Frayed: Reclaiming My Body After Pelvic Organ Prolapse
Imagine the elastic band on an old pair of stretchy pants that you’ve stretched beyond their usual limits one or three too many times. Eventually, the once-taut band doesn’t bounce back. Your pants sag tenuously at the thickest part of your hips. The elastic frays. The pants, once so snugly framing your curves and neatly draping over your thighs, now pucker and bulge in directions that defy your understanding of the laws of physics.
Now imagine that elastic band is your vagina.
If it is, you’re in good company. All vaginas ultimately experience some degree of degraded elasticity. For about 50% of people with vaginas, this degradation will result in a very awkward type of hernia of the uterus, bladder, bowel, or vaginal vault into the vagina. The medical term for this condition is “pelvic organ prolapse.”
I had never heard of pelvic organ prolapse until 2017. A year before, I had given birth to my third child, second nine-pounder. Recovery from his delivery had taken a while: a second-degree tear required several layers of healing, and sex hurt for about six months. I thought I’d been trending toward normal until one October morning, reeling through my ordinary get-the-day-going chaos – get dressed, dress kids, feed kids, feed self, get older two to bus, get littlest in car seat, find phone keys wallet – when my vagina snapped.
The change in my anatomy was acute and instantaneous. I’d chugged my morning coffee. Taken my morning dump. And then, as I was standing up to pull my pants back on, I felt and heard it: a popping in between my legs. It didn’t hurt, but I clearly felt something new, somewhere it shouldn’t be. I was too terrified to immediately investigate, and spent the day walking around gingerly, trying not to waddle in the halls or writhe at my work desk or otherwise inadvertently reveal that I had what felt like a small soft squishy ball lodged into my retired birth canal.
Later that evening, I braved a look. Using a handheld mirror, I discovered what looked like a lump, or bulge, not quite protruding outside my vagina, but definitely opening the labial door wider than it had ever been outside the experience of pushing out a baby. I proceeded to Google. “Lump in vagina” resulted in a horrifying list of possibilities, amply fueling my pre-existing health anxiety. “Bulge in vagina” led me to the Mayo Clinic page on pelvic organ prolapse, which sounded pretty spot on.
The very next day, I saw my OBGYN. I had a rectocele, he told me, which is a prolapse of the lower bowel into the vagina: not dangerous, possibly uncomfortable, probably reparable. He referred me to a urogynecologist. “I’m sorry,” he said. “These kids.”
The most common cause of pelvic organ prolapse is vaginal childbirth. The push present I’d never wanted.
The urogynecologist to whom I was referred was confident she could fix the rectocele. But I wouldn’t be able to lift anything heavier than ten pounds for six weeks post-op, so she did not recommend surgery until my one-year-old could get in and out of his own car seat. Since the prospect of surgery terrified me, I appreciated the imposed delay. I also secretly hoped the prolapse would fix itself. From what I could tell, it just showed up one day, like a zit. Couldn’t it go away just as well?
The answer, it turned out, was no. Gradually, the bulge between my legs became the least disturbing of a cascade of mortifying symptoms. I began to feel a constant heaviness in my crotch, and worried my vagina was going to fall out. Carrying my son up the stairs or going for a run made it worse. Bowel movements became at first tricky, and eventually a major production. My stools would get stuck in the prolapse bulge I not-fondly called my “poop pocket”; I had to plunge my hand into my vagina to splint my bowel into a proper defecating position. The urinary stress incontinence I’d ignored since my eldest was born became un-ignorable. Tampons wouldn’t go in right. I was too self-conscious to enjoy foreplay and sex hurt.
Cue the inward spiral. Holding my baby or playing soccer with my older two felt hazardous. I feared exercise but also feared the health risks associated with not exercising. Experts only intensified the dilemma. One told me never to squat, while another encouraged squats: “How are you going to get off the toilet without squatting?” A third frowned as I explained the ache I’d feel during runs: “I just wish my patients would swim instead.” I was paranoid of using my body.
Days after my youngest turned three, I followed up with the urogynecologist, ready for my minimally invasive rectocele repair. After an exam, which included a catheter and excavation of areas I’d generally considered exit-only, the doctor sighed. “Your rectocele’s actually not gotten worse,” she offered, confusing me. She proceeded to explain: “Everything else has prolapsed. Unless you get a hysterectomy, a repair won’t hold.” Later, second and third opinions confirmed her prognosis. But that day, overwhelmed by the sting of the catheter – as well as anger at my body, resentment toward the small humans who’d unwittingly broken me, and frustration with the dearth of helpful prolapse information online – I could not handle her poor bedside manner and declined her future services.
Shortly thereafter, a pandemic happened. During the work-from-home era, my symptoms waned, presumably because I could tend to them in the privacy of my own home. No longer needing to jerry-rig a Squatty Potty in the office restroom, I got a break from the social anxiety aspect of prolapse, which had previously evaded notice. Also, the slow-down mandate gave me time to pay attention to my body. I learned that a whole slew of things aggravated my between-the-legs bulges: diet, alcohol, dehydration, hormones. Getting to know my physical self better allowed me to treat her with more compassion. I ended up managing my symptoms conservatively for far longer than I thought I could. But ultimately, Kegels and bone broth were not going to reverse five stage III hernias; aging and gravity were likely to make them worse. Six years after that initial pop, I found a new urogynecologist – with social as well as surgical skills – and I decided it was time for an overhaul.
In late October, I had a full pelvic floor remodel. As I write, I’m ten weeks post-op and I feel amazing.
Do I still wish that my body had bounced back after childbirth? That my netherparts had not frayed like a spent pair of stretchy pants? That I’d been informed of pelvic organ prolapse before my bowel moved into my vagina? Yes. But now, I can wish these things and at the same time love my body. Loving my body was what led me to choose surgery. And surgically reinforcing my most vulnerable parts – the parts that carried three children, that connect me to my partner, that clean me out and get me where I want to go – was an act of self-love. I hoped that surgery would resolve my most pronounced prolapse symptoms, and it did.
What I was too afraid to hope for was a body I no longer feared using. The physical and psychological toll of living with prolapse was massive. Recovering from the trauma of major surgery and adapting to a rearranged set of organs have allowed me to replace my stress and fear with hope. For the first time since 2017, I’m excited about my body, and proud of what it can do.
About the Author
Harper Hutchinson (she/they) reads, writes, and mothers in Minneapolis. Her poetry and prose appear in print and online in several small presses.
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