7 Ways Your Vagina Might Change After You Give Birth
By Korin Miller | Originally Published December 20 on Self | Featuring Dr. Sherry Ross
Vaginas deserve trophies. Hello, self-cleaning organs that can deliver both pleasure and babies. Speaking of which, there’s lots of talk out there about how vaginas change after childbirth. Pushing a tiny human out of that much tinier hole does, in fact, have an effect. But for most people, it’s probably not as bad or permanent as you’ve heard.
While childbirth is no picnic for your nether region, your vagina can handle it. “The vagina is very resilient,” Sherry Ross, M.D., an ob/gyn and women’s health expert and author of She-ology: The Definitive Guide to Women’s Intimate Health. Period., tells SELF. Still, it can take anywhere from 12 weeks to a year for your vagina to go back to its normal state, and some things may never be 100 percent the same again, Jessica Shepherd, M.D., a minimally-invasive gynecologist at Baylor University Medical Center at Dallas, tells SELF.
If you give birth vaginally, here some changes you can expect your vagina (and some nearby parts) to go through afterwards.
1. Your vagina may dry out for a bit.
When you’re pregnant, elevated levels of certain hormones, including estrogen, are coursing through your body. Then, after you give birth, your estrogen drops, which can cause trouble for your vagina.
Estrogen helps to keep your vaginal tissue moist with a clear lubricating fluid, according to the U.S. National Library of Medicine. Without enough estrogen, not only will you not have the same level of moisture, your vaginal tissue can shrink and become thinner. This can all leave you with a serious Sahara situation down there, Dr. Shepherd says.
If you’re not breastfeeding, your vaginal moisture should go back to normal within a few weeks. But breastfeeding can keep those estrogen levels low and shift you into what’s sometimes called “postpartum menopause,” which can make you dry the whole time you’re nursing, Dr. Ross says. Once you stop nursing, your vagina should go back to its normal and hydrated state pretty quickly.
In the meantime, using lube can help relieve discomfort during sex. This soreness can also rear its head when you’re not having sex, though. If you’re dealing with intense, painful postpartum vaginal dryness, ask your doctor about vaginal lubricants or moisturizers made specifically to address this issue. Depending on your situation, they may have OTC recommendations. They may also prescribe estrogen (it comes in various forms, including some you put directly into the vagina) to help increase your vaginal moisture, says the U.S. National Library of Medicine.
2. Your vagina (and possibly perineum) will be sore as hell.
Your perineum is the area between your vagina and anus. Though it’s not specifically a part of your vagina, it can also tear during a vaginal delivery. ”If you can imagine a cantaloupe coming out of your vagina, it’s no wonder that the perineum is affected during childbirth,” Dr. Ross says. With that said, perineal tearing isn’t a guarantee.
Between 53 and 79 percent of vaginal deliveries will cause some kind of tearing, according to the American College of Obstetricians and Gynecologists, but there are actually four degrees of lacerations, with each building on the ones before it.
- First-degree tears only involve the skin around the vaginal opening or the perineal skin, according to the Mayo Clinic, and they may or may not need stitches. These typically heal within four weeks, Dr. Shepherd says.
- Second-degree tears involve damage to the perineal muscles, which help support the uterus, bladder, and rectum, and usually require stitches, Mayo Clinic. Dr. Shepherd notes that these also tend to heal within four weeks.
- Third-degree tears are lacerations of the perineal muscles and the muscle around the anus. Unlike the less serious tears, these may require surgical repair in an operating room, not the delivery room. These can take up to 12 weeks to heal, Dr. Shepherd says.
- Fourth-degree tears, which affect the perineal muscles, muscles around the anus, and the tissue lining the rectum, are the most serious. Like third-degree tears, these usually need to be fixed in an operating room, but they can take even longer than 12 weeks to heal, Dr. Shepherd says.
According to a July 2016 ACOG practice bulletin, it’s hard to pin down the true incidence rates of different kinds of tearing, but third- and fourth-degree varieties may only make up around 11 percent of all labor-related lacerations.
