Stage 1 Prolapse After Birth: Exactly What You Need to Know
If you found your way here, there's a good chance you've recently been told you have a stage 1 prolapse after birth, or you're worried that you might. First, take a deep breath. Pelvic organ prolapse can sound scary postpartum, and I know that hearing the word "prolapse" often sends people straight to Google, which usually makes things feel even more overwhelming.
So, I'm going to pretend you're sitting in my treatment room, and I'm going to tell you everything I know about stage 1 prolapse after birth. My goal is that by the end of this blog, you'll feel much more at ease and, more importantly, you'll walk away with a list of tangible action items you can start implementing to help reduce the symptoms you're currently experiencing.
One of the biggest mistakes I see is women being told to simply wait it out…. While time certainly plays a role in postpartum healing, there are also specific things you can do to improve your symptoms and build confidence much sooner. That's exactly what we'll cover in this blog.
What Is Stage 1 Prolapse?
Pelvic organ prolapse is the descent of one or more pelvic organs into the vaginal canal.
There are several different types of prolapse depending on which organ is involved:
Uterine prolapse: the uterus descends into the vaginal canal.
Cystocele: the bladder descends into the vaginal canal.
Rectocele: the rectum descends into the vaginal canal.
Urethrocele: the urethra descends into the vaginal canal.
Enterocele: the small intestine descends into the vaginal canal.
Pelvic organ prolapse is graded on a scale from 1 to 4.
A stage 1 prolapse is the mildest form of prolapse. There is only a small amount of descent of the pelvic organ(s).
With a stage 2 prolapse, there is a greater degree of descent.
A stage 3 prolapse means the pelvic organ has descended to the entrance of the vagina but is not protruding outside of it.
A stage 4 prolapse is the most severe stage, where the pelvic organ is protruding outside of the vaginal opening.
The important thing to know is that if you've been diagnosed with stage 1 prolapse after birth, you have the least severe stage of prolapse. While the diagnosis can sound intimidating, understanding what stage 1 actually means is the first step toward knowing what you can do about it.
Why Prolapse Can Happen After Birth
First, I want you to know that pelvic organ prolapse is incredibly common after having a baby.
Some studies report that 40–60% of postpartum women have some degree of pelvic organ prolapse. The reassuring part? Only 3–6% of women actually have symptoms from it. In other words, seeing some degree of prolapse on an examination does not automatically mean it will affect your daily life.
The strongest modifiable risk factor for pelvic organ prolapse is vaginal birth, and the risk increases with subsequent vaginal deliveries. Research also shows that having a C-section is protective against pelvic organ prolapse compared to vaginal birth.
Other risk factors include:
Chronic constipation
Obesity
Connective tissue disorders
A larger genital hiatus (a larger vaginal opening)
While these risk factors can increase your chances of developing prolapse, they don't determine how you'll feel or whether you'll have symptoms. Many women with a stage 1 prolapse go on to feel completely normal, especially with the right education and rehabilitation.
Common Signs and Symptoms
The most common symptom of pelvic organ prolapse is a feeling of pelvic heaviness or pressure. Many of my patients describe it as feeling like something is about to fall out of the vagina, and that's probably the most common description I hear in the clinic.
Depending on which pelvic organ or organs are involved, you may also experience:
A feeling of incomplete bladder emptying
A feeling of incomplete bowel emptying
Low back pain
With more advanced stages of prolapse, you may be able to see or feel a bulge at the vaginal opening.
One thing I always tell my patients is to pay attention to when their symptoms occur. Prolapse symptoms are typically better first thing in the morning after you've been lying down all night. As the day goes on, gravity places more stress on the pelvic organs, so it's very common for symptoms to become more noticeable by the afternoon or evening.
How Stage 1 Prolapse Is Diagnosed
Pelvic organ prolapse is diagnosed during a physical examination. As a pelvic floor physical therapist, I cannot formally diagnose prolapse, but I can recognize it, treat it, and refer you to the appropriate provider if needed.
For most people, a stage 1 prolapse is treated with pelvic floor physical therapy, regardless of who makes the diagnosis.
The examination is typically performed as an internal vaginal examination while you're lying on your back. In some cases, I'll also perform a standing vaginal assessment if I need more information to guide your treatment plan.
If you're nervous about an internal examination, I've written an entire blog explaining exactly what to expect during a pelvic floor examination. You can read that here.
One question I get fairly often is whether prolapse shows up on imaging. In most cases, it does not. Pelvic organ prolapse is typically diagnosed during an internal vaginal pelvic floor muscle examination, not on imaging.
Can Stage 1 Prolapse Improve?
