Can vaginal delivery worsen existing prolapse?
Yes, vaginal delivery can worsen existing pelvic organ prolapse, particularly if the prolapse is moderate to severe before pregnancy. The stresses of labour may stretch or weaken pelvic floor tissues further.
Detailed Medical Explanation
Labour and vaginal delivery can put significant strain on the pelvic floor, especially if a woman already has a prolapse. Instrumental deliveries, large babies, and prolonged second stage of labour further increase risk. For some women with existing prolapse, planned caesarean section may be considered to prevent worsening, but this decision should be individualised and discussed with a specialist. (NHS: Prolapse | NICE NG123)
Clinical Context
Women with prolapse considering pregnancy or delivery options should have consultant-led, multidisciplinary care. Preventive strategies and postpartum pelvic floor rehab are essential.
Evidence-Based Approaches
Shared decision-making and personalised planning are recommended by NHS and NICE for delivery in women with prolapse. (NICE NG123)