There is a growing whisper, a chorus of birthing people, threatening to become a roar. The loudest of us are those who are fed up with bounce back culture, and apathy around the physical and emotional struggles that can accompany pregnancy, birth, and raising a child. Among them, there is a woman who struggles with what feels like the betrayal of her own body. A woman who has pelvic organ prolapse (PoP), a condition an astonishing number of people know nothing about. That woman is me.
Although 3% of U.S. women–over 3 million women—experience pelvic organ prolapse in their lifetimes, it wasn’t until 2020 that I learned more than I ever wanted to know about the pelvic floor: 34 years in to owning a vagina. This learning started in the shower when, a few days after giving birth vaginally to my beautiful baby, I noticed a bulge at my vaginal opening. Still soaked, I called the ObGyn who had followed my pregnancy. She brushed me off and told me to wait six weeks and request a referral to pelvic floor physical therapy. Though quick to provide the referral, my primary care doctor had a similar reaction.
None of the medical professionals really seemed concerned about how I felt about my PoP, and how it was affecting my self-image and quality of life, even months after my body was supposed to have healed. Inside, I moved between moments of panic, despair, and feeling guilty for having those feelings, considering how much worse off other women sometimes fared post-birth. I couldn’t jump, I couldn’t walk long distances (I have always been an avid walker), yoga—which used to bring me such comfort—was a humiliating reminder of my PoP (many poses can cause air to become trapped in your vagina and then escape.) I was scared, frustrated, and SO uncomfortable from the constant urge to pee and a hanging/pulling sensation.
PT helped some, but I spent so much time doing Kegels and other exercises, only to have my symptoms come roaring back as soon as I was back work, sitting and standing behind a desk for 8-10 hours a day. The best my PT had to offer was encouragement to “keep up with exercises” and “ask about surgery” once I was sure I didn’t want more children. I dug deep into the pelvic floor PT space on social media and joined closed online groups of women struggling with PoP. This helped, but it also broke my heart: women with PoP talked about urinating on themselves while playing with their children. Other women described having to insert their fingers into their vagina in order to have a bowel movement, and some women felt they would never be able to enjoy sex—or their lives—again. And it wasn’t just a few women. One group had 22,000 members; another had 16,000.
It has been more than two years since I gave birth, and while I am grateful that PoP is not life-threatening and that I was able to access a pessary (something else related to PoP that people, including many medical providers, seem to know little about—look it up) and identify ways to control my symptoms, I still have bad days. And two years out, I and certain that once my partner and I make a final decision about whether to have more kids, I want corrective surgery. In other words, PoP is not a minor discomfort.
I think about it every single day because I can feel it every. single. day. It feels like a betrayal that not a single advocate for women’s health and rights (that I know of) has dedicated any significant attention or writing to this issue. And it was demoralizing to join a well-known postpartum fitness program where I was living at the time, only to be encouraged to do burpees and other not-PoP friendly exercises. (It’s also problematic, given that almost half of women who have given birth develop PoP at some point.) I am 36 and have identified as an intersectional feminist for nearly half my life. I developed and implemented comprehensive sexuality education programming and have a master’s degree in public health. Not one of the scholars, advocates, or feminist activists I’ve met or whose work I read is talking about this issue. Is it any surprise I was also ignorant until it happened to me?
And a part of me understands why. Why would people in the United States, where I live, dedicate time to this quality-of-life issue when our country is ground zero for maternal mortality among developed nations; when the disparities, driven by the realities and legacies of white supremacy, are literally stealing a disproportionate number of Black women and their infants from their families? In a country where we no longer have the constitutional right to bodily autonomy and feminists are rapidly organizing to ensure every person has access to safe abortion care, who would take the time to talk about the fact that 3 million people’s pelvic organs are hanging outside their bodies by various degrees? But as the self-described “Black, lesbian, mother, warrior, poet” Audre Lorde said, “There is no thing as a single-issue struggle because we do not live single-issue lives.” And so, I believe that this issue can and must be a point of advocacy—alongside efforts to advance racial, gender, and economic justice–and I also believe (and research is revealing) that the disparities in who has access to the resources needed to treat PoP fall along racial and class lines. There are so many of us who can add our voices to the to this chorus, and we will not be silenced.
*For this piece, I was asked to share one initiative I love and want to highlight. Sadly, I haven’t found any PoP-focused initiatives that I feel approach this issue with a justice and equity lens, so I’m hesitant to name the handful I came across. I am hopeful that groups like Chamber of Mothers will be successful in securing federal paid family and medical leave, because it is inhumane that there are birthing people navigating PoP who are denied the time they need to heal, find answers, and care for and bond with their infant. I am so grateful to Ninti for allowing me the space to talk about this issue on their platform and encouraging you to learn more about their groundbreaking approach to improving awareness and support on women’s health issues in the workplace.