My current status - all good

I'm still breastfeeding, almost 14 months after birth. But my pubic symphysis is 99% back to normal. I didn't say 100% because when I'm extremely tired or sick, there can still be some pain in pubic symphysis area. If I walk toooooo much, I can feel it too. But that's only minor compared to my back pain. And I really can live with my back pain now, so I would say my pubic symphysis is ok enough.

There can still be a little bit of bladder prolapse feeling, not real bladder prolapse, if I carry lots of heavy stuff. So I try not to carry my 10.7kg DD2 whenever possible. It's easier now since she can walk.

What I did for my recovery? Not much. I didn't exercise. I didn't go to any therapy. I did see a physio for bladder prolapse though and thanks to her tremenous efforts I can hardly feel the discomfort unless I over do myself. What I did was just rest as much as I could, used the belt when needed, knew what I should do and what I shouldn't, and that's pretty much it. I would say you really need to look after yourself, take it easy, let the pain be your guide and listen to your body, if you're lazy like me who don't like going to any medical appointments and who don't like exercise at all.

Bladder prolapse and exercise for PSD

Bladder prolapse was another major problem for me. I was told it was minor but it was already causing me too much discomfort. When I wanted to sit down I always felt it was squashed/squeezed (YKWIM). When I stood up I always had to hold my breath to 'help' keep my bladder where it should be. When I walked I also had to hold my breath trying to keep my bladder where it should be. If you're having the same feeling as I did, maybe we share the same problem.

From what I was told, it doesn't affect sex, it doesn't affect another pregnancy. To me, the above statements are true. Bladder prolapse is simply due to the weakened muscles on your vagina wall. When the muscles are weak, they cannot support the bladder above it, hence bladder falling a little bit down, causing the discomfort. It doesn't cause any problems, just discomfort. Of course mine didn't protrude so I don't know what'll happen if the bladder "falls out".

However, the bladder prolapse can become worse when you're pregnant because the hormones will weaken the muscles further causing the bladder to fall even more. BUT don't worry, here's the good part: after I suffered from a lot worse bladder prolapse during my 2nd pregnancy, I started pelvic floor exercises straight after the birth (of course I was doing them when pregnant too but the exercises could hardly beat the speed of the muscles' weakening), and STAYED IN BED AS MUCH AS I COULD for the first month after the birth, and have continued doing the pelvic floor exercises and now I can hardly feel the bladder prolapse. I think it's almost recovered, just waiting for the last bit to finish after I wean my 2nd baby (which will be in 7 months hopefully).

The key is, you need to get a special physiotherapist who specialize in pelvic floor exercises. Maybe ask your hospital. My current physio is one of them. She sticks her finger/s into my vagina and tells me how to do the pelvic floor exercises. It's "squeeze, lift, lift, lift, hold, relax". If your physio does this to you then you've got the right one. Then she can tell me whether I'm doing it correctly or not. If not, the exercise can hardly help you. But if you do it correctly, you can see improvements in days. I benefit from this special physio and thanks to her efforts I'm now rarely feeling any discomforts in my vagina.

Although no one would admit it to me, I agree with you that prolapse could be part of the side effect of the separation. I have this theory but no one agreed with me, probably because they've never had a separation in their lives.

So in summary, my answers:

yes to sex,
yes to another pregnancy,
a good physio for pelvic floor exercises,
keep doing the pelvic floor exercises

About exercises for PSD: from my experience, core strength and pelvic floor exercises are the only exercises that I could do when I had PSD. No other exercises can help, if they don't aggreviate the condition. I was given some exercises by various physios who seemed confident in what they're doing but only felt more pain after doing them. Only symmetrical exercises can be done under this condition.

Having another baby after PSD

This is my personal story and what I would give as advice if someone asks. I hope it helps more people.

Having another baby after suffering PSD saved me. Now my second baby is 4.5 months and I feel I'm healthy again, after 5 years of pain, discomfort, desparation and limited mobilty.

