Introduction
During a natural vaginal birth the female vagina changes. It is subjected to enormous pressure and must expand tenfold in order for the child to pass through the birth canal. Since the vagina is elastic, this stretching can return.
However, complications such as pelvic floor weakness can also develop. In addition, traumatic birth injuries may occur, which, depending on their extent, must be treated and take some time to heal. Permanent damage is rare, however.
How does the vagina change after a birth?
In a natural birth, the child moves from the uterus through the birth canal to finally see the light of day. The birth canal consists of a muscle tube, the vagina. The vagina is able to enlarge tenfold at birth.
The muscles of the pelvic floor also loosen to allow an unhindered birth. In addition to the vagina, bony structures such as the pelvis also play an important role in the birth process. The extent to which the structures of the female body have to change and the extent to which complications arise depends on the individual circumstances of the woman as well as the size and position of the child.
In addition to the strong stretching of the vaginal canal, it can also be damaged in unfavorable situations. Depending on the elasticity of the musculature, the size of the child’s head, the preparation for birth and the speed of birth, tears may occur. The vagina usually tears at its lateral or posterior vault.
High vaginal tears close to the cervix are also possible and often require surgical treatment. Tears can bleed and burn and can be uncomfortable in their healing. Depending on their depth, they may need to be sutured or heal by themselves.
After healing, they are in most cases no longer visible or noticeable. In rare cases, however, scar hypertrophies can occur. Perineal tears can also occur.
An episiotomy may also be necessary if there is an imbalance between the vaginal opening and the size of the child’s head. Depending on the depth of the tear, it heals at different rates. If the muscle layer is involved, there may be problems when going to the toilet.
There may be pain when walking, sitting or defecating. Scars that develop after sewn tears are weak points that can tear open again during another birth. After the birth, there is a postpartum flow, during which wound secretion is released.
This is completely normal and persists after about three weeks. During the postpartum period a hormonal change occurs. This can cause an oestrogen deficiency, which makes the vaginal mucosa thin and susceptible to injury.
Vaginal dryness can also occur and the natural vaginal flora can change. Due to the loosening of the pelvic floor muscles, bladder weakness can also occur, which can regress spontaneously and should be observed. Since the vagina is elastic as a muscle tube, it regresses after a birth. Changes that are visible from the outside or noticeable during sexual intercourse can be reduced, for example, by pelvic floor exercises. A permanent “being worn out”, as many women fear, does not occur.
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