I just had my 4th, with 7 years between #3 and #4. Ofter giving birth to her, I realized that my uterus was falling out!! I was mortified. My midwife said not to worry, that it may work itself back over time. It did...to an extent. I "feel" it. It drives me crazy. I am a runner, so it was an issue for me. I noticed that the days I run, it's worse. Plus, if I do any heavy lifting, standing, etc on top of it, I can really feel the pressure/pain by the end of the day.
I had a consult with a surgeon, who said that the best option for me down the road is the complete reconstruction, basically-because of my activity level. The nip/tuck surgical option would probably require me to have to have it again, within 5 years. HOWEVER, I have a toddler at home and the recovery requires no lifting for 6 weeks! So, I tried the pessary, which did not work for me, either. The thing never stayed put.
Yes, birthing 4 children took it's toll. Since my toddler was a huge surprise,and turned my life upside down, I honestly would have told you at one time, NO, don't have another! Just being honest. But, now that I have her and we are all so in love with her, I don't think of NOT having her because of what it did to my body. I am coming to terms with my prolapse - we are making peace...LOL!!
If you want another, I say go for it. Your body is basically shot, anyway, if you are turning 40 ---- LOL!!!! Just kidding( I am almost 40, too). In the big scheme of things, it's not the worse thing in the world......?? :)
I wish you the best of luck!!.