So what actually happens? Will your vagina bleed? How long will it hurt? When can you have sex? We talked to leading gynecologists to find out exactly what to prepare for. Ahead, discover 13 things to expect from your vagina after birth.
You'll experience postpartum bleeding. After delivering your baby, expect to experience postpartum bleeding for up to six weeks. During the first ten days, expect heavy bleeding and bright red blood. You can also expect to see small clots (no bigger than a quarter) during the first three days. This is all normal, as your body sheds the extra tissue and blood from your uterus (this discharge is called lochia). After the first ten days, the bleeding slows down. You will continue to bleed lightly or spot, however, for up to six weeks after you give birth vaginally or by C-section.
You'll have uterine contractions (a.k.a. cramps). You'll experience cramps as your uterus shrinks to its pre-baby size. This process is called involution. For many first-time mothers, the pain is negligible. After subsequent births, the pain can be more intense since the uterine muscles have been compromised. Either way, this is a positive sign that your body is doing what it should be doing, and can be addressed with a warm compress and/or ibuprofen. It will subside in about three days.
Your vagina might tear. It's not a question of whether you'll be sore, but of how much you'll be sore. More than 53 percent of births cause tearing around the vaginal opening, according to the American College of Obstetricians and Gynecologists. Depending on the severity of the tearing, your vagina and perineum could be sore for four to 12 weeks. Significant tears can necessitate stitches after birth or, in some cases, surgery to repair the damage. Even without tearing, you will be left with a bruised perineum.
You will experience internal bruising. When the baby passes through, it's inevitable that you'll experience internal bruising in your vagina. You can't see it, but you'll feel a soreness that should subside within two weeks.
Your period will seem off when it returns. When your body begins ovulating again, your period could be different than how it was before getting pregnant. Thanks to all the hormonal changes going on, you could end up with a lighter or heavier period. And it's not just the intensity of the bleeding, but the duration, as well, explains Dr. Jessica Shepherd, a board-certified ob-gyn and a spokesperson for Paragard.
You'll have a (slightly) wider vagina. Things can also feel looser down there post-childbirth, but it tends to gradually go back to normal. If, however, you have a very large baby (or have had many babies), it might not go back to exactly the way it was before. The telltale indicator is tampons: If you insert a regular tampon and it ends up sliding out over time, that can be a sign that your vagina is ever so slightly wider than it was pre-birth.
You might end up peeing yourself a little. It's not uncommon to experience urinary incontinence post-birth, especially when engaging in activities like jumping, running, or even sneezing and laughing. "Up to 30 percent of women may experience urinary incontinence for up to six months," says Dr. Shepherd. “As the uterus enlarges during pregnancy, it impacts the ability for the bladder to extend and enlarge when it's filled, so there are changes in how the bladder is able to function. Furthermore, during vaginal delivery as the baby passes through the birth canal there can be an effect on the urethra."
Kegel exercises can help strengthen those muscles—aim for five minutes a day, three times a day. Doctors advise keeping up with this regimen during pregnancy as well, to condition the pelvic floor muscles ahead of the birth.
You'll have to wait about six weeks to have sex. Doctors usually advise women to wait to have sex. “After a woman has a baby, it takes about six weeks for a woman's vagina to heal from a delivery,” says board-certified ob-gyn Pari Ghodsi, M.D.. During that time, sex is off-limits. It's important to give yourself a break after giving birth. “It is important for a woman to realize that things take time,” says Dr. Ghodsi. “It won't feel the same at first, but with time, things typically go back to normal.” Even after things heal up, you might not feel emotionally ready to re-enter into intimate moments. Dr. Shepherd recommends considering talking to a therapist or sex therapist if you're experiencing anxiety associated with sexual intimacy. “Some people may also just feel different in the pelvic region, and there are pelvic physical therapists that can help identify muscles that need to be strengthened or loosened in order to relieve discomfort or urinary incontinence,” explains Dr. Shepherd.
Your orgasms could feel weaker. When you do go back to having sex, you may think your orgasms feel less powerful post-birth. You're not imagining it. That same weakened pelvic floor that's causing leakage is also responsible for weaker orgasms which is more incentive to keep practicing those Kegels. In time, your orgasm should go back to being its original earth-shattering self.
Your vagina will feel dry if you're breastfeeding. Nursing can cause estrogen deficiency, which in turn causes vaginal dryness, explains Christine Greves, M.D., a board-certified ob-gyn in Orlando, Florida. It's not a permanent problem by any means—the dryness will only last as long as you're nursing—but in the meantime, introducing water-based lube into your sex life can make all the difference. You can also get a prescription topical estrogen cream that will help combat dryness.
Your labia could be a different color or shape. Your vulva and vagina before and after birth can look totally different. Pregnancy causes a rise in estrogen and progesterone, which in turn causes an increased blood flow. That increased blood flow can cause the labia to darken and even cause a slight change in shape. The change in shape is also due to the surge in blood—the labia majora may retract, and their retraction can cause the labia minora to appear larger or even show for the first time. The coloring and shape may return to their original appearance when your hormones and blood flow level out after birth, but the change may also be permanent. "There are some women who say it looks the same and there are some women who notice their labia is longer or hangs differently," explains Dr. Shepherd.
You're able to conceive right away. While it's true that breastfeeding decreases your chances of getting pregnant, it's still possible to conceive. "There is good data that exclusive breastfeeding suppresses hormonally the ability to ovulate, but there is always that potential that you can still ovulate (and therefore conceive),” says Dr. Shepherd.
You will need postpartum care. Not unsurprisingly, new moms will need to see their health care provider make sure everything is healing up and in working order. Your first checkup will occur 4-6 weeks after vaginal birth, followed by another visit at 12 weeks. That visit is to go over any continuing issues or discuss contraceptive care and birth control, explains Dr. Shepherd.