Introducing POP advocate – Sally Maconochie

It’s a condition that is rarely spoken about, but one Australian woman has set out to change that – meet Hudson Institute’s new pelvic organ prolapse (POP) advocate, Sally Maconochie.

Who are you and how did you hear about Hudson Institute?

I’m a professional consultant based in Brisbane. In 2016, I suffered a traumatic birth which caused partial levator avulsion, urinary incontinence and a cystocele and rectocele prolapse. Following surgery in 2020 I reached a definite low point in my life, realising I’d never be as able as I was before childbirth, that I’d probably never be able to do anything in terms of exercise, and might never be able to dance, run or walk with my little boy. As I lay in bed, I couldn’t understand how this had happened to me. I was so angry that nobody had told me all the ways I could have helped to prevent prolapse and birth injury – that I was facing a life of immobility that could have been prevented. In my anger and grief, I started researching prolapse and stumbled upon Hudson Institute’s research.

What do you know about POP?

I know that it impacts an enormous number of women around the world. The critical thing is that nobody talks about it. That’s why I am talking about it to anybody who will listen! I will forever talk to girls about the importance of avoiding constipation and actively caring for your body, your pelvic floor and all of your female organs. I’ll forever remind people that women’s anatomy, ability and longevity has suffered under a male-dominated medical system for too long, and that we need to get it out of the shadows of gender inequality.

What is the most surprising thing you know about POP?

I was convinced my whole life that my pelvic floor muscles were strong (they were) and that this, plus kegel exercises, would prepare me for childbirth. In reality, though, my muscles were too strong and always ‘on’, which meant that the physical demands of childbirth led to a catastrophic failure of these very tight muscles, which led to prolapse. If only I’d been educated that you need to turn OFF your pelvic floor as well as turning it on.

Why do you think POP is not spoken about more, and what can we do about it?

There’s a lot of talk about getting women back into the workforce by providing more access to childcare, but what happens for women who can’t physically sit in an office, or use public transport, or have the confidence to show up in any capacity because they feel like their pelvic organs are exiting their body or they’re afraid of peeing themselves in an interview? So, improved access to childcare will help a lot of women, but there’s 25 per cent who have an entirely different barrier to overcome.

What’s next on your POP journey?

My levator avulsion meant an 80 per cent chance that the prolapse would recur. Because of that, I’ve lived the last two years in fear of doing anything that might risk it. Unfortunately, in August this year my bladder prolapse repair failed. And now I’m waiting for an appointment with my surgeon to see if there’s anything else I can do. Throughout all of this, I’ve had to deal with the grief of knowing that I can’t have another baby because carrying another child would be catastrophic to my pelvic organs.

What would you like to see come from Hudson Institute’s research?

More awareness of POP and its impacts, but ultimately, I want to see real solutions for women before, during and after childbirth, along with the all-important communication campaign surrounding this. I hope we can get surgeons, researchers and people like me, and develop a campaign targeting high schools and universities to deliver more awareness to young women of how they can enter their child-bearing years with open eyes.