Pelvic organ prolapse (POP) can feel like a daunting diagnosis. And combining pregnancy with existing prolapse may deepen your concerns…
Is prolapse during pregnancy safe — for both you and your baby?
Will your POP get worse?
Will your pelvic floor ever recover?
It may help to know that millions of people experience POP. And plenty of them have perfectly healthy pregnancies and babies!
So, let’s talk about how to navigate prolapse during pregnancy.
First… Can You Get Pregnant With Pelvic Organ Prolapse?
The short answer is yes. Prolapse alone doesn’t cause fertility challenges. Especially with mild prolapse, you might not have any issues conceiving or carrying to term! While you certainly can get pregnant with an existing prolapse, getting there might be a little trickier. That’s because prolapse can make penetrative sex painful or difficult. Go easy on yourself.
Still, if you suspect you have a prolapse, have a chat with your health care provider right away.
Pregnancy with prolapse may carry certain risks depending on the type (uterine, bladder, rectal) and severity of your prolapse. Advanced stages of prolapse (stages 3 and 4) are associated with complications like preterm labor, cervical infection, or even miscarriage.1 It may also limit your birthing options.
I’m not sharing this information to frighten you, but only to stress the importance of having a candid conversation with your doctor. It’s likely they’ll want to keep a closer eye on you as you grow that baby.
For more advanced prolapse cases, multidisciplinary care — including urogynecologists, pelvic physical therapists, and your obstetrician — is important to make sure that both you and your baby stay healthy.3 The good news is, things like using a pessary — a silicone device that sits inside the vagina to keep your organs in place — during pregnancy can sometimes help reduce these risks while improving symptoms during pregnancy.4 And even if your prolapse is more advanced, vaginal delivery can be a safe option when managed appropriately!3
The Pregnancy-Prolapse Cycle
Pregnancies and prolapses can go hand in hand. All that extra pressure during pregnancy can strain your pelvic floor muscles and make them more prone to weakness. And weak pelvic floor muscles can’t support the pelvic organs as well as could before.
But pregnancy isn’t the only risk factor for prolapse. Things like chronic constipation, straining during movements, and genetics can all increase your risk. However, the biggest risk factor is vaginal birth — especially your first delivery or a forceps-assisted birth.5
Vaginal Delivery and Pelvic Organ Prolapse
Having POP does not automatically mean you need a cesarean section. Vaginal delivery is often possible, even if your prolapse is more advanced. However, cesarean delivery may still be recommended if you have certain obstetric indications or severe complications like uterine rupture or cervical laceration.
The key is getting proper care for your prolapse throughout your pregnancy.
So let’s talk about how to relieve some of that pressure!
4 Tips to Manage Pelvic Organ Prolapse During Pregnancy
#1 Consult your provider.
Talking with your healthcare provider, and seeking multidisciplinary expertise in addition to your OB can make a world of difference. Consider specialists like a urogynecologist and pelvic floor physical therapists — they can help you reach all of your pregnancy and birthing goals.
A pelvic floor physical therapist can assess your pelvic floor muscle strength, function, body mechanics, and even bowel health. They’ll collaborate with you and your healthcare team to help prevent your prolapse from worsening. They can also give you key recommendations for how to keep those muscles in tip-top shape throughout your pregnancy and beyond.6
#2 Use a support device.
Your pelvic floor PT might recommend some internal or external devices to give your pelvic organs the extra support they need. Pessary devices provide structural support and symptom relief during pregnancy. It’s important to use them as directed by your healthcare team. In some states, a pelvic PT can fit you for a pessary. You can also get one from your urogynecologist. Some over-the-counter options include Poise Impressa or Revive.
External support options for prolapse include:
#3 Exhale with exertion.
Proper breathing techniques reduce pressure on your pelvic floor during physical activity. Pay attention to your breathing during everyday movement. For example, most people hold their breath when lifting, pushing, or working out, which increases pressure on the abdominal muscles and pelvic floor.
Instead, when exerting any effort, minimize that pressure by exhaling. Exhaling with exertion decreases the pressure on your pelvic floor and the risk of pelvic organ prolapse.
#3 Poop properly.
Straining while pooping can put serious pressure on your pelvic floor, which can worsen prolapse symptoms. I highly recommend the Squatty Potty to get your muscles in prime pooping position and decrease pressure on the pelvic floor muscles.
Another great way to have healthy #2’s is to avoid constipation. And while constipation is a pretty common pregnancy woe, there are things you can do to help! Try these tips to keep your bathroom trips running more smoothly:
- Eat a high-fiber diet, including veggies, fruits, and whole grains.
