After Childbirth and Prolapse, I Turned to Weight Lifting

As a mother, feeling strong requires different abilities than the ones I had before becoming a parent.

After my daughter was born a year and a half ago, I was plagued by the sensation that my vagina was falling out. I gave birth in the early days of the pandemic, a time when it was hard to access non-emergency medical care. My vagina certainly felt like an emergency, but I waited. Eventually, I was able to see a pelvic floor physical therapist, who told me that I had pelvic organ prolapse: a condition where one or more of the organs in the pelvis descend from their normal position and bulge into the vagina.

At some point in their lifetime, around one-third of people with vaginas will experience prolapse. In the United States, thirteen percent of those who suffer from it will eventually have surgery for the condition. It can be miserable, and not just because of the physical sensation. Feeling like a fundamental part of your body is not working, particularly after the hard work of pregnancy and birth—a major risk-factor for prolapse—can be demoralizing. In our pleas for basic parental leave, new parents find ourselves on Twitter, or in the pages of the New York Times, demanding that recoveries from childbirth be taken seriously. As the House debated a measly four weeks of mandatory paid parental leave in November, I read description after familiar description of life at a month postpartum. Parents wrote about their healing vaginas, their c-section stitches, their cracked nipples, leaky bladders, and frayed psyches. Nearly everyone wrote about sleep.

When it comes to treating prolapse, there is no universal consensus among providers, and a widespread lack of evidence-based care borne of inadequate research. I experienced this myself: In my first year postpartum I saw four physical therapists—two paid for by my health insurance, and two out of pocket—none of whom agreed with one another. One told me I didn’t have a prolapse at all, another that I shouldn’t lift anything heavier than ten pounds (say, my baby), and another that I shouldn’t sit cross-legged (utter nonsense). I wove a frustrating, circuitous, and costly path before I found my way to the support that did help me. I found it not, as one would hope, through doctors who were concerned about my ongoing discomfort and distress but, as is the way with much of women’s healthcare, via very well-read, very angry women on the internet.

I’m eager to talk about my prolapse and to join others in asking that my body be acknowledged. But not just to demand the most rudimentary social support for parents, however desperately necessary. My prolapse tells a longer story of becoming a mother—a becoming that has lasted not four weeks, or four months, but in the constant newness of mothering, indefinitely.

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As anyone who has cared for a small child knows, avoiding heavy lifting is impossible. In recent years, researchers have challenged the recommendation to avoid it in order to prevent or alleviate prolapse. Nonetheless, “don’t lift” remains standard advice. For me, nearly the opposite has been true: Gradually adapting my body through strength training has made the daily tasks of childcare, and every other kind of movement, much more comfortable.

My prolapse tells a longer story of becoming a mother.

After months of frustrating physical therapy, I decided to try something different. At a loss, I posted in a large Facebook group for academic parents, describing my experience and asking for advice. Almost immediately, I heard from dozens of women across the country who had struggled with all kinds of pelvic-floor issues. I was touched by their support and relieved to feel less alone. Among the women who contacted me was a doctoral student in psychology who, after navigating postpartum prolapse, had turned her attention to supporting perinatal, pelvic, and maternal health. I learned that, for some people with prolapse, full-body progressive overload training could be useful. After more research, I found a personal trainer who specializes in postpartum recovery and had herself experienced postpartum prolapse.

When I first met my trainer, I was exhausted and fed up. I didn’t know what to say when she asked me about my goals: Did I want to hike with a big backpack? Go for a run? Lift a car? I laughed, but she was dead serious.

What I wanted most of all was just to walk comfortably. When I was pregnant, I’d imagined taking long strolls with my daughter nestled against my chest in a carrier. Now, seven months into parenthood, I could barely carry my own weight down the block with confidence. Getting my daughter in and out of her car seat left my body feeling like Jell-O. Seeing other new moms carrying their babies, even hiking up big hills, filled me with envy.

In my first session with my trainer, we simply focused on walking. I paraded around her backyard trying, and failing, not to feel bleak and self-conscious. 

“I feel like a chicken.”

“Try not to be weirded out,” she said. “I just want to see you move as naturally as possible.”

“I just can’t find good posture.”

She observed, very gently, that I was holding myself rigidly in an attempt to both avoid discomfort and achieve what felt like good alignment. Though this session was far from an immediate fix, it helped me see how I was unintentionally guarding my movements and making it harder for my body to find a new, functional pattern—however imperfect-looking—in the process.

