Reviewed by Prof. Dr. Fuat Yuksel.
Childbirth is an amazing but excruciating experience, especially without an epidural. According to Pregnancy, Birth and Baby, 1 in 3 women experience birth trauma, which may be physical, emotional, and/or psychological. Apart from this fact, you may have many people come up to you and tell you all sorts of scary things soon after you get pregnant. These scary things make many women wonder even more what exactly will happen to their vagina after childbirth.
No doubt, looking at your baby after birth can be a divine experience. It may make you forget all about the labour pains, but just for a moment. That’s because your reproductive organs will throb with pain. Your muscles stretched to push that baby out. Many women are left wondering about that one muscular tube – their vagina; how has it changed, and what will become of it? Let’s find out.
Loosening
When you’re trying to push the baby out of your birth canal, it will also stretch the pelvic floor muscles. That’s why women may feel that their vagina is “looser/wider” after childbirth.
However, there are other factors that affect the birth canal, such as the size of the baby (especially, the head), genetics, method of delivery (C-section, forceps, or vacuum), and the number of children you’re having/have had. It may not be possible for your vagina to stretch back to the pre-pregnancy state. Many women experience their tampons slipping out more easily than before. However, it isn’t always the case for all women.
Dryness
Vaginal dryness occurs due to a drop in the levels of estrogen after childbirth. Normally, estrogen helps in the production of fluid that lines the vaginal tissue walls. This keeps it moisturized and elastic. If you’re breastfeeding, the drop in the estrogen levels may last the duration of it.
That’s because the hormone that helps in milk production blocks the production of estrogen. Fortunately, it is temporary. Your vagina will start feeling normal again once you’ve stopped breastfeeding.
Dryness in the vagina after childbirth can also result in painful sex. You should talk to your doctor about it, since they may prescribe lubricants or topical creams to combat it.
Soreness
Soreness in the vagina after childbirth is most likely due to what happened to your perineum (the area between the vagina and anus) during childbirth. In some cases, the doctor cuts the skin between the vaginal opening and anus to increase the size of the opening. This is known as episiotomy. This can also leave the area sore.
It can take a few weeks to months for the soreness to go away. You might feel more pain when coughing or sneezing. If you have gotten stitches, make sure you keep the area clean and dry to avoid any risk of infection.
Urinary Incontinence
This occurs because of what your pelvic floor muscles go through. They hold a lot of organs in place down there, such as your uterus, bladder, and bowel. They get weak postpartum, even if you get a C-section. That’s because of the weight of the baby and the bodily changes that occur due to hormonal fluctuation.
Moreover, childbirth affects the nerves in the area, which is many women experience urinary incontinence. They may end up peeing while doing normal activities like laughing or sneezing. Fortunately, it will get better after some time. However, you can try doing pelvic floor exercises to strengthen the muscles in the area. You can take the help of a pelvic floor physical therapist. If it doesn’t get better with time, you should talk to your health care provider.
Vaginal Tear
It is common for women to get vaginal tears during childbirth. These are known as perineal tears and have four categories based on the intensity of the damage.
- First-Degree Tears: If it affects just the skin between the vaginal opening and anus, it is a first-degree tear. It will heal on its own in about a month or so.
- Second-Degree Tears: It results in the tearing of the muscles in the perineum and goes deep into the vagina. This kind of tear needs stitches. It will take a few weeks to heal completely.
- Third-Degree Tears: This is when the tearing extends to the muscles around the anus. You’ll need to have surgery for it. Usually, it takes three months or more to heal.
- Fourth-Degree Tears: This is the most severe type of tear in the vagina after childbirth. The tear extends from the skin of the vagina right up to the rectum. Your doctor may perform a separate procedure on you under general anaesthesia. It also takes more than three months to heal.
According to the Royal College of Obstetricians and Gynaecologists, 6% of the births result in third- or fourth-degree tears in first-time mothers.
Reluctance to Have Sex
Childbirth also brings changes to the sex life of individuals. It may be due to several reasons. Vaginal dryness can make sex painful and uncomfortable. The scar tissue in the perineal area can also cause pain. Other than that, it may be that the emotional and physical toll of bringing a little human being into the world has left you tired.
You might also not feel as good about yourself. One study found out that women felt worse about their bodies as months passed after vaginal delivery. Also, weakened pelvic floor muscles can result in a weak orgasm. For this too, you can consider pelvic floor physical therapy. Moreover, you shouldn’t force sex. Make sure to talk to your partner about it. The postpartum vagina needs a month or two to heal.
Changes in Appearance
You may notice a change in the appearance, shape and colour, of your vulva (clitoris, labia minora, labia majora, and vaginal opening) after vaginal birth. It occurs due to the drop in the levels of estrogen and progesterone after birth.
Previously, it may have looked darker due to the increase in the blood flow to the area. The birth canal itself is swollen and bruised for some time because of how much the vaginal muscles have stretched.
Vaginal Discharge
Vaginal discharge or lochia is inevitable. Your body has to get rid of the tissue, mucus and blood in the uterus. This comes out as a red discharge. Keep in mind that it’s not the same as a heavy period after giving birth vaginally. Initially, it will have an intense red colour, which will then turn pink, brown, and, finally, yellow.
What Are the Treatment Options for Your Vagina After Childbirth?
There are surgical and non-surgical treatment options that you can consider.
Pelvic Floor Therapy for Vagina After Childbirth
As mentioned above, pelvic floor therapy can help with more than a few vaginal changes that occur after delivery. The strengthening of the floor muscles can better support the pelvic organs.
Moreover, it helps with postpartum urinary incontinence. Kegel exercises can be really helpful with that. You have to clench (hold) your muscles and then relax them for a few seconds. Repeat this exercise 3 times throughout the day.
Vaginal Cosmetic Surgery for Vagina After Childbirth
This includes vaginoplasty, where the surgeon aims to tighten the vaginal muscles that have loosened as a result of childbirth. Women can want to undergo this cosmetic surgery after the vaginal walls become loose due to ageing or weight loss.
The number of children you’ve had can also impact how “wide” the vagina gets over time. Some women believe that getting this surgery can increase sexual pleasure. However, that’s not entirely true as it depends on many other factors.
Keep in mind that vaginoplasty reconstructive surgery is different from the one that aims to improve the aesthetics of the vagina. This closely related cosmetic surgery is labiaplasty. It has to do with improving the appearance of labia majora and/or labia minora after childbirth or correcting any asymmetry.
It is important that you have clearly defined goals that you can communicate to the cosmetic surgeon. S/he will recommend a treatment to you depending on your needs.
Summing Up the Discussion
Bringing a baby into the world can certainly be an emotional rollercoaster. You may not have enough time to even think about yourself. However, many women struggle with their self-perception after giving birth. They do not feel confident in the way that they appear. The key is to give your body time to heal. Soon after birth, postpartum care is of the utmost importance.
It’s not just your vagina, but your whole body goes through many changes after giving birth. Your breasts may get bigger; you may have loose skin across the abdomen, your hair may fall, and you may have heavy periods. Stepping into the role for the first time can be overwhelming, but you also need to take care of your body. That includes your vagina after childbirth.
