I saw a patient yesterday who had had a repair 6 weeks ago and was really happy with how everything was going. Things were  great – no leakage, no lump, defaecation easier and she had come to me to find out about exercise in the future. But things were so good she felt energised like never before and with a family wedding coming up in Spring, she and hubby decided to do some serious gardening last weekend (yes at 6 weeks post-op) to get ready for the big event to be held in a marquee in the back yard. So there was pruning, potting, prolonged weeding (in a squatting position) and general frenzied activity to tart up the outside.
Later that day I had another patient who was telling me the history of the first appearance of her prolapse. She had two relatives that she helped in the days before Christmas with moving house-packing boxes which usually involves repetitive bending, shifting said boxes into the trailer and then furious vacuuming to ensure the bond gets retrieved. Then of course it was Christmas- lots of shopping for groceries, cooking for hours, heavy eating and then the endless washing up. The next day she had terrible dragging pelvic pain and ache and for the first time ever, noticed the bulge at the vagina.
Now both these stories got me thinking. Thinking about how hazardous things women do every day, in every neighbourhood, in every country, can be. So just as we have safety rules for work places to ensure the safety of workers, we need a set of rules for around the home to protect women from ……..themselves mostly! Most women these days are human dynamos- buzzing around from dawn till bedtime- getting up before the sun to go for a run or pump iron in the gym, working insane hours  in the paid workforce, coming home to shop, cook, wash and generally helping all and sundry with often very physically taxing tasks.
So here are some rules to make the home a safer place and prevent that possibly mild prolapse, which is perfectly possible and legitimate following those vaginal deliveries, turning into something which demands surgical attention and some rules to especially guide those women who have had surgery to ensure they don’t cause their surgery to fail!

1. If you are moving or helping someone else to move house, your job is to pay for the removalist (always cheaper than gynae repair surgery), or make the cups of tea for all the big strong male relatives who should be helping. If packing light boxes avoid repetitive bending.
2. When gardening, always use a kneeling pad and do the weeding on all fours rather than squatting (gently engaging your low tummy and pelvic floor). Always get your partner to lift the potting mix bags and pot plants. If there is no one to do this, then buy smaller quantities not the big bulk bags. If you have had gynae surgery you shouldn’t lift over 15 kilos for life.
3. Spread the shopping/cooking load at Christmas amongst the family.
4. Always undertake ‘pelvic floor safe’ exercising – no sit-ups, curl-ups, crunches, double leg lifts or lifting heavy weights.
5. If you discover a small prolapse, then seek help from a Continence and Women’s Health Physiotherapist to ensure you are doing everything you can to prevent that early prolapse from worsening.

Now back to that first patient- she is suitably chastened and is going to be much more careful for the next 6 weeks until her healing is complete and that good fibrosis that helps hold surgeries up, is in place.