As a pelvic health trained clinician, I get questions about prolapse during pregnancy almost every week. If you dealt with prolapse symptoms after a first pregnancy, it's natural to worry about what a second (or third) pregnancy might bring. Let's talk through what prolapse actually is, how common it really is, and ,most importantly, what you can do about it.
What Is Prolapse?
Pelvic organ prolapse happens when one or more pelvic organs (bladder, uterus, or rectum) shift from their normal position because of changes in the pelvic floor muscles, ligaments, and connective tissue. Hormonal shifts during pregnancy affect these tissues too. Add in increased abdominal pressure and the growing weight of your baby - it's easy to see why prolapse symptoms are so common during pregnancy or why existing symptoms can feel more noticeable.
One thing I want to name clearly: how prolapse is often diagnosed is flawed. Lying on your back, being told to bear down, and being handed a diagnosis on the spot doesn't reflect how your pelvic floor actually functions in daily life - standing, moving, lifting, throughout the day. That's a conversation for another newsletter, but keep it in mind if you've ever felt like a diagnosis didn't match your lived experience.
The Numbers
Here's where I want to be careful with you, because the research is genuinely messy. Depending on how studies define and measure symptoms, reported prevalence of prolapse symptoms during pregnancy ranges anywhere from about 10% to 45%, and the risk does appear to increase with each subsequent pregnancy and vaginal delivery. Some studies show it climbing from around 10-20% after a first vaginal birth to closer to 30% after multiple births.
The wide range isn't a flaw in the research so much as a reflection of how differently prolapse gets defined, screened for, and reported across studies. What I want you to take from this: having symptoms doesn't mean you're broken, and it doesn't mean your organs are "falling out." It's a common response to the demands pregnancy places on your body.
Recognizing the Signs
Common symptoms of prolapse during pregnancy include:
- A feeling of heaviness, pressure, or "something coming down" in the pelvis
- A visible or palpable bulge at the vaginal opening
- Lower back and pelvic pain that worsens with prolonged standing
- Difficulty fully emptying your bladder or bowels
- Pelvic pain that builds throughout the day
- Discomfort (or pain) during intercourse
Mild versions of these symptoms are common during pregnancy simply because of increased pelvic pressure. But persistent or worsening symptoms deserve evaluation and support - ideally before you give birth - not after.
Risk Factors to Know
Research points to several factors that increase the likelihood of prolapse symptoms during pregnancy:
- Previous pregnancies and vaginal deliveries
- Being over the age of 35
- Carrying multiples (twins, triplets)
- Chronic constipation or a chronic cough
- A prior history of prolapse
- Genetic predisposition to connective tissue laxity (hEDS, EDS)
- Higher pre-pregnancy BMI
What Actually Helps
Ideally, you're working with a qualified pelvic health provider who looks at your whole body - not just your pelvic floor in isolation.
Pelvic Floor Muscle Training. Supervised, individualized pelvic floor training is one of the most well-supported interventions for reducing prolapse symptoms during pregnancy. The key word is supervised - this isn't about doing endless kegels on your own. It's about training that's specific to how your body is actually functioning.
Pessary Use. For symptomatic prolapse, a properly fitted vaginal pessary can offer real, meaningful support during pregnancy. Satisfaction rates with pessary use are generally strong across the research, often well above 70%, when the fit and follow-up care are right.
Strength Training. A strong body supports a strong pelvic floor. Emerging evidence suggests that appropriately programmed strength training during pregnancy may actually help reduce the severity of prolapse symptoms, not worsen them.
Nutrition. Well-rounded nutrition and hydration, with a real focus on preventing constipation. This matters more for prolapse symptoms than most people realize. Straining from constipation puts direct, repeated pressure on your pelvic floor.
Lifestyle. Toileting habits, stress management, and getting enough sleep all play a role. We hold a surprising amount of tension in our pelvic floor, especially when the rest of the body isn't being cared for.
When to Reach Out
Contact a pelvic health provider if you notice:
- New bulging or pressure sensations
- Difficulty with bladder or bowel function
- Persistent pelvic pain or discomfort
- Any change in your pelvic area that concerns you
Earlier intervention tends to lead to better outcomes and can help prevent symptoms from progressing.
What About Birth?
Current research suggests that people with prolapse during pregnancy can typically give birth vaginally without it worsening their prolapse symptoms. What matters most is having a birth team who understands how to support your pelvic floor through positioning, breathing, and perineal support during delivery.
Your Next Steps
If any of this resonates, here's where to start:
- Schedule a comprehensive pelvic health evaluation
- Learn more about how your pelvic floor actually functions
- Talk openly with your OB or midwife and birth team about your symptoms and your birth plan
- Consider joining my Empowered Pregnancy program (details below)
Prolapse during pregnancy is common, and for most people, it's manageable with the right support. You are not broken, and you're not alone in this.
Ready for More Support? Join Empowered Pregnancy
If you want real guidance (not just information, but a plan) - Empowered Pregnancy is a fully digital program combining birth prep education, a fitness program built for pregnancy, and nutrition support, all in one place.
What's included:
- Birth education + prep course (with resources you keep for life)
- A templated fitness + mobility program built for pregnancy
- Pelvic floor prep throughout pregnancy
- Nutrition resources
- Postpartum education (vaginal or cesarean-specific paths)
- A postpartum early rehab program
- Direct support from me via the app
- Weekly check-ins
๐ Learn more and join Empowered Pregnancyโ
I'm currently having a SUMMER SALE on this program - $50 off with code EMPOSUMMER
Not ready to commit? Schedule a free discovery call and let's talk about whether it's the right fit for you.
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With peace and love,
Dr. Ellyn Halley, DC, Doula, Coach
โDoc Halley Solutionsโ
Follow me on Instagram + TikTok for more content - ellynhalley.dc
In person chiropractic care! You can find me at 1500 Green Bay St, La Crosse WI 54601 within the same space as the Parenting Place and The Motus Project. I am excited to offer in person care to women in the Coulee Region, and offer hybrid care - in person + online. You can book your first appointment or schedule a consult below!
If you're looking for an "all in one" program that includes a prenatal exercise program, birth education, pelvic prep + mobility, nutrition information, and more - combined with regular support + check ins - I have you covered. Check out my Empowered Pregnancy program for incredible prenatal support. SUMMER SALE - $50 off with code EMPOSUMMER
Looking for more support around exercise, pelvic health, and nutrition (and birth prep if you're pregnant!)? Apply for 1:1 coaching with me:
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**Disclaimer: The content in this email is not intended to be medical advice. The content here is for informational purposes only. Please consult with your healthcare provider regarding any medical or health related diagnosis or treatment options.
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