No matter the degree, if you tear during your delivery or your doctor cuts the area in what’s known as an episiotomy (this used to be more common but is now most typically done when an infant is large or gets stuck on the way out), you’ll feel pretty damn sore down there while it heals. To soothe the pain, you can try things like applying ice packs to the area, or cooled witch hazel pads (with a napkin in between so the witch hazel isn’t actually making contact), according to the Mayo Clinic. You can also use a squeeze bottle to douse the area in warm water while peeing, or look into numbing sprays with lidocaine that you can apply until you’ve healed, Dr. Shepherd says.
3. You could have some scar tissue that could make sex uncomfortable for a bit.
If you had a tear or episiotomy after a vaginal delivery, you’re probably going to have some scar tissue in your vagina and on your perineum afterwards. Unfortunately, even the thought of having sex after this might make you wince. “The extent of the damage in this area will determine how much you feel scarring in this area [during] sex,” Dr. Ross says.
The scar tissue usually heals over time, making sex more comfortable as you go (just be sure to use plenty of lube and go slowly in the meantime). But if you find that it’s not getting better with time, talk to your doctor. Some women need surgery to remove the scar tissue—and get rid of the pain, Dr. Shepherd says.
4. Your period may get heavier—or lighter.
Being pregnant throws your hormones out of whack, and your body has to reset after your baby has vacated the premises. This even applies to your uterine lining, which builds up before you get your period. Of course, you won’t get a real period while you’re pregnant (though you might have some spotting). But when you do start getting a postpartum period, it may be lighter or heavier than before. If your estrogen is generally lower than it was before you got pregnant, your uterine lining can be thinner, Dr. Shepherd says, giving you a lighter period. If your estrogen is a little higher, your lining may build up more thickly, creating a heavier-than-before period.
5. Yes, your vagina may be a bit wider, but don’t let that freak you out too much.
While your vagina and vaginal opening typically shrink back down after stretching during a vaginal birth, having a big baby, a baby with a big head, or several vaginal deliveries makes it less likely that it will go back 100 percent, Dr. Ross says. The result: Your vagina might be slightly wider than it was in the past. This may not be something you pick up on much, or you might. Sometimes, a tampon is actually the giveaway.
“Some women notice tampons may not stay inside the vagina like they used to before having babies,” Dr. Ross says. “A slender or regular tampon may be out of the question to use comfortably and may fall out more easily.” It’s not that you put in a tampon and it shoots out of your vagina—instead, it may slowly slide out while it used to just stay put. Kegel exercises may also help here, Dr. Ross says.
6. You can pee yourself from doing basic things like walking downhill, jumping jacks, and even laughing and sneezing.
Childbirth can damage your pelvic floor , which is made up of muscles and other tissues that help keep organs like your uterus, bladder, and bowel in the correct positions so they function properly, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Childbirth can also affect the muscles and nerves that control your bladder and urethra (the tube through which pee leaves your body). All of this can lead to pee leaking out of your body at inopportune times.
“The good news is [this urinary incontinence] will improve over time, but it is definitely a symptom that is not talked about enough,” Dr. Ross says. This issue’s quite common; 25 to 45 percent of women have some sort of urinary incontinence, whether it’s caused by childbirth or not, according to the NIDDK. What’s more, women are twice as likely as men to have this health condition, and the discrepancy is due in part to pregnancy and childbirth.
Kegel exercises may help strengthen your pelvic floor muscles and combat urinary incontinence, Dr. Ross says. But if you’re not experiencing much improvement or this issue is affecting your life, definitely talk to your doctor to figure out your options, which can range from learning behavioral modification techniques to pelvic floor physical therapy and more.
7. Your orgasms may also become weaker, depending on how your pelvic floor has changed.
“During orgasm, the muscles of the vagina and uterus produce powerful, rhythmic contractions. These contractions are a source of pleasure…as they release muscle tension built up during the [excitement and plateau phases,” Dr. Shepherd says. If your pelvic floor has weakened due to childbirth, those contractions may no longer be as strong, so you might find your orgasms don’t feel as forceful as they used to. But all hope isn’t lost! Here, again, Kegels may help you strengthen your pelvic floor and, over time, regain some of that intensity.
While all of this can be frustrating to experience, try to remember it absolutely doesn’t mean anything’s wrong with you, just that your vagina went through a completely natural change after doing something pretty incredible. And no matter what, know that you shouldn’t be embarrassed to bring any of this up with your doctor—if anyone can help you figure out a fix for something that’s bothering you, they can.