A pessary is a soft, removable device designed to provide support within the vaginal canal. During pregnancy, a pessary can be used to support the cervix or uterus, offering a non-surgical approach to manage certain conditions. This device helps maintain the position of pelvic organs as the body undergoes changes throughout gestation. Its application provides a supportive framework, aiming to alleviate specific pregnancy-related concerns.
Preparing for Pessary Insertion
Before pessary insertion, meticulous preparation is important. Begin by washing your hands with soap and water to ensure hygiene. If using a reusable pessary, clean it with mild soap and warm water, then rinse and dry completely. Applying a water-based lubricant to the pessary can ease the insertion process, making it more comfortable.
Finding a comfortable position is important. Many individuals find it easiest to insert a pessary while standing with one foot elevated on a stool or chair, or by lying down with knees bent. Squatting is another helpful position. Your healthcare provider will provide specific instructions tailored to your pessary and needs; adhere to these guidelines before insertion.
Precise Insertion Technique and Depth
Once prepared, insertion requires a gentle approach. Most pessaries, especially ring types, need to be folded or compressed before insertion to reduce their size. For example, a ring pessary can be folded in half or into a figure-eight shape. Gently push the folded pessary into the vagina, aiming it upwards and slightly towards your lower back, similar to inserting a tampon.
Proper placement involves guiding the pessary deeply enough so it sits securely and comfortably without causing discomfort. For a ring pessary, the front edge typically rests just behind the pubic bone. If inserting a cervical pessary, like an Arabin pessary, advance it until it encircles the cervix, unfolding once released to provide support. The vagina is a closed space, so the pessary cannot travel further into the body beyond its intended position. If the pessary feels uncomfortable after initial insertion, gently push it a little further until it settles into a comfortable spot.
Confirming Proper Placement and Addressing Concerns
After insertion, it is important to confirm the pessary is correctly positioned. A properly placed pessary should not be felt, allowing you to move and go about daily activities without discomfort or pressure. Test the placement by gently bearing down or moving around to ensure it remains securely in place and does not feel as though it might slip out. The goal is for the pessary to provide subtle support, without drawing constant attention.
Some mild changes can occur after pessary insertion. An increase in vaginal discharge, typically whitish, or even light spotting, can occur as the body adjusts to the device. However, if you notice pink or bloody discharge, this might indicate the pessary is rubbing against the vaginal wall, suggesting an improper fit. Similarly, unusual odor or a change in discharge color could signal an infection. In such cases, consult your healthcare provider.
Ongoing Care and When to Contact Your Doctor
Maintaining proper care for your pessary is important for its effectiveness and your comfort. If instructed on self-management, regular cleaning of the pessary with mild soap and water, typically daily or weekly, is recommended. Following cleaning, the pessary should be thoroughly rinsed and dried before reinsertion. Regular check-ups with your healthcare provider are important to ensure the pessary fits correctly and is not causing irritation.
Contact your healthcare provider if you experience:
- Persistent pain or discomfort
- Foul-smelling or discolored vaginal discharge
- Vaginal bleeding beyond mild spotting
- Inability to urinate or have a bowel movement
- Development of a fever
- Pessary repeatedly falling out
If the pessary frequently dislodges, a different size or type may be needed.