Pelvic Organ Prolapse in Pregnancy: What to Know

Q: Can pelvic organ prolapse happen during pregnancy, or only after birth?

Prolapse is more often noticed after birth, though pregnancy itself puts steady, growing load on your pelvic floor as your uterus gets bigger. This is why pelvic floor exercises during pregnancy, rather than waiting until after birth, are recommended as a way to help prevent it. If you notice any heaviness, pressure, or unusual sensation in the pelvic area while you are pregnant, mention it to your midwife or GP.

Q: How do I know if what I am feeling after birth is prolapse or normal postpartum recovery?

Some pelvic heaviness and discomfort in the early days after birth is expected as your body recovers. Signs worth raising with a healthcare professional include a dragging feeling that lingers, a sense of pressure or something coming down into the vagina, a bulge you can see or feel near the vaginal opening, changes to your bladder or bowel, or discomfort during sex. You do not need to be sure something is wrong before raising it. Your GP or midwife can assess and advise.

Q: Does having prolapse symptoms mean surgery will be needed?

The first approach for prolapse symptoms is non-surgical. Pelvic health physiotherapy, guided pelvic floor exercises, and a few lifestyle adjustments are the main routes for managing symptoms, and you may see real improvement through them. Around 1 in 9 women with prolapse will need surgery at some point in their lifetime. Getting assessed early gives you the clearest picture of where you are and what is likely to help.

Q: How do I access a pelvic health physiotherapist after birth?

You can ask your GP or midwife for a referral to a pelvic health physiotherapist. In some parts of England, Scotland, Wales, and Northern Ireland you can refer yourself, though this varies by location. The most reliable way to find out what is available near you is to ask at your postnatal appointment or check your local NHS service online.

A tired stressed pregnant woman resting at home.

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If you have come across pelvic organ prolapse and felt a quiet unease you could not quite place, that makes sense. It is a topic almost nobody explains clearly before birth, and the conversations tend to happen afterwards, if they happen at all. What prolapse means for your body during and after pregnancy, what it can feel like, and what you can do about it are all worth understanding now, in plain language.

What pelvic organ prolapse is and why pregnancy increases the risk

Pelvic organ prolapse (POP) is when one or more of the pelvic organs, your bladder, womb (uterus), or bowel, shifts down from its usual position and presses into the vagina. Your pelvic floor is a layer of muscles and ligaments that sits like a hammock at the base of the pelvis, holding those organs in place. When that hammock is weakened or overstretched, the organs it supports can move down.⁹

Pregnancy and childbirth are among the main things that can weaken the pelvic floor muscles and the supportive tissue around them. Prolapse affects around one in three women who have had children. That figure is worth knowing because it shows how common the experience is, and why a little awareness before birth genuinely helps.¹⁰

Prolapse exists on a spectrum, and around 1 in 9 women (11%) will need surgery for it in their lifetime. Still, if something doesn't feel right after birth, it's worth getting assessed rather than waiting.¹¹

Some things beyond childbirth can put extra pressure on the pelvic floor. Carrying extra weight places ongoing load on the supporting structures. Long-term constipation means repeated straining that builds up over time. A persistent cough or regular heavy lifting can have a similar effect. These are areas where small adjustments can take some strain off the pelvic floor alongside whatever else you are doing to support recovery.¹²

Pelvic floor exercises in pregnancy: the practical foundation

The most useful thing you can do during pregnancy to support your pelvic floor is to practise pelvic floor exercises regularly. Surveys suggest around one in four women have never done them.¹

Pelvic floor exercises, sometimes called Kegels, strengthen the group of muscles that support your bladder, womb, and bowel. The basic move is to squeeze and lift the muscles you would use to stop the flow of urine, and hold in wind, and hold for a few seconds, then let go fully. Doing this a few times a day, steadily through pregnancy, can make a real difference to how those muscles cope with late pregnancy and birth. Regular pelvic floor exercises are one of the main ways to help prevent and ease pelvic floor problems.²

A few general habits are worth building during pregnancy too. Staying ahead of constipation matters, because straining puts repeated pressure on the pelvic floor. Keeping stools soft with fibre and fluids takes some of that strain off. If you need to lift, it is worth asking your midwife about safe technique, since how you lift changes how much load travels through the pelvis.³

Symptoms to be aware of after birth

In the weeks after birth, you might notice a few sensations worth paying attention to. A dragging discomfort or a feeling of heaviness around your lower tummy and in the vagina is one of the more common ones. You might feel like something is coming down into the vagina, or like you are sitting on a small ball. You might notice a bulge or lump near the vaginal opening, or simply a pressure that was not there before. You might have no noticeable symptoms at all.⁴

