Pregnancy with endometriosis or a prolapse: what to tell your midwife

If you already live with endometriosis or a prolapse, pregnancy raises its own questions. The NHS pages on both conditions say little about pregnancy itself, so here’s what they do say, and what to bring up with your midwife.

Endometriosis and pregnancy

The NHS says endometriosis can make getting pregnant harder. It lists surgery as an option when endometriosis is affecting your fertility, and referral to a fertility specialist if you have difficulty getting pregnant. It says you won’t be given hormone treatment if you’re trying to conceive. See improve your chances of getting pregnant.

Tell your midwife at your booking appointment that you have it, so it’s in your notes and they can ask your GP or obstetrician if anything needs reviewing. Always get severe pain checked, because pain can have other causes. See ectopic pregnancy for the symptoms that need urgent help.

Prolapse and pregnancy

The NHS lists pregnancy and childbirth among the causes of pelvic organ prolapse, which can happen when the pelvic floor muscles weaken. Its self-care advice is to do regular pelvic floor exercises. It describes a pessary as a plastic or silicone device placed in the vagina to support the pelvic organs.

If you have a prolapse, tell your midwife early so your care can be planned. Ask whether you should see a women’s health physiotherapist, and what it means for your birth and recovery. See pressure down there in pregnancy.

Questions to ask

Is there anything about my condition that should change my antenatal care?
Should I see a specialist during pregnancy?
Are any of my current medicines or devices a problem in pregnancy?
What does it mean for my birth choices and my recovery?

If you’re taking medicine for either condition, don’t stop it without advice. Ask your GP, midwife or pharmacist.

Questions people ask

Does endometriosis get better in pregnancy?

The NHS page doesn’t say, so ask your midwife or specialist about your own situation.

Can I use a pessary while pregnant?

Ask the team that fitted it before changing anything.

Will a prolapse affect how I give birth?

Raise it with your midwife or obstetrician early, so your birth options can be discussed.