Babies Postpartum Care What Happens to Your Vagina After Pregnancy? By Chaunie Brusie, RN, BSN Chaunie Brusie, RN, BSN LinkedIn Chaunie Brusie is a registered nurse with experience in long-term, critical care, and obstetrical and pediatric nursing. Learn about our editorial process Updated on October 05, 2022 Medically reviewed by Alyssa Dweck, MD Medically reviewed by Alyssa Dweck, MD LinkedIn Alyssa Dweck, MD, MS, is a board-certified gynecologist and an assistant clinical professor at the Mount Sinai School of Medicine. She provides care to women of all ages, and she has delivered thousands of babies. Learn about our Medical Review Board Print AntonioGuillem / istock Table of Contents View All Table of Contents Post-Pregnancy and Birth Vagina Concerns Change in Function Urinary Incontinence Treatment Reparative Surgery Your body goes through a lot of changes during pregnancy: your vagina, abdomen, breasts, skin, and hair can all look and feel different during and after pregnancy and birth. Some changes are clearly visible, like that dark line that can show up on your stomach, which is known as the linea negra. Others may not be as visible, such as changes to your vagina after birth. Many pregnant people wonder how pregnancy will affect their vagina, and if delivering a baby will permanently stretch it out or cause incontinence. Growing an entire human being isn't always easy, and your body will change as a result. However, while your vagina will be impacted by giving birth, most of these changes are temporary and/or can be lessened by interventions like doing pelvic floor exercises. Learn more about your vagina after birth. Post-Pregnancy and Birth Vagina Concerns Your vagina is a structure that is inside your body. Anything that you see on the outside, including your labia (the folds or "lips"), clitoris, and mons pubis (the mound where pubic hair grows) are parts of the vulva, not the vagina. The vaginal opening is where menstrual blood passes and the baby comes out during delivery. Potential changes in the vagina after birth include the following. Stretching Your vagina stretches during birth in order to be able to let the baby pass through the birth canal. One study found that the pelvic floor muscles involved during birth can stretch more than three times their normal amount. The vagina is designed to stretch and accommodate a baby. After delivery, the tissue will usually shrink back down to its pre-pregnancy state. The vagina may get looser after having a baby as a result of the pelvic floor muscles around the vagina getting stretched out. This change can be more pronounced based on several factors, such as how large your baby is, any complications during delivery, and how many babies you have already delivered. Genetic factors and being overweight also are influential. Practicing pelvic floor exercises like Kegels can help strengthen your pelvic floor post-baby. Talk to your doctor to find out when you are healed enough to start these exercises. Change in Appearance Most changes in the appearance of your vulva and vaginal opening that can occur after pregnancy are only temporary. Hyperpigmentation, however, may be permanent. Giving birth also may cause swelling or discoloration from pregnancy or the process of giving birth. The swelling and discoloration can occur whether you have a C-section or vaginal birth, because of pregnancy hormones. Depending on the duration and intensity of labor you have been through, the labor process itself can lead to swelling. Instrumented delivery such as forceps or vacuum assist also may be influential in swelling. What Is the 4th Trimester? Tears or Episiotomy Healing Stretching, tears, and rips can occur around the vaginal opening during childbirth. These injuries should heal with a little time. While less common than they used to be, episiotomies are sometimes necessary to help make room for the baby. An episiotomy is when a doctor or midwife makes a small incision in the perineum (the skin that connects the anus to the vaginal opening) to create more room for the baby to pass through. In general, an episiotomy heals in about three to six weeks and in some cases, can leave a scar. The amount of scar tissue will depend on how much of the perineum was involved and other injuries to the tissue. This scar tissue is not typically noticeable and does not affect your vagina's appearance or function. Your Guide to Labor and Delivery Forceps Injury The use of forceps as medical intervention during childbirth can cause injuries to the vaginal tissue. Most doctors no longer use forceps, however, if your baby needed forceps to come out and you are still experiencing vaginal pain at your first postpartum checkup, bring this up with your doctor. Change in Function In general, your vagina's function will not change as a result of pregnancy or delivery. However, sometimes the pelvic floor muscles that control the vagina are affected. These muscles surround and support the bladder and vagina, so they can be injured or weakened during birth or from the strain of pregnancy. In some cases, damage to the pelvic floor muscles can lead to complications such as bladder dysfunction or uterine prolapse. Urinary Incontinence One of the most common issues that women have after childbirth, for example, is urinary incontinence. Some women find that they leak urine, especially with strenuous