increase the chance of trauma to the pelvic floor.
Large Baby or Multiple Births: Delivering a large baby or twins increases pressure on pelvic muscles.
Aging and Hormonal Changes: Postpartum hormonal shifts and aging reduce tissue elasticity, exacerbating prolapse.
Other Contributing Factors: Chronic coughing, obesity, heavy lifting, and constipation can increase pelvic pressure and worsen prolapse.

Symptoms of Uterine Prolapse After Childbirth

The symptoms of uterine prolapse vary depending on the severity but often include:

Sensation of Heaviness or Pulling: Many women feel a dragging sensation in the pelvis or lower back.
Bulge or Lump in the Vaginal Area: In more severe cases, a noticeable protrusion may be felt or seen at the vaginal opening.
Discomfort or Pain: This can occur during walking, standing, or sexual intercourse.
Urinary Problems: Difficulty urinating, frequent urination, or urinary incontinence can arise.
Bowel Issues: Constipation or difficulty with bowel movements may occur.
Lower Back Pain: Persistent pain in the lumbar region is common.
Recurrent Vaginal Infections or Irritations: Due to exposure and poor drainage.

Diagnosis of Uterine Prolapse After Childbirth

A pelvic exam by a healthcare provider is usually sufficient to diagnose uterine prolapse. The doctor will assess the position of the uterus, check for other pelvic organ prolapses, and evaluate muscle strength.

In some cases, imaging tests such as ultrasound or MRI may be used for further evaluation.

Treatment Options for Uterine Prolapse After Childbirth

Treatment depends on the severity of the prolapse, symptoms, age, and the woman’s desire for future pregnancies.

Conservative Treatments

Pelvic Floor Exercises (Kegel Exercises): Strengthening pelvic muscles can improve mild prolapse and prevent progression.
Pessary Devices: A vaginal pessary is a removable device inserted into the vagina to support the uterus and relieve symptoms.
Lifestyle Modifications: Managing weight, avoiding heavy lifting, treating constipation, and controlling chronic cough can reduce pressure on pelvic muscles.

Medical Treatments

Hormonal Therapy: Estrogen therapy may be recommended for postmenopausal women to improve tissue health and elasticity.

Surgical Treatments

For moderate to severe prolapse or when conservative methods fail, surgery might be necessary.
Uterine Suspension: Restores the uterus to its proper position by reinforcing ligaments.
Hysterectomy: Removal of the uterus may be considered in cases where other surgeries are not suitable or desired.
Pelvic Floor Repair: Repair of muscles and tissues to strengthen pelvic support.

Prevention of Uterine Prolapse After Childbirth

Pelvic Floor Training: Starting Kegel exercises during pregnancy and continuing postpartum can help maintain muscle strength.
Healthy Weight Maintenance: Avoid excess weight gain to reduce pelvic pressure.
Proper Labor Management: Skilled obstetric care can minimize prolonged or traumatic deliveries.
Avoid Heavy Lifting: Especially in the postpartum period, avoid activities that strain the pelvic floor.
Manage Chronic Conditions: Control coughing, constipation, or any factors increasing abdominal pressure.

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When to See a Doctor?

You should see a doctor if you notice any of the following symptoms, especially after having a baby:

A feeling of heaviness or pressure in your lower belly or Pelvic Pain area
A bulge or something sticking out of your vagina
Pain or discomfort when walking, standing, or during sex
Problems with urinating, like difficulty going, frequent urges, or leaking
Trouble with bowel movements, such as constipation
Ongoing lower back pain
Frequent vaginal infections or irritation

If you experience any of these symptoms, it’s a good idea to talk to your healthcare provider. Early treatment can help you feel better and prevent the problem from getting worse.

Frequently Asked Questions

Normal postpartum discomfort usually improves over time. Uterine prolapse causes persistent pelvic pressure, a vaginal bulge, and urinary or bowel problems that don’t go away and need medical attention.

If you notice symptoms like pelvic heaviness or a vaginal bulge, see a healthcare provider promptly. Early diagnosis through a pelvic exam helps manage the condition and prevents it from worsening.

Women who have had vaginal births, especially multiple or difficult deliveries, are more likely to develop prolapse. Age, obesity, chronic coughing, and heavy lifting also increase the risk.

Uterine prolapse can range from mild discomfort to severe symptoms affecting daily life. Severe prolapse may cause pain, infections, and urinary or bowel difficulties that require treatment.

If untreated, prolapse can worsen over time, causing increased pelvic discomfort, urinary and bowel problems, infections, and interference with daily activities and sexual function.

Yes, uterine prolapse can recur after treatment, especially if risk factors such as weak pelvic muscles or heavy lifting persist without proper management.

Strengthen pelvic floor muscles with exercises, maintain a healthy weight, avoid heavy lifting, manage chronic cough or constipation, and seek proper care during childbirth.

Mild prolapse can improve with pelvic exercises and lifestyle changes. Vaginal pessaries help support the uterus, while severe cases may require surgical treatment.

Look for pelvic heaviness, a vaginal bulge, discomfort during activity, or urinary/bowel issues. A healthcare provider can confirm diagnosis with a pelvic exam.

Rest well, avoid heavy lifting, keep the area clean, do gentle pelvic floor exercises as advised, eat nutritious foods, and attend postpartum checkups to ensure proper healing.

After delivery, the uterus is enlarged and begins to contract to return to its normal size. This process, called involution, can take about 6 weeks and may cause cramping.