I am the last person you could have imagined would be talking about this,” says Helen Ledwick, from her home in leafy south Manchester.
I went to a Catholic school in Lancashire, so speaking publicly about intimate health is not in my DNA. But the more I do it, the easier it gets, and it’s something we have to talk about.’
Helen, 44, a former BBC radio producer, talks about the pelvic organ prolapse she experienced after the birth of her second child in 2015.
This is where the organs within the pelvis slide down from their normal position into the vagina, causing a feeling of heaviness, bulge, or drag. Although not life-threatening, prolapse can cause pain, sexual dysfunction, and incontinence.
It is particularly common in mothers, because pregnancy and childbirth weaken the pelvic floor muscles. But menopause is also a trigger, since hormonal changes can affect the elasticity and mass of the pelvic muscles.
Helen Ledwick, 44, a former BBC radio producer, has revealed all about the pelvic organ prolapse she experienced after the birth of her second child in 2015.
Helen believes that lack of knowledge, shame and stigma are the factors that prevent women from acknowledging that there is a problem and seeking help.
New figures suggest that six in ten women are living with at least one symptom of poor pelvic floor health, such as urinary incontinence or pelvic organ prolapse; however, 69 per cent have never mentioned it to an NHS professional, according to a recent survey by the Royal College of Obstetricians and Gynecologists (RCOG).
Helen believes that a lack of awareness among the public and health professionals, as well as shame and stigma, prevent women from acknowledging that there is a problem and seeking help. She has now written a book, Why Moms Don’t Jump, to help break taboos about pelvic floor health and share expert advice. This follows the success of his eponymous podcast, which has been listened to by tens of thousands.
Helen does not remember ever receiving advice on how to prevent a prolapse after giving birth in 2015, even though her risk was increased because she had a difficult delivery and needed surgery for a severe perineal tear (tissue damage between the opening vaginal and anal).
“I left the hospital postpartum, and surgery, with no idea that exertion, lifting, and daily exertion could damage my pelvic floor,” says Helen.
Two weeks later, after picking up her oldest son, then a toddler, and straining in the bathroom, she suddenly felt an unpleasant sensation, like “sitting on a doorknob.”
She now knows this was the prolapse: “To think that your insides are falling out is terrifying,” she says. “Despite being my second birth, I had no idea prolapse was something that could happen.”
The RCOG has also called for better education on pelvic health.
“Very few women receive information about pelvic floor health or risk factors,” says Dr. Ranee Thakar, RCOG president and consultant urogynecologist. “Many women don’t know or are too embarrassed to seek help for symptoms that can have a real impact on their lives.”
Meanwhile, the lack of a standard national treatment pathway, which would mandate GPs to refer all patients to specialists, means a lottery of postcodes for affected women: while some may be referred to a gynecologist or physiotherapy , others may be asked to wait to see if the prolapse gets better on its own.
Although some minor prolapses may resolve on their own, most cases require medical treatment. Options include vaginal pessaries, which support the organs, or surgery to secure the organs in place.
However, as Good Health previously reported, thousands of women have reported being harmed by a type of prolapse surgery that uses plastic mesh implants.
After a campaign, backed by the Mail, health watchdog NICE halted use of the mesh in 2018, saying it could only be used in clinical trials.
Frustrated by the misinformation she was given, Helen began posting to Instagram in 2018 about her prolapse.
While there are other forms of prolapse surgery, such as a procedure to sew the pelvic organs in place, according to the RCOG, up to 30 percent of these fail.
“Surgery is not a quick fix and often fails if the person is active, so it tends to be more successful in older women,” says Tina Mason, a pelvic health physiotherapist at Women’s Health Brighton. “If surgery is needed, then a good slow rehabilitation plan is vital.”
This should prompt a referral to see a pelvic floor exercise physical therapist, he adds, which can help improve symptoms in up to 70 percent of cases.
In Helen’s case, the severity of her perineal tear meant she had an automatic referral to see a pelvic health urogynecologist and physiotherapist. The urogynecologist said that she could have surgery or pelvic floor exercises and pessaries to control her symptoms.
Helen felt that surgery was not right for her at the time; she also had trouble finding a pessary that was right for her. Instead, she took the advice to avoid standing for long periods, running, jumping, or lifting (the official guidelines have since been updated to restrict only “heavy lifting,” acknowledging the importance of staying active).
As a result, Helen was afraid to be active with her children or to return to playing netball and jogging. ‘I felt as if there was a shadow over me; A part had been taken away from me and I couldn’t be the mother I imagined I would be,” she says. Frustrated with the misinformation she was given about her, she began posting to Instagram in 2018 about her prolapse.
“It had helped me a lot to talk to someone, I felt very strongly that we needed to get rid of the shame around this,” he says.
Within days, hundreds of women were sending messages to share their experiences with pelvic floor problems, which they had never been able to talk about before. This encouraged Helen to start a podcast, where she interviews experts who share information about symptoms and treatments, as well as patients who tell their stories.
She says: ‘A 59-year-old woman contacted me and said she was furious because she had seen a gynecologist every year of her adult life, but had never been told about the prolapse, and now she had one.
“It’s great that I’m helping people, but I’m not a medical expert and you shouldn’t have to turn to a podcast or Instagram for reliable information.”
Pictured is Helen’s podcast, Why Mums Don’t Jump, a show that explores the taboos surrounding women’s health after childbirth.
Helen still experiences occasional discomfort from her prolapse, which she likens to the discomfort of wearing underwear two sizes too small, and discovers that her bowel doesn’t always empty completely.
But after developing a core and pelvic strengthening regimen with a private women’s health physical therapist, whom she still sees occasionally, she now feels able to live with her symptoms.
“I run, I dance with my children (now eighteen and eight),” she says. I no longer live in fear.
The good news is that more and more help is available. Since 2021, NHS England has been establishing pelvic health clinics to provide women with coordinated support from midwives, doctors and physiotherapists, during and after pregnancy.
And the government’s Women’s Health Strategy for England, launched last August, raised concerns that prolapse is seen as “something to be accepted after childbirth” and reminded GPs to check pelvic health at postnatal checkups.
For Helen, change can’t come soon enough. “There are so many women who have been suffering in silence for so long, feeling broken and ashamed,” she says.
‘With a little investment, we could return people to their families and their jobs. We could bring them back to life.
Why Mums Don’t Jump (Allen & Unwin, £14.99).