2.5 years after I had my first baby PSD finally settled down and I felt I could live a pretty normal life again. Although my mobility was still limited due to PSD and minor prolapse and incontinence, I had learned how to life my life with them.

3 years after I had my first baby I fell pregnant. One of the reasons I wanted another child was because I heard a new birth will give my body a chance to reshuffle and possibility to solve all my old problems from the first birth. And it turned out to be true.

Diary of my second pregnancy is here: http://pubicsymphysis.blogspot.com/2010/05/psd-diary-for-second-pregnancy-to-be.html. In summary, I had a lot of pelvic pain, a very shattered unstable pelvis, much worse prolapse and incontinence, controled constipation through diet, very very limited mobility during the second half of this pregnancy.

But now 4 months after the birth I feel I'm the healthiest person in the world.

Here's my story in conjunction with what I would say to people who've had PSD and want to have another child:

During the pregnancy,

1) rest AS MUCH AS YOU CAN,

2) do AS LITTLE AS YOU CAN.

3) Ask your hubby to look after other children.

4) Do all your house chores (if you can do ANY!) in a sitting position. I
bought a kitchen stool with adjustable heights and castors so I could "walk
around" on it in the kitchen.

5) minimal lifting!

6) minimal walking

7) no exercise at all apart from pelvic floor exercises, which still didn't
help much with the prolapse due to baby growing heavier. But I would imagine
the prolapse to be much worse without it.

8) As soon as you start to have the symptoms, wear the belt! And wear it as much
as you can.

9) Try to avoid hills, stairs, and walk in small steps instead of large steps,
meaning separate your legs as little as you can.

During birth:

I used on all fours position, as advised by a few medical professionals, which protected my pubic symphysis area. It worked. My pubic sysmphysis wasn't damaged this time. And this position made the birth very quick. Do not separate your legs too much during birth. On all fours make it only about your shoulder's width so it wouldn't separate your pubic area.

Ceasarean is an option. But I was too scared to go through it. I thought it would be easier for me to do what I'd done before. :) But one main reason I still did natural birth was the possibility to heal the old problems through natural birth. The 'reshuffle'. :)

The birth was still painful and my pelvis felt like broken into hundreds of small pieces. But I could still WALK, which was a good sign. Last time I couldn't move at all.

Now After birth:

1) Start wearing the belt as soon as you can and as much as you can.

2) Start pelvic floor exercise as soon as you can and do as much as you can.

3) Stay in bed as much as you can. Rest as much as you can. I stayed in my bedroom for at least 1 month after birth. Apart from going to the toilet and having meals, I didn't leave my bed at all. And we have an ensuite so the toilet is in the bedroom; I had all my meals brought to my bedroom so I didn't need to walk out of the bedroom for meals. My parents came from overseas to help me so I could afford to do this. So if you can, get someone to do everything for you during the first or even the second month.

4) I was still in pain (painful unstable pelvis) 1 month after the birth of the 2nd baby so I still controlled my activities. I only did very limited activities such as very gentle walking for maybe 5-10 minutes each day, and then still rested as much as I could. This lasted for about 1.5 months.

5) I started seeing a physio at 10 weeks. I didn't do any exercise at all before this, apart from pelvic floor exercises. I still felt very weak, pelvis very unstable, and very bad back pain. Physio gave me very gental exercises to strengthen my tummy muscles. It was very difficult at first. But I found very soon I started to feel stronger and stronger. The physio also taught me how to do pelvic floor exercises correctly so I started to see a lot of improvements on prolapse and incontinence.

6) About 3 months after the birth I was pretty much pain free and during that time I gradually increased my activities (walking, shopping etc), using pain as my guide.

7) Now 4 months after birth I'm a normal person. I feel I'm healed. No PSD. No prolapse. Minor incontinence. No back pain unless I do too much.

I never imagined a life like this, pain free, can do anything I want. It's like I'm alive again, free again.