Postpartum Prolapse

When 34-year-old Hannah first noticed a deep pelvic heaviness a few weeks after giving birth, she did what many new mothers do: she dismissed it. “Everything down there feels weird after a baby,” she told herself. But the sensation didn’t fade. Some days it felt like pressure; other days it bordered on a bulge. On a warm Tuesday afternoon, while carrying her infant in a car seat across the driveway, she felt a sudden drop – an unmistakable shift.

“I thought something was literally falling out,” she said.

Her midwife’s response was immediate: this sounds like pelvic organ prolapse.

The words landed with surprise, fear, and a bewildering sense of déjà vu: how had she never heard of this?

Hannah’s experience reflects a quiet trend unfolding across postpartum care – a condition that is medically common, personally distressing, and socially invisible.

A Condition Few Talk About, Yet Millions Experience

Postpartum prolapse – a form of pelvic organ prolapse after birth, occurs when the pelvic floor muscles and connective tissues no longer provide adequate support, allowing pelvic organs such as the uterus, bladder, or rectum to shift downward. For some women, symptoms appear immediately. For others, they emerge months or even years after childbirth.

Despite affecting an estimated half of all women at some point in their lives, prolapse remains one of the least-discussed postpartum conditions.

Lauren Ohayon, founder of Restore Your Core® and a widely consulted expert on postpartum pelvic floor recovery, says uncertainty around the condition fuels stigma and confusion:

“There are thousands of women who get a prolapse seemingly out of nowhere or they had a birth and had a prolapse, but was it the birth? Was it the pregnancy? Was it… who knows? So, it can be hard to know what caused your prolapse.” – Lauren Ohayon

Her framing captures a central truth: while childbirth is often involved, postpartum prolapse rarely has a single identifiable cause.

What Postpartum Prolapse Actually Feels Like

Women who develop prolapse after childbirth often describe symptoms that range from mildly distracting to life-altering. Among the most commonly reported:

A persistent pelvic heaviness

Bulging or a feeling of “something dropping”

Difficulty keeping a tampon in

A dragging sensation during or after activity

Lower back or pelvic discomfort

Trouble fully emptying the bladder or bowels

These symptoms – core indicators among the signs of postpartum prolapse – can fluctuate throughout the day, and often worsen after long periods of standing, lifting, or carrying a baby.

Yet even with pronounced symptoms, many women wait months before seeking help.

Why It Happens: Birth Is Only One Piece of the Story

Although vaginal delivery increases the likelihood of prolapse, clinicians emphasize that many factors contribute. Research points to a complex interplay of:

Pregnancy-related load on the pelvic floor

Genetics, particularly connective tissue elasticity

Chronic constipation or straining

Heavy lifting in the early postpartum months

High-impact exercise before the pelvic floor has recovered

Hormonal shifts, especially during breastfeeding

This variability makes it difficult for new mothers to answer a question frequently typed into search bars: how to know if you have prolapse after childbirth.

There is no single moment, movement, or mistake that “causes” postpartum prolapse.

The Late-Onset Pattern No One Warns Mothers About

One of the most misunderstood aspects of prolapse is its timing. Symptoms do not always appear at the six-week checkup. In fact, many women report feeling perfectly fine for months before a familiar scenario unfolds: picking up a toddler, sprinting after a stroller, returning to running, or coughing through a cold.

That’s because the postpartum body continues to reorganize long after the initial recovery window. Hormones shift. Core coordination rebuilds. Daily loads change. The postpartum pelvic floor – already stretched and fatigued – may struggle to adapt without adequate support.

The delayed onset often leaves women questioning their own role:

Did I lift too soon? Exercise incorrectly? Push too hard?

Experts say the answer, overwhelmingly, is no.

The Psychological Cost of a Condition Cloaked in Silence

While the physical symptoms can be unnerving, the emotional impact of postpartum prolapse often runs deeper.

From interviews with women navigating prolapse, certain themes appear repeatedly:

Fear of worsening the condition

Embarrassment discussing symptoms

Anxiety about sexual activity

Distrust of their own bodies

A sense of isolation, even among friends who’ve had children

The lack of open, public conversation has created a vacuum where fear fills the silence. Many women turn first to Google – rarely a comforting strategy – and find conflicting advice ranging from “avoid all lifting” to “just do Kegels,” neither of which reflects the complexity of the pelvic floor.

The Good News: Prolapse Is Far More Treatable Than Most People Realize

Although prolapse can sound daunting, specialists emphasize that symptoms often improve dramatically with the right approach.

Pelvic Floor Physical Therapy

Regarded as the gold standard in care, pelvic floor PT can teach women to:

Re-coordinate their core and diaphragm

Address underlying tension (not just weakness)

Manage internal pressure during daily movement

Lift, carry, and exercise without symptom flare

The nuance is important: many women assume a weak pelvic floor is always the issue, but a significant subset develops postpartum prolapse symptoms from a pelvic floor that is overactive, tight, or unable to relax – making self-diagnosis tricky.

Breathwork and Pressure Management

Techniques that improve breathing patterns reduce downward pressure on the pelvic organs. This includes calming habitual “sucking in,” breath-holding, and abdominal bracing – patterns common in new mothers.

Smart Strength Training

Specialized programs – like Restore Your Core® – focus on strengthening through coordinated, whole-body movement rather than isolated pelvic squeezing. These approaches help rebuild stability without overwhelming recovering tissues.

Lifestyle Adjustments

Small habits have outsized impact:

Exhaling with exertion

Avoiding constipation

Adjusting lifting mechanics

Reducing all-day pelvic gripping

Incremental changes often create early wins, restoring a sense of control.

When to Seek Evaluation

Medical experts recommend reaching out for assessment if you notice:

Persistent pelvic heaviness

A bulge or pressure at the vaginal opening

Difficulty with bowel or bladder function

Symptoms that worsen with activity

Fear or uncertainty about returning to exercise

Pelvic floor PTs, urogynecologists, and trained postpartum movement specialists can differentiate between normal postpartum recovery and true prolapse, and guide safe next steps.

A Quiet Truth Emerging in Women’s Health

Prolapse after childbirth is not a rare complication, it is a common outcome of a monumental physical event. The silence surrounding it has led many women to believe they are anomalies, or worse, that they are responsible for their symptoms. They aren’t. You aren’t.

With proper support, prolapse is manageable. Symptoms can improve. Function can return. Strength can rebuild. And many women go on to run, lift, hike, and live fully without fear.

Postpartum recovery is not linear, but it is absolutely navigable. And no one should have to navigate it in silence.