activity, such as jumping or sneezing. This is common, but it's not normal or untreatable. Ask your health care provider for suggestions on strengthening your pelvic floor muscles to prevent incontinence. Sexual Function One study found that 91.3% of women reported some kind of sexual problem after having a baby. The reasons can range from sleep disruptions from the baby to how a woman feels about her vagina. The nerves in the pelvis can also be damaged or changed during the pregnancy and delivery process. The pelvic floor muscles that worked so hard during birth play a role in sexual function and orgasm, too. Some women do experience a lack of sexual satisfaction or feeling like their vagina doesn't quite "work" the same way it used to as a result of weakened pelvic floor muscles. Painful sex can also be due to dryness caused by the hormonal changes of pregnancy and breastfeeding; this dryness is temporary and can be treated with lubricants. If sex is very painful for you after having a baby, talk to your doctor to rule out any complications or infections. Treatment Options Fortunately, certain exercises can help strengthen weakened pelvic floor muscles. Kegels—simple, repetitive squeezing or tightening of the pelvic floor muscles—provide some benefit. Other exercises that use your core muscles are safe to perform during pregnancy and can help engage the entire pelvic floor to keep it strong. Don't start any new strenuous exercises, of course, but if you've been exercising before your pregnancy, keep it up because there are many benefits. Exercising Your Core Post-Pregnancy Pelvic Floor Therapy Studies have found that postpartum pelvic floor exercise programs are very helpful in decreasing postpartum urinary incontinence and pelvic floor strength. The most effective programs are run by trained health professionals and include a vaginal resistance device. It may be difficult to do these exercises on your own. If you are struggling with weakened pelvic floor muscles, talk to your doctor. Many doctors and insurance companies are recognizing the benefits of supporting women through and after pregnancy to prevent any future problems. Reparative Surgery In severe cases, surgery may be needed to repair the pelvic floor and support any structures that may have dropped, such as the uterus or bladder. Changes to Your Body After Pregnancy A Word From Verywell In general, the vagina is a structure that is designed to accommodate a baby and will not change significantly in structure or appearance after pregnancy. In some cases, however, as a result of damage or weakening of the pelvic floor muscles, a woman might experience post-partum changes such as urinary incontinence, bladder dysfunction, or pain during sex. If you experience any of those changes, don't let embarrassment prevent you from seeking help. These issues are very common and often highly treatable. Speak to your doctor about treatment options. 13 Sources Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American College of Obstetricians and Gynecologists. Changes during pregnancy. American College of Obstetricians and Gynecologists. Vulvovaginal health. Reviewed June 2020. Ashton-Miller JA, DeLancey JOL. On the biomechanics of vaginal birth and common sequelae. Annu Rev Biomed Eng. 2009;11(1):163-176. doi:10.1146/annurev-bioeng-061008-124823 Vora RV, Gupta R, Mehta MJ, Chaudhari AH, Pilani AP, Patel N. Pregnancy and skin. J Family Med Prim Care. 2014;3(4):318-324. doi:10.4103/2249-4863.148099 Jiang H, Qian X, Carroli G, Garner P. Selective versus routine use of episiotomy for vaginal birth. Cochrane Database Syst Rev. 2017;2(2):CD000081. doi:10.1002/14651858.CD000081.pub3 American College of Obstetricians and Gynecologists. What is an episiotomy?. Reviewed October 2020. John LB, Nischintha S, Ghose S. Outcome of forceps delivery in a teaching hospital: A 2 year experience. J Nat Sci Biol Med. 2014;5(1):155-157. doi:10.4103/0976-9668.127316 Woodley SJ, Boyle R, Cody JD, Mørkved S, Hay-Smith EJC. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2017;12(12):CD007471. doi:10.1002/14651858.CD007471.pub3 Moossdorff-Steinhauser HFA, Berghmans BCM, Spaanderman MEA, Bols EMJ. Prevalence, incidence and bothersomeness of urinary incontinence between 6 weeks and 1 year post-partum: a systematic review and meta-analysis. Int Urogynecol J. 2021;32(7):1675-1693. doi:10.1007/s00192-021-04877-w Acele EÖ, Karaçam Z. Sexual problems in women during the first postpartum year and related conditions. J Clin Nurs. 2012;21(7-8):929-37. doi:10.1111/j.1365-2702.2011.03882.x. Golmakani N, Zare Z, Khadem N, Shareh H, Shakeri MT. The Effect of Pelvic Floor Muscle Exercises Program on Sexual Self-efficacy in Primiparous Women After Delivery. Iran J Nurs Midwifery Res. 2015;20(3):347-53. Gutzeit O, Levy G, Lowenstein L. Postpartum female sexual function: risk factors for postpartum sexual dysfunction. Sex Med. 2020;8(1):8-13. doi:10.1016/j.esxm.2019.10.005 Harvey MA. Pelvic floor exercises during and after pregnancy: a systematic review of their role in preventing pelvic floor dysfunction. J Obstet Gynaecol Can. 2003;25(6):487-98. doi:10.1016/s1701-2163(16)30310-3 By Chaunie Brusie, RN, BSN Chaunie Brusie is a registered nurse with experience in long-term, critical care, and obstetrical and pediatric nursing. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Featured Video