Mar 05 2010
A Womans Body After Birth – Vagina and Perinuem
Very little is written about the changes in a woman’s body after birth. As many of the changes are ‘messy’ or make women feel embarrassed, woman are reluctant to discuss them, even if their closest friends. In the third of a multi-part series, Jodi Cleghorn looks at the immediate changes a woman experiences, as well the bleeding women experience after giving birth.
Few women know what their vagina, vulvas, clitoris and perineum look like before birth. Many more women feel highly uncomfortable or have difficulty actually calling these areas of their body by their true names.
“I think spending time looking at everything in the mirror with a midwife during pregnancy may have been helpful for me,” says Mandi, who had a HBAC late last year, “to learn more about my own vagina, what’s normal and what’s normal for me.”
It is not surprising that women are reticent to talk about the changes to this most intimate part of their body after birth. This silence leaves new mums feeling very unsure and even more inhibited to ask questions about changes to their vagina or share their experiences.
“My sister was the only one who really talked about what happened to her vagina afterward,” says Julia. “I’m glad she did because mine freaked me out for a while.” Dani who sustained a third degree tear birthing the first time remembers, “Other women spoke about vaginal soreness, bleeding, and ‘baby bellies’ but no one really spoke about how it felt to have significant tearing. But thankfully there are some who do share and make life easier for those who come after them.”
The way in which care providers interact with the most intimate areas of a woman’s body after birth affects how she feels and thinks about her vagina. “I was so scared about what had happened down there,” says Nickole of her first birth. “The attitude of the hospital staff made me think that it must be really messy and a huge hole that they’ve tied up. It took a while to recover from that — to look. I felt my second birth was the reclaiming of my yoni. I could see it, and the people around me really honoured my yoni — instead of being urgh about it.”
“My midwife asked if it was OK if my doula looked at my tears, then if my partner could,” says Lily who had two significant tears. “At no point did anyone just assume that they could pry between my legs because I was prone on my back. Even though I was very sore and disappointed about having torn so badly, the respect and dignity they showed me went a long way to feeling OK about it all.”
All women who plan to birth naturally would be lying if they said that they didn’t expect some soreness in their vagina and perineum after birth. What many women don’t expect is just how much pain and swelling there is. “I had a massively swollen labia and was unable to walk properly,” says Mandi, “I couldn’t get my legs closer than a metre apart.” While many women want the swelling to go down, swelling often protects injuries that are better cushioned. Then there is the ’sting’ and razor blades of peeing while grazes and tears heal. “I had stitches in my tear,” says Julia, “but it was the pain of the grazes that lasted six weeks and was agony when I needed to urinate.”
Healing from stitches can be a traumatic experience for women. “I was all swollen and the stitches were cutting in,” said Nickole of her first birth experience. “My doctor said they did very good stitches, but they were very tight.”
“My vagina looks very different from the tearing,” says Cindy, who had third degree tears after the birth of her son two years ago, “and the doctor bungled the stitches so I have some skin which should be on the inside on the outside. It was a long, bad healing process which almost required surgery.”
Serious tears and episiotomy wounds need time to heal and bed rest. Natural remedies such as comfrey, calendula, honey and lavender have all been successfully used to aid healing of wounds, tears and grazes. 2
Even though standard medical texts cite that a woman’s vagina will regain much of its former tone after six weeks, any woman who has birthed knows this is an optimistic timeframe. Mandi describes herself as feeling very open and too big after birth and worries now that her vagina won’t return to a healthy tightness. As many women will attest, concerted pelvic floor exercises are what assist the vagina to regain pre-birth tone, not just the passage of time.
The intensity, duration and feelings a woman has towards the changes to her vagina and perineum are what makes her experience uniquely her own. The the type of birth (especially if an instrumental birth accompanied by an episiotomy), any physical trauma, the size of the baby, the general health of a woman, the amount of rest after birth, any preparation of the vagina and and perineum for birth (such as perineal massage) and the regularity and correct practise of pelvic floor exercises will impact on the extent of post birth changes of the vagina and perineum in the early weeks after birth.
References
1. “Sex, Birth and the Pelvic Floor” by Jeni Drew, in Down to Birth (2008:1)
2. Post Partum Perineal Care by Ronnie Falcao
