Does the Age You Have Your First Baby Affect Your Pelvic Floor?

The age at which you have your first baby could impact more than your birth experience — it might also affect your long-term pelvic health.

We all know that vaginal birth and getting older are key risk factors for pelvic organ prolapse (POP). But did you know that being older at the time of your first vaginal delivery may increase your risk even more?

With more women now having their first babies in their 30s or even 40s, this is something we need to talk about.

What Is Pelvic Organ Prolapse (POP)?

Pelvic organ prolapse happens when the muscles and tissues that support your pelvic organs (like your bladder, bowel, or womb) become weakened, often after childbirth. This can cause a ‘bulge’ in the vaginal wall or feelings of pressure and discomfort. Around 1 in 5 women will need surgery for POP in their lifetime (Wu et al., 2014; Smith et al., 2010).

Why Does Age at First Delivery Matter?

As we age, we naturally lose muscle mass and strength — including in the pelvic floor (Melton et al., 2000; Jung et al., 2023). Recovery after injury (like childbirth) also becomes harder. That means when women have their first vaginal delivery in their 30s or later, their pelvic floor may not bounce back as easily as it would have in their 20s.

Research shows:

• Women who have their first baby over the age of 30 are more likely to need surgery for prolapse later in life (Leijonhufvud et al., 2012).

• Each year you delay your first delivery increases your risk of developing prolapse symptoms by around 6%, regardless of birth method (Wang et al., 2021).

• Even one year after giving birth, older first-time mums are more likely to show signs of pelvic support weakness (Urbankova et al., 2019; Nygaard et al., 2021).

How Does This Affect the Pelvic Floor?

Here’s how age at the time of first birth can increase your POP risk:

Pelvic floor muscle strength

One study found that women aged 30+ had significantly lower pelvic floor muscle (PFM) strength at 6 months postpartum compared to younger mothers (Diez-Itza et al., 2011). Ageing also affects how well our muscles recover, with increased muscle stiffness and reduced regenerative ability (Rieger et al., 2021; Alperin et al., 2016).

Genital hiatus size

This is the vaginal opening area that can enlarge after childbirth. A wider genital hiatus (GH) is associated with higher prolapse risk — and studies show older mums often have a slower or incomplete recovery in this area (Rosett et al., 2023; Swenson et al., 2024).

Levator ani muscle damage

Damage to the levator ani — the key pelvic support muscle — is more common in older first-time mums. Multiple studies confirm increased risk of trauma or “ballooning” with each year of maternal age (Kearney et al., 2006; Dietz & Simpson, 2007; Rahmanou et al., 2016).

Muscle quality and healing

As we age, our muscles change: they shrink, become more fibrous, and accumulate fat. These changes are well-documented in both the pelvic floor and other muscles and mean recovery after strain (like childbirth) may be compromised (Burnett et al., 2020; Bukovsky et al., 2001).

But Isn’t Prolapse Just About Having Kids?

Not quite. It's about how and when you give birth, as well as genetics, hormonal health, and lifestyle. Even women who’ve had C-sections or only one vaginal birth can experience prolapse — but age at delivery is an important piece of the puzzle.

What Can You Do About It?

If you’ve had your first baby later in life — or are planning to — knowledge is power. The sooner you strengthen your pelvic floor, the better.

At Kegel8, we’re passionate about helping women prevent and manage prolapse, leaks, and other pelvic floor issues. Whether you’re a new mum, a hopeful mum-to-be, or years past your last delivery, it’s never too late to take control of your pelvic health.

👉 Use a clinically proven pelvic toner like the Kegel8 Ultra 20 

👉 Support your pelvic floor with SRC during pregnancy and for postpartum recovery

👉 Follow our 12-week programme designed by pelvic specialist Amanda Savage

👉 Top UK Physiotherapist Amanda Savage has created a 12 week Prolapse Management Programme for Kegel8 - take a look to learn how to manage prolpase.

👉 Start early —  and stay consistent

Final Thoughts

Delayed childbirth is more common than ever — and that’s OK. But we must be aware of how our age at first delivery may affect our pelvic floor, so we can take preventative action and recover properly.

Prolapse is not an inevitable part of motherhood or ageing — and with Kegel8, it doesn’t have to be your story.

References (Selected)

• Wu JM et al. Obstet Gynecol. 2014;123:1201–6.

• Smith FJ et al. Obstet Gynecol. 2010;116:1096–100.

• Leijonhufvud A et al. Am J Obstet Gynecol. 2012;207:303.e1–7.

• Wang R et al. Female Pelvic Med Reconstr Surg. 2021;27:e423–6.

• Urbankova I et al. Int Urogynecol J. 2019;30:1689–96.

• Nygaard IE et al. Am J Obstet Gynecol. 2021;224:193.e1–19.

• Diez-Itza I et al. Int Urogynecol J. 2011;22:1505–11.

• Rosett HA et al. Urogynecology (Phila). 2023.

• Swenson CW et al. Am J Obstet Gynecol. 2024;230:e110–12.

• Kearney R et al. Obstet Gynecol. 2006;107:144–9.

• Dietz HP & Simpson JM. Aust N Z J Obstet Gynaecol. 2007;47:491–5.

• Rahmanou P et al. Am J Obstet Gynecol. 2016;215:451.e1–7.

• Rieger M et al. Ann Biomed Eng. 2021;49:1836–47.

• Alperin M et al. Am J Obstet Gynecol. 2016;215:312.e1–9.

• Burnett LA et al. J Biomech. 2020;98:109436.

• Bukovsky A et al. BMC Clin Pathol. 2001;1:4.