Does the Vagina Go Back to Normal After Birth?

Recovery From Vaginal Birth: A Timeline and Tips

Giving birth is a tremendous ordeal for a woman's body, and even the speediest and smoothest of labors involves a considerable recovery process. The length of time it takes a woman's body, in particular her vagina, to return to normal—and yes, it should return more or less to normal—varies greatly. Factors at play include the baby's size, length of the labor and birth, previous births, genetic factors and whether there's tearing and need of stitches. In the initial, hormone-riddled hours and days after giving birth, it's common and perfectly normal to wonder whether your vagina will ever recover and return to normal. Take comfort in knowing that, in time, it almost definitely will. The worst discomfort should pass in a few days, and by your six-week postpartum OB-GYN appointment you should be well on your way to a full recovery.

The Physical Effects of Vaginal Birth

Mother holding her newborn baby child after labor in a hospital.

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It seems a miracle that a woman's vagina can stretch enough to allow an infant's body to pass through it and enter the world, but it can, albeit sometimes with medical assistance. A combination of hormones and the vagina's incredible natural elasticity make birth and full postpartum recovery possible.

In the first few days after giving birth, the vagina and perineum (the area between the vaginal opening and anus) will be swollen and painful. The degree of swelling and pain depends on genetic factors—every woman's body responds differently during and after delivery—along with the length and difficulty of labor and delivery and whether she has given birth before.

Tearing and Episiotomies

Postpartum recovery will be more painful and take longer if you experience perineal tearing, whereby the perineum tears naturally to accommodate the baby's head during delivery. Less common is an episiotomy, meaning a physician cuts the perineum to aid delivery. Episiotomies are no longer recommended but are sometimes still used when necessary. Up to half of all women delivering vaginally will have at least a small tear requiring stitches. Almost all of these are first-degree tears, which involve only torn skin, and second-degree tears, which involve the tearing of both skin and vaginal muscle. More severe third- and fourth-degree tears occur in less than 2 percent of births. The use of forceps and vacuum extractions are other unusual medical interventions that cause a greater degree of pain and lengthen the postpartum recovery period.

The Healing Process

Mother holding her newborn baby child after labor in a hospital.

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After a vaginal birth, a mother can expect to bleed from the vagina for two to four weeks and might experience spotting for up to two months. During this time only maxi pads, not tampons, should be used. Vaginal swelling, soreness and sometimes numbness should lessen day by day, with the worst of the discomfort dissipating within a week or two. Over-the-counter pain relievers are usually sufficient to help with the pain. Some women report that their vagina feels fine and normal again after only a few weeks, but for most it takes up to six weeks for the pain and discomfort to go away. If you have stitches, expect it to take around seven to 10 days for the wound to heal. The stitches will dissolve without requiring removal.

Follow the instructions of your doctor's nurses for postpartum care. Use warm water in a squirt bottle to clean the vaginal area after using the bathroom, and gently pat yourself dry instead of rubbing with toilet paper. Change maxi pads regularly. If you have stitches, avoid touching your vagina before it has healed. You can use ice packs, pain-relieving spray, witch hazel pads and a sitz bath to aid recovery. Avoid sitting in a way that feels uncomfortable. If and when it doesn't hurt to do so, start doing pelvic floor exercises (Kegels) regularly. Doctors recommend these exercises as an excellent way to help your vagina recover from birth.

Getting Back to Normal

Wait until your six-week postpartum OB-GYN appointment to resume sex and exercise, with your doctor's approval. By this time, many women feel fully recovered, while others still experience some pain or discomfort. After a physical exam, your doctor may give recovery advice that includes waiting a little longer to have sex.

Another symptom that might not be relieved at this stage is vaginal dryness, which is the result of lower estrogen levels. If you're breastfeeding, dryness might be an issue until you wean your baby and your estrogen levels return to normal.

When it comes to resuming having sex after birth, listen to your body and only do so when you feel comfortable. Lubricant and a careful, gentle approach are advisable. If you feel pain, stop, and try again in a few more days or weeks.

It's normal to feel that your vagina is wider or looser than it was before giving birth, even past the six-week mark. Every woman is different, and it's usually just a matter of time, patience and lots of Kegels before your vagina feels and looks close to its former self. An exception is when there's recovery from third- and fourth-degree tears, which can result in lasting differences in size, tightness and sensation in the vagina. In these cases, and in any instances of vaginal issues that continue to bother you past 12 weeks, it's important to consult your OB-GYN.