please help, questions about birthing after prolapse


I have a friend in Finland who just found out she has a prolapse and she is 36 weeks pregnant. I had two questions:
1) Would she be better of with a c-section???
I know that labouring can easily make things worse, although I have also heard cases where it did not make any difference for the prolapse. I have myself actually wondered why is that... Could the difference be in the kind of prolapse: i.e. if a woman has only uterine prolapse then the labor doesn't hurt her situtation so much, meanwhile maybe birthing is more harmful for rectocele and cystocele...? Anyone knows anything about this???
And can c-section do any harm for her prolapse???

2) If she has a vaginal birth, what is the best pushing position with prolapse???

THANK YOU SO MUCH!!! Hope I can get this info to her before too late...

I discovered prolapse after my second birth. My first birth was a c/s; my second birth was natural. I actually blame my c/s (see my post for compromising my pelvic area. I went on to have my third birth natural and I had no negative difference (see in fact, I rarely even notice the prolapse. As far as good birthing positions, you can see from my post I was standing! :) It's important to listen to the body and to follow its cue. To try to force yourself into a position to birth may not be wise because perhaps you need to move into a totally different position to help the baby get into the optimal position. Birth is really something that has to be lived and cannot be planned. Unless of course you schedule a c/s.

I find it interesting that she discovered prolapse at 36 weeks pregnant (though I've heard of this happening and I think sometimes it resolves itself after the birth) as with me all my organs were pulled up as the baby rose higher into the abdomen. I personally feel there are too many risks to mother and baby (prematurity, infection, materal or infant death) to have a c/s unless there is iminent danger to baby and since there has been nothing to prove that c/s will prevent further prolapse. We have women who have only have c/s births and prolapse, women who have never birthed who have prolapsed. Posture, good nutrition, and treating the body well are the best rememdies.

I can totally agree with what you say, it makes so much sense. And at the same time it really opens my wounds... I ... (crying...) remember how in my son's birth I wanted to be on my fours as I just felt that would be the best for me. But my doula (who is actually very accomplished midwife) did not let me to, because she thought the labor was not advancing well enough...
I had had EXCATLY the same moment in my first labor: fully dialeted but the baby did not descend. In Finland they told me not to push (I had no urge) as it wouldn't 'do any good before the baby has descended... Here in States my doctor with my midwife-doula had me pushing ever since the cervix was open... for 2 hours... It as SO HORRIBLE!!! ... When he actually was descended, I pushed him out ONCE.

So, excatly what Christine wrote in her article... It makes me cry, I feel so much rage... Not just because of the prolapse (there has been other factores too, I believe) but... I feel like they forced me to do things I didn't want to do which I also knew were not good for me!!! I blame myself (yep, I know I shouldn't...) why I didn't keep my mind... Emotionally this second birth has been traumatising... I am obiously not over it yet.

But I thank you Jane, I am very happy that you had such a wonderful third labor. It gives courrage... I do remember you from earlier, I had one question about getting pregnant one more time and you answered me at that time as well... thanks.

I don't excatly when she found out about her prolapse. I don't think it was now, 36 weeks pregnant (sorry my misleading writing).

I am just trying to help her, I don't really know her... I just gave my email info to a Finnish baby discussion site, so that anyone suffering from prolapse can contact me... This is because there is not very much info at all in there and not everyone knows English...
So I am a sort of mediator here...

There are so many women who have experienced traumatic births even when the outcome was good. It is really sad. Once I am certain that I am through having children, I am writing a letter to my former OB's practice and the local hospital (don't want to do it now, just in case I would have to transfer for care during another labor) about my success with homebirth and how all their regulations and caregivers created a situation whereby I could not sucessfully birth. Doctors really want to get the baby out now. Don't know if it's impatience or fear that the longer a woman labors the more likely a problem is to develop. It almost seems regardless, they will not comply with the mother's wishes. I know this is not true for all. But I have an acquaintance on the homebirth list who transfered to the hospital during her third labor. She had previously had two c/s and had really wanted a natural birth. However, she sensed something was wrong and went to the hospital. She told them she knew her uterus had ruptured and she wanted a c/s immediately. The nurses checked her, listened to the baby's heartrate (which was apparently fine), and told her she was dialated to nine and to just walk around and she'd vaginally deliver. They treated her like a child and were really condescending. They would not listen to her protests until an hour or more later, at which time they did a c/s to find her uterus had indeed ruptured and this time delay created a situation where her precious baby had died before the c-section. I get so angry at how their procedures, regulations, and just inability to trust the patient's instincts-- especially the instincts of a laboring mother-- create a system of victimization and injury. And sadly in this case death. Again, we really need to be in charge of our own care. You tried with a doula and I had a doula with my first birth too and she woefully let me down. That was a lot of money for nothing. During my second birth, my midwives had me pushing when I felt the urge, but not the "purple" pushing they were having me do. I love them dearly, but I do think we could have held off a little. The sensation was so different during my third birth when the urge to push was overwhelming and really I was alone (my dh was here, but I quit telling him what was going on :) except for the last ten minutes. I didn't have anyone else's fears of what might happen to deal with. I just had my body and my baby and what they instructed me to do.

Thank you for your question. I'm sure this thread rings lots of bells for lots of women.
I briefly add my thoughts:
No - your friend would not be better off for having a c-section, This may even contribute to prolapse as some stage.
In labour women often want to lean fwd, e.g. in cat, standing can be good too. Follow what feels right.
Take your time.
Don't push prior to having no choice but to push, unless there's a rock solid reason otherwise.
Dim lights.
Loving support…
We're mammals - and these are the conditions mammals birth best…

Thank you for your support of others. From the darkest times the light can shine.
I had a traumatic 1st birth and found prolapse traumatic - but it's taken me to this world of wonderful women and a happier whole-ier life.

Good luck, xwholewomanuk