To Pessary or not Pessary….

That is the question.

But if you have worked with me you 100% know my answer. Pessary. Always Pessary.

Let’s start with what is a pessary. A pessary is a medical device which is inserted into the vagina to help give droopy organs a lift, aka, a prolapse. We typically hear of older women who have given birth to 8 kids get pessaries. Not healthy 30 year olds. I got a pessary at 12 weeks postpartum after only having 1 kid.

Pessaries can also be used to help with urinary incontinence.

Simply put, pessaries are the magic. Simply magic.

They are non-invasive. Inexpensive. Discrete. Autonomous medical devices.

YOU get to decide when you wear it. YOU get to decided how long you want to wear it. YOU get to decide when you’re done using it.

So why is every woman who delivers a baby vaginally not getting a pessary?

Because OB/GYNs are the main fitters for pessaries and they believe you should wait a year or more to get a pessary. I think this is BS…..here is why.

A prolapse takes time to heal as it primary affects the connective tissue of the body. The connective tissue is a webbing type tissue which gives organs and structures support. The pelvic floor and birth canal are SURROUNDED with this connective tissue. And when a baby comes out, guess what, it stretches the tissue. And connective tissue takes to sweet sweet time to heal. Healing of connective tissue is also massively affect by sleep, diet, stress and if you’re breastfeeding or not. And can we all agree that after having a baby you’re not sleeping, eating to survive, stressed to the max and maybe choosing to breastfeed? All of these slow connective tissue healing, and slow prolapse healing.

So circling back, I believe every women at her 6 weeks follow up should be given the option of a pessary if she had a vaginal birth.

Sadly this isn’t happening. I refer patients back to their OBs for pessaries and they always tell me their OB doesn’t give them out until 12 months PP! Luckily for my patients, I warn them they are going to get this push back and they press their OBs to get them.

Now that we’ve cleared that up. How does a pessary help in the acute postpartum phase.

A pessary holds up the organs which may have prolapsed down into the pelvic floor. This allows the connective tissue to be also be lifted up and put back into place. When the organs and connective tissue are in a more supported positions, the pelvic floor can also fire more effectively; resulting in a stronger pelvic floor.

I am almost 16 months postpartum, am still breastfeeding, and still have a prolapse. Has it healed over time, yes; that’s how connective tissue works. But I would not have been able to do all the running and weight training I wanted to without the extra support.

The good news is, the APTA has granted PTs the ability to fit for pessaries. So you can bet I’ll be like Oprah and giving them out to everyone.