Bladder and bowel changes can be a sign too. You might feel your bladder is not emptying fully, find yourself needing to wee more often, or notice a small leak when you cough or sneeze. You might find it harder to fully empty your bowels. Sex may feel uncomfortable, or you may notice less sensation than usual. If any of these turn up after birth, it is worth mentioning them to your GP or midwife rather than waiting to see whether they settle on their own.⁵

These sensations can shift through the day. They often feel stronger after you have been on your feet for a long stretch, then ease off when you lie down. That pattern of coming and going is a known feature of prolapse symptoms, so if you notice it, mention it when you speak to a healthcare professional.⁶

What physiotherapy can offer after birth

If prolapse symptoms do come on after birth, the first approach is non-surgical. A pelvic health physiotherapist can assess what is going on and put together an exercise programme suited to you. Supervised pelvic floor muscle training with a specialist physiotherapist is the main non-surgical route, and it can ease symptoms and improve how things work over time.⁷

If pelvic floor exercises feel hard to do on your own, or your symptoms are not improving, you can ask your GP or midwife for a referral to a pelvic health physiotherapist. In some areas you can also refer yourself directly, though this varies across England, Scotland, Wales, and Northern Ireland. Checking with your local NHS service or asking your midwife is the most reliable way to find out what is available where you are.⁸

If you have questions about your pelvic floor during pregnancy, your antenatal appointment is a good place to raise them. If symptoms turn up after birth, note when they happen and what they feel like, and bring that with you to your postnatal check or GP appointment.

Frequently Asked Questions

Can pelvic organ prolapse happen during pregnancy, or only after birth?

How do I know if what I am feeling after birth is prolapse or normal postpartum recovery?

Does having prolapse symptoms mean surgery will be needed?

How do I access a pelvic health physiotherapist after birth?

Sources

[1] Pelvic floor health

Surveys suggest around one in four women have never done pelvic floor exercises.
[2] Pelvic floor health

Pelvic floor exercises (sometimes called Kegels) work by strengthening the group of muscles that support your bladder, womb, and bowel. Guidance from the Royal College of Obstetricians and Gynaecologists supports pelvic floor exercises as a key way to help prevent and manage pelvic floor problems.
[3] Pelvic organ prolapse

Avoiding constipation matters because straining puts repeated pressure on the pelvic floor. Avoiding repetitive heavy lifting and seeking guidance on safe technique is worthwhile.
[4] Pelvic organ prolapse - NHS inform (Scotland)

A dragging discomfort or a feeling of heaviness around the lower tummy and genitals is one of the more common descriptions. Some people describe it as feeling like something is coming down into the vagina, or like sitting on a small ball. You might notice a bulge or lump at the vaginal opening. Some women have no noticeable symptoms at all.
[5] Pelvic organ prolapse - NHS inform (Scotland)

You might feel your bladder is not emptying fully, find yourself needing to urinate more often, or notice a small leak when you cough or sneeze. Difficulty fully emptying your bowels is another possible sign. Sex may feel uncomfortable or less sensation than usual.
[6] Pelvic organ prolapse

Symptoms may be more noticeable after you have been on your feet for a long time and ease off when you lie down. That pattern of fluctuation is a known feature of prolapse symptoms.
[7] Pelvic organ prolapse (POP)

If prolapse symptoms do develop after birth, the first approach is non-surgical. A pelvic health physiotherapist can assess what is happening and put together a tailored exercise programme to help. Supervised pelvic floor muscle training with a specialist physiotherapist is the primary non-surgical route for managing prolapse.
[8] Pelvic organ prolapse (POP)

If pelvic floor exercises are difficult to do on your own, or your symptoms are not improving, you can ask your GP or midwife for a referral to a pelvic health physiotherapist. In some areas it is also possible to self-refer directly, though availability varies across England, Scotland, Wales, and Northern Ireland.
[9] Pelvic organ prolapse - NHS inform (Scotland)

Pelvic organ prolapse is when one or more of the pelvic organs shifts down from its normal position and presses into the vagina. The pelvic floor is a layer of muscles and ligaments that sits like a hammock at the base of the pelvis, holding those organs in place.
[10] Pelvic organ prolapse

Pregnancy and childbirth are among the main factors that can weaken the pelvic floor muscles and the surrounding supportive tissue. The condition affects around one in three women who have had children.
[11] Pelvic organ prolapse

NHS guidance indicates that around 1 in 9 women (11%) will ever need surgery for prolapse in their lifetime.
[12] Pelvic organ prolapse

Excess weight places ongoing load on the supporting structures. Chronic constipation means repeated straining that compounds over time. A persistent cough or repetitive heavy lifting can have a similar effect.