As you anxiously await the birth of your baby and watch your cute little bump grow, it’s only natural to start wondering how labor and delivery will affect your vagina after birth.
Will your vagina really be able to stretch enough to accommodate your infant’s head if you have a vaginal delivery? Will the muscles and tissues of your perineum (the area between the vaginal opening and the rectum) stretch or tear naturally? Or will your practitioner deem it necessary to do an episiotomy? And how long will it take for your vagina to heal after delivery?
Just as every labor and delivery is different, so is every woman. But knowing generally what to expect and how to help things along will hopefully ease your mind. You have enough to think about, after all.
Changes to your vagina after birth
After nine months of pregnancy and the strain of delivery, you can expect some changes to your vagina after birth even if you didn’t give birth vaginally. Depending on how you delivered, you can expect some (or all) of the following changes to your postpartum vagina:
Stretching of the vagina
Just how much stretching you experience during a vaginal delivery depends on many variables, including the size of your baby, your genetics and how many deliveries you’ve had before. Each progressive birth will likely stretch your vagina a tiny bit more.
The circumstances of the birth, including how long you push and whether forceps or vacuum extraction are required, also play a role.
If you have a C-section and don’t push beforehand, you shouldn’t expect any stretching of the vagina after giving birth. If you do push before the C-section, the baby puts a lot of pressure on your entire vaginal area, which may cause some stretching. But if the baby’s head never makes its way through the vaginal opening, stretching should be minimal.
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Soreness, discomfort, and bruising
If you had a vaginal delivery, you can expect your postpartum vagina to feel tender and uncomfortable immediately after delivery. Even if your perineum was left intact during baby’s arrival, the area has still been stretched and bruised.
Most women without vaginal tearing tend to feel some mild to not-so-mild vaginal discomfort for about three to five weeks (though it can vary widely depending on the person).
The pain may be worse when you cough or sneeze, and you may even find that it hurts to sit down for a few days — but the soreness and discomfort should fade a little with each passing day. In the meantime, try these tips to relieve postpartum perineal pain.
If you progress through labor and begin pushing but deliver by C-section, your vagina may very well get strained, and you may experience some vaginal discomfort post-delivery — especially if the baby is close to crowning.
Burning and pain as tears heal
If the perineum tears during delivery or you have an episiotomy, you’ll experience some burning due to the laceration, which usually requires stitches. There are various degrees of vaginal tears, from a minor break of the skin to more serious tears involving the muscles of the vagina, anus, anal sphincter and rectum.
The wound itself will take about seven to 10 days to heal if the tear was small, or up to six weeks for more significant lacerations. The area may also be tender for several weeks as you recover, so try to take it easy if you can. If the stitches heal easily, you should expect the pain to be gone within several weeks (but again, it can vary based on the severity of the tear).
If your pain doesn't subside or gets worse after you leave the hospital, give your practitioner a call.
Vaginal discharge
Whether you had a vaginal birth or a C-section, your uterus needs to empty itself of the extra blood, mucus and tissue it required during pregnancy. This means you’ll experience postpartum vaginal bleeding (known as lochia) after birth.
Bleeding will likely be heavier than your period for the first three to 10 days after giving birth. You’ll then experience light bleeding or spotting that lasts from four to six weeks after delivery, changing in color from red to pink to brown and finally yellowish-white.
Vaginal dryness
Lower levels of estrogen thin out the tissue in the vagina and increase vaginal dryness and tightness after birth, especially compared to pregnancy. You may feel even more dry if you’re breastfeeding, which suppresses estrogen, although dryness should dissipate once you stop breastfeeding your baby.
Changes in appearance
Your vagina may look roomier, swollen or more open than it did before giving birth, especially if you gave birth vaginally — although changes to the vagina after birth vary widely.
Within a few days of delivery, swelling will recede, and within a few weeks your vagina will have contracted and regained much of its muscle tone. However, your vagina may never regain exactly the same shape as it had as before birth.
Practicing your Kegels may help your vagina get as close as possible to its pre-pregnancy appearance.
How will changes to the vagina after birth affect me?
Pregnancy and birth can cause some changes in your perineal area that can affect how your body functions. These include:
Painful sex
In the weeks to months after a vaginal delivery, your vagina may be noticeably stretched out, and sex after birth may feel tender and even painful for a little while (typically, you’ll be advised by your provider to wait four to six weeks post-delivery before you resume sex).
If you don’t get intimate for several months after giving birth, sex may feel a bit uncomfortable at first.
Even if you gave birth via C-section, vaginal dryness after pregnancy can make sex painful. Use a lubricant (such as K-Y jelly or Astroglide) once you get the okay from your doctor to start having sex again. And if you use latex or polyisoprene condoms, pair with a water-based lubricant (not an oil-based one, which can cause the material to tear or break).
