Significant changes in women’s bodies occur with pregnancy and following childbirth and it is not uncommon to experience postpartum problems. The majority of these changes will improve with time especially with appropriate management.
At the base of the pelvis there is a group of muscles known as pelvic floor muscles. These hold the pelvic organs such as the uterus, vagina, bladder and bowel in the correct position. Vaginal birth, and the weight of the baby during pregnancy may weaken or damage the pelvic floor muscles and supporting ligaments. This may result in some of the following symptoms:
- Distortion of the vagina or perineum (area between the vagina and anus)
- Heaviness or dragging sensation in the vagina
- Pain in the vagina or perineum during sex
- Changes in appearance of one or both of the labia (lips around the vagina)
- Incontinence
How can postpartum problems be treated?
The vast majority of women make a complete recovery from any pelvic floor weakness and injury. This recovery is best reinforced with the help of specialist women’s health physiotherapists, who can advise the best way of performing pelvic floor muscle retraining.
We would always recommend that women continue to do pelvic floor exercises to help prevent problems later in life, such as incontinence or prolapse.
A small minority of women experience ongoing problems after childbirth including pain, scarring or heaviness in the vagina, which may be uncomfortable. This can also affect sexual function and cause great distress, which should not be ignored.
Not all women require a surgical solution to their pelvic floor problem. Our care is tailored to your individual symptoms and expectations. We also take into account any plans for future children when deciding what treatment to recommend.
Vaginal scarring or tearing
Although the vagina is stretchy and is designed to accommodate the birth of a child, it is not uncommon for the perineum to stretch so far that it causes tearing, requiring the need for stitches.
Most women will experience some degree of vaginal tearing after vaginal childbirth, especially if it is their first time giving birth. Many of these tears will require stitching. The stitches usually dissolve after approximately 4–6 weeks, depending on the extent of the injury as well as the type of stitch used. The area will then continue to heal for several months after the delivery.
Normally, the vagina and perineum heal without any problems, but for a small minority of women, there can be scarring or distortion where the area has failed to heal correctly. This may cause no symptoms at all, but can sometimes produce pain, especially during sexual intercourse, or may lead to loss of confidence and sexual libido.
Often this can be managed with a ‘watch and wait’ approach, or by using conservative measures such as vaginal dilators to break down any scar tissues. Alternatively, the vagina can be stretched if there has been any narrowing or shortening. If these methods fail, then the vagina and perineum can be refashioned.