- Use the bathroom when you need to, rather than waiting or stalling.
- Stay on the toilet only as long as you need to.
- Talk with your OB about different prenatal vitamins to take. They can help you choose one that meets your nutrient needs without worsening constipation from minerals like iron.
- Drink lots of water.
- Ask your doctor for a pregnancy-safe stool softener, fiber supplement, or magnesium recommendation.
And for those #1’s, don’t push your pee out. Just sit and let the flow of urine begin on its own.
5 Exercises for Pregnancy with Existing Prolapse
Any quick “Dr. Google” search might tell you that Kegels and other strengthening exercises are the way to fix a pelvic organ prolapse. But here’s the truth: In folks with POP, I see as much pelvic floor muscle overactivity as I do pelvic floor weakness. That means it’s equally important to work on relaxation as it is to work on strength.
#1 Diaphragmatic Breathing
Diaphragmatic breathing, or belly breathing, is unquestionably good for your pelvic floor and core. Often, though, we focus primarily on filling our lower belly as we inhale—which can put additional pressure on the pelvic floor and worsen symptoms of prolapse.
So when you practice belly breathing, think about expanding all the way around — not only into your low belly, but also into your rib cage and mid- and upper-back.
#2 Kegels in Quadruped
Kegels can be helpful for preparing your body for childbirth. In the case of POP, you’ll just want to practice them in a position that minimizes the pressure of your internal organs on your pelvic floor — namely, on your hands and knees. Beyond that, be sure you’re practicing Kegels correctly to get the most benefit from them.
#3 Modified Bridges
Bridges are good for your butt, and they’re gentle on your pelvic floor, even if you’re experiencing prolapse. When you’re pregnant, you’ll want to make one small modification: Practice with a pillow under your hips.
Lie on your back with your knees bent and your feet flat on the floor. Contract your pelvic floor muscles and lift your butt off the pillow until your hips are in line with your knees and shoulders. Hold for 3 seconds (exhale!), then gently lower down.
While you’re pregnant, limit lying on your back to 1 or 2 minutes. If you feel dizzy, lightheaded, or nauseous, turning onto your side will help relieve symptoms.
# 4 Puppy Dog Pose
As I mentioned, strengthening and relaxing are equally important for POP. This pose offers a nice deep stretch to help release pelvic floor tension.
Start on all fours, with your knees together. Gently walk your fingertips forward, while keeping your thighs vertical, and let your chest relax toward the floor. Lift your hips gently toward the ceiling. Relax in this position for 3 to 5 breaths.
Listen to your body! If this stretch feels uncomfortable, take a break.
#5 Take a load off
I realize rest isn’t technically an exercise, but in the case of POP, it counts. This is because standing for long periods of time can increase discomfort. Especially as your pregnancy progresses, being on your feet puts more and more pressure on your pelvic floor muscles. So, strike a good balance between activity and rest.
We’re here for you.
Pregnancy with existing prolapse requires individualized care and attention but is entirely manageable with proper support systems in place. If you’re looking for expert guidance, check out the V-Hive’s Pregnancy Support Program. You’ll find evidence-based resources and expert-led prenatal exercises designed to support your body — and your prolapse — through pregnancy and beyond.
Start today with a free trial membership and get instant access to everything you need for a stronger, more supported pregnancy!
Sources
- Atiligan, A.E., et al. (2020). Pregnancy with preexisting total uterine prolapse. Clinical Medical.
- Shqara, A.R., et al. (2024). A multidisciplinary approach for treating women with pelvic organ prolapse in pegnancy: A series of eight women. Isr Med Assoc J.
- Cigna Healthcare. (2024). Gellhorn pessary.
- Deprest JA, et al. (2022). International urogynecological consultation (IUC): pathophysiology of pelvic organ prolapse (POP). Int Urogynecol J.
- Pratiwi, H.A. (2025). The association between pelvic floor exercise and the occurrence of urinary incontinence in postpartum women: A literature review. World Journal of Advanced Research and Reviews.
Further Reading
Iglesia, C. (2021, December). 5 things I wish all women knew about pelvic organ prolapse. ACOG. Retrieved from https://www.acog.org/womens-health/experts-and-stories/the-latest/5-things-i-wish-all-women-knew-about-pelvic-organ-prolapse
Mohamed-Suphan, N. and Ng, R. (2011, October) Uterine prolapse complicating pregnancy and labor: a case report and literature review. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22037938/
Vargas, B., et al. (2022). Management of pelvic organ prolapse during pregnancy: Case report. Case Rep Women’s Health.