This is probably the question I get asked most often, and my answer is that we have to separate structural prolapse from symptomatic prolapse.
Structural prolapse
Whether the actual stage of your prolapse changes depends on why the prolapse is there in the first place.
Sometimes the primary issue is the pelvic floor muscles and the support they provide. Other times, it's the ligaments that support the pelvic organs. If the prolapse is primarily related to the ligaments, that's not something I can restore. What I can do is teach you how to minimize the things that cause prolapse to progress and help keep it from getting worse.
Symptomatic prolapse
The symptoms of stage 1 prolapse after birth can absolutely improve.
In fact, I experienced a symptomatic prolapse after I gave birth to Ace, and I treated it myself with exercise. Today, I don't worry about it.
Recovery is absolutely realistic if you're willing to commit to reducing straining, improving your single-leg stability, and improving your core coordination.
This is also why I encourage my patients not to get too caught up in the stage of their prolapse. A stage 1 prolapse is very mild. If we're talking about a stage 4 prolapse, my concerns are different. But with a stage 1 prolapse, our focus shifts away from the number and toward your symptoms. My goal is to help you manage those symptoms so you can get back to doing whatever activities you want to do.
One other question I get all the time is, "Can I still have more children if I have a prolapse?" The answer is absolutely yes. I've written an entire blog on pregnancy with an existing prolapse, which you can read here.
Pelvic Floor Exercises and Rehabilitation
I'll give you a little insight into what pelvic floor physical therapy for stage 1 prolapse after birth typically looks like.
At your first visit, we'll spend time talking before we do anything else. We'll discuss what's driving your symptoms, the activities you enjoy, and what you want to be able to do without pelvic floor symptoms. Then we'll perform an internal examination to assess for prolapse and determine what else may be contributing to how you're feeling.
Before you leave, you'll have an initial home exercise program.
For most people, we start with the basics: getting your core muscles working together again and addressing constipation if it's present. In fact, many of my patients notice a significant reduction in their prolapse symptoms simply by improving constipation. Once we've reduced unnecessary straining, we can use exercise to fine-tune the rest.
One of the first things I teach is pressure management. I teach you how to inhale while allowing your pelvic floor to lengthen, then exhale while coordinating your core and pelvic floor to engage together. I commonly see patients doing the exact opposite before they start physical therapy, so learning this coordination can make a big difference.
I consider these the foundation of rehabilitation. Once you've mastered the basics, we progress your program to include more functional exercises like single-leg stability, glute strengthening, and other movements that help you return to the activities you enjoy with confidence.
Daily Habits That Support Recovery
The good news is that some of the biggest improvements often come from the small things you do consistently every day.
Here are the daily habits I encourage my patients to focus on:
Avoid straining. Whether you're having a bowel movement or lifting something heavy, reducing unnecessary strain on your pelvic floor is one of the best things you can do.
Treat constipation. Constipation is one of the biggest drivers of prolapse symptoms that I see. Improving your bowel habits alone can make a noticeable difference.
Exhale when you lift. Whether you're picking up your baby's car seat, carrying your toddler, or lifting something around the house, exhaling during the effort helps with pressure management.
Return to exercise gradually. I like to emphasize glute strengthening as you build back into your regular exercise routine.
Take breaks if you're symptomatic. If you notice your symptoms getting worse throughout the day, try lying down with your legs elevated up the wall for a few minutes. Giving gravity a chance to work in your favor can help reduce that feeling of heaviness or pressure.
None of these habits are meant to keep you from living your life. They're simply small adjustments that can help reduce symptoms while you continue getting stronger.
When to Seek Professional Help
If you've given birth and you're postpartum, I genuinely believe it's beneficial to have a pelvic floor assessment. Whether you're having symptoms or not, there's almost always room to improve your core strength, glute strength, pelvic floor coordination, and overall movement.
If you're experiencing symptoms like pelvic heaviness, pressure, leakage, or prolapse, it's even more important to get checked out.
One of the hardest parts of the postpartum period is that so much of your identity changes. The last thing I want is for pelvic floor symptoms to keep you from doing the things you love. Whether that's exercising, chasing your kids around the backyard, running, lifting weights, or simply getting through your day comfortably, those are the things we're working toward together.
If you're local to Northeast Texas, we'd love to help. We are currently accepting new patients in Sulphur Springs, Canton, and Rockwall.
To schedule an appointment, call our office at 903-962-2600 or
, and Landry or another member of our team will get you taken care of.
You don't have to just live with prolapse symptoms because someone told you they're "normal after having a baby." There are things you can do, and we'd love to help you get back to feeling like yourself again.