Over the course of a few sessions, I began to get stronger and to feel a lot less scared of moving. Some of the movements we focused on were the very ones I routinely used when I lifted my daughter. At first, every new exercise triggered a wave of alarm about exacerbating the sensation of my prolapse. But, over time, I realized that while I could still feel the prolapse, it wasn’t any worse. Moreover, I was moving and doing things I enjoyed without worry. I was also comfortably lifting more weight than I ever had before.

Becoming a mother had reorganized my sense of self as much as it had changed my body. Despite having a powerful, almost transcendent experience of childbirth, the prolapse had undermined my confidence in my physical abilities. Working towards a sense of fortitude in a new activity helped me to discover a different source of strength—one that matched the demands of my new life.

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At ten months postpartum, the weights I used for my home workouts started to feel light. I ordered some new kettlebells online and watched the UPS delivery worker struggle to reach my front door. It was thrilling, and triggered memories of walking past the men who filled the weight room of my college gym and toward the cardio machines where women seemed more likely to congregate.

Since the rise of Crossfit in the early 2000s, women have increasingly participated in strength training. But it has remained a highly gendered physical pursuit. This is unfortunate, because strength is especially important for the day-to-day labor of care—feminized work, but work for which muscle is essential. Perhaps this binary conception of strength training is one reason why it isn’t actively encouraged for women with prolapse.

Becoming a mother had reorganized my sense of self as much as it had changed my body.

Before I found my trainer, as I performed all kinds of new parenting tasks with my rearranged body, I sensed that I was struggling to find movement patterns that felt functional. I desperately wanted to exercise, as I always had, because I knew it was critical to my mental health. But when I searched online for advice about postpartum fitness and strength, I almost exclusively found information about weight loss. I’d grown up against a cultural backdrop of disordered thinking about food and exercise. Now, in the midst of trying to come to terms with my own shape-shifting—on way too little sleep and with almost no time to take care of myself—I felt once again betrayed by the way our culture treats women.

Until my daughter was born, I associated gym workouts with preternaturally toned bodies and highly sexualized marketing rather than, say, badass mothers of young children who are theoretically capable of lifting cars. Getting to know one such woman was extremely powerful. When my daughter was about a year old, my trainer taught me to do a kettlebell swing: a maneuver that involves swinging a kettlebell between your legs, within close thwacking range of a number of sensitive body parts. She gave a graceful demonstration for my benefit, and in my usual exhausted haze, I figured it looked pretty doable. On my first try, I flailed and felt the kettlebell smack my backside a little too forcefully. I barely steadied myself before buckling in laughter, accusing my trainer of pioneering a new, unconventional prolapse treatment. After the intimately unpleasant experience of one medical practitioner after another prying at my body, laughing about its imperfections with someone who got it was cathartic.

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Now, I’m pregnant again, and still training. With the extra weight of pregnancy, and my almost thirty-pound toddler demanding, “Mama, carry you!” I sometimes feel the prolapse again. It’s annoying, but it also doesn’t bother me in the same way as it did before, and it doesn’t stop me from moving.

Women’s health is still shrouded in needless shame by the medical establishment and a culture that is primarily interested in women’s bodies for what they look like rather than what they can do. When I first found myself navigating prolapse, the other parents I mentioned it to mostly hadn’t heard of it despite its extraordinary prevalence. Google prolapse and you’ll find a lot of articles about just how many women suffer from it but are embarrassed to discuss it. I wasn’t ashamed as much as I was sad, but when you google a set of symptoms, it’s distressing to get the message that, maybe, you should be. I refuse this embarrassment, and I refuse to pass it on to my daughter. The pelvic floor is a part of the body like any other. For many of us, at various life stages, it will need some extra attention.

The care I got was instrumental to my mental as much as my physical health. As an active person, being able to move again without anxiety saved me from the worst of postpartum depression. I would not have had the care I needed were it not for paid leave—which I benefited from through my partner’s job, since I work on a freelance basis. I was exceptionally lucky to have this support, but I shouldn’t be. Pelvic floor health, and mental health, should not be a privilege exclusive to middle-class families.

Parents need so much more than a month of paid leave. Sharing the grisly details of life at four weeks postpartum is important so that policymakers are forced to reckon with what that inadequate number means for birthing parents’ bodies, their mental health, and their families. To quote the novelist Lydia Kiesling, I really do hope people google rectocele. But recovery does not stop at four weeks, or anything like it. The grim debate about supporting parents in the US can’t end here.

In order to feel strong as a mother, I have found that I need fundamentally different abilities than I had before becoming a parent: ones that allow me to move confidently not in spite of but in sync with the constant mutability of my body. These aren’t capacities I could develop overnight. The time it took to figure out how to manage my prolapse through strength training was also the time it took to carve out space for myself as a person in my own, remade life.