Incontinence
Research suggests that following childbirth, women are more likely to experience an urge to pee or even urinary leakage (incontinence) when they sneeze, laugh or perform any strenuous activity — even if they delivered by C-section.
That’s because your nerves and pelvic muscles (which help you to hold in urine and feces) weaken during pregnancy due to hormonal changes and the weight of your baby on your pelvic floor.
If you’ve given birth vaginally, your pelvic floor muscles will be stretched and strained, increasing the risk of urinary incontinence.
Difficulty having bowel movements
It may take three to five days after you give birth before you have your first postpartum poop (although there’s a wide range of normal). Weakened pelvic floor muscles during pregnancy and childbirth along with pain medications can slow things down, even if you had a C-section.
Pushing during a vaginal delivery can also lead to hemorrhoids or anal fissures, which can of course make that first postpartum bowel movement more challenging.
Your doctor will likely recommend that you use a stool softener or a fiber supplement after giving birth to help move things along more smoothly.
What can I do about changes to the vagina after giving birth?
Keep in mind that your body is made to stretch to accommodate your baby, and your vagina after birth will naturally rebound on its own in time.
That said, there are a few steps you can take before and after pregnancy to prevent and address changes to the vagina after birth.
Consider perineal massage
Perineal massage in the month or so before your due date may help prepare your vagina for childbirth. Some research suggests it may reduce the risk of episiotomy and tearing, and many moms swear by it anecdotally — although studies are inconclusive. (Keep in mind that if you’ve already given birth vaginally, perineal massage probably won’t do much.)
Do your Kegels
The best way to help restore your vagina after giving birth is by doing pelvic floor (Kegel) exercises during and after pregnancy.
Kegels strengthen the muscles of the pelvic floor, may help you to avoid tearing during delivery, help resolve postpartum urinary incontinence, and make sex (when you're ready for it and get the all-clear) more pleasurable.
For best results, do Kegels for five minutes a day, three times a day, during pregnancy and again after giving birth as soon as you’re comfortably able.
If they seem like a hassle, try to do them when you're sitting still and have the chance — while breastfeeding, checking email, or working at your desk. The effort will be worth your while.
If you want to take it a step further, you may want to check out vaginal exercisers, or devices that help you do Kegel exercises. But ask your doctor before buying or using one and understand that you won't get the okay until after the four-to-six-week recovery period has passed.
Protect the vagina for the first six weeks postpartum
Inserting anything into the vagina before it’s fully healed could cause an infection, which will slow down the recovery process.
No matter how you delivered, your doctor will likely tell you to hold off on sex and tampons until about four to six weeks post-birth — though you may get the green light to get back to normal sooner or later than that.
What causes the vagina to stretch during birth?
Though it’s hard to imagine, a baby really is able to make his way through the birth canal and out the vaginal opening. Your body is made to do this!
Your vagina itself is tremendously elastic, with accordion-like folds that are designed to open it up for childbirth. In addition, your body has been preparing for this moment since the beginning of your pregnancy by releasing these pregnancy hormones:
Estrogen, which increases blood flow to the folds of the vagina so that this connective tissue is better able to expand and stretch during childbirth as you push.
Relaxin, which helps your body relax and loosens the ligaments and joints in the pelvic area. That way, it’s able to expand and create space for your baby to make his grand entrance.
Will my vagina ever be the same after giving birth?
The million-dollar question every woman wants to know: “Will my vagina go back to the way it used to be after I have a baby?” Though this may not be quite what you want to hear, the answer is: not exactly. But it will likely be very close, because the vagina not only has the elasticity to expand but also the capacity to retract.
Though an obstetrician or midwife will be able to tell that you’ve had a vaginal delivery by doing a physical exam, you may not feel or see any difference. Depending on how much it was stretched, the vaginal opening may return to a point very close to its original structure given enough time and pelvic floor exercises.
Will your partner notice? Unless you experience a major birth trauma (such as a third- or fourth-degree tear to the outer vagina), your partner shouldn't notice much of a difference, if any at all. In fact, some couples find that having a baby makes them feel closer and they enjoy sex even more.
If after two months (or more), you’re still having problems that might be related to your vagina and pelvic floor — painful sex, urinary or fecal incontinence, or general pain — there’s no need to suffer. Ask your provider for a referral to a pelvic floor physical therapist who can offer up specific exercises and treatments, as well as give you feedback on the proper way to do Kegels.
And if your vagina still feels too slack six months after giving birth, talk to your doctor about other possible remedies.
Rest assured that your vagina was built to handle childbirth — and it will be back to its old self, given time and patience.
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