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There can be a dark side to your vagina after birth, but you won’t know until the dripping stops, the swelling goes down, and you can finally see and feel yourself.
There is a timeline of what happens to your vagina immediately after giving birth, but this article is about later on, as you heal up and things get back to what might be their new normal. We’ve covered what happens immediately after birth: you’ll be bruised, swollen, bleeding, and feel like your vagina feels wide. Your perineum may be sore, too.
These effects should start to heal and progressively improve over the next three to four months. Some people take longer to heal, while others recover more quickly.
The other articles in this series include:
The effect of a vaginal birth on your vagina
A vaginal birth can stretch out your vagina, weaken pelvic floor muscles, and result in issues such as unsatisfying sex to stress urinary incontinence.
Typically, there are two major issues: stretched-out collagen inside your vaginal walls and weak or dysfunctional pelvic floor muscles. These two combined can result in a dysfunctional pelvic area, loose-feeling vagina, and issues with bowel movements and urination.1,2
These problems will be worse immediately after birth, but sometimes can linger on into ‘real life’.
You may also have vaginal or vulvar tears that can vary in severity and how well they heal. How these heal and what is done about them at the time is important, because if you tear badly, but it’s not picked up, your vagina can heal poorly or you can end up with a lot of scar tissue. Prompt inspection is important if you suspect something is amiss.3
You may have had an episiotomy during birth, whereby the perineum is cut to help get the baby out. These cuts can heal poorly, with a lot of scar tissue or having created a too-tight vaginal entrance, making sex or masturbation uncomfortable later on. You can also end up with chronic pain or discomfort.4
What to expect after a vaginal birth
Vaginal laxity
You can expect your vagina to feel a bit looser than before giving birth, forever. This is normal. It doesn’t mean that sex will be like ‘throwing a sausage down a hallway’; it just means you will need to put more effort into your pelvic floor function (and any dysfunction) and check in with your partner to adjust how you go about sex.5
A vaginal birth is not a sex-life death sentence – there are plenty of women having great sex after having kids.
If you are having issues with pelvic laxity, then your best bet is to see your doctor to make sure nothing untoward is happening, and then get a referral to a pelvic physiotherapist or see an osteopath for guidance on your pelvic floor function. Pelvic floor physiotherapy is the best-evidenced first step. Some clinics also offer energy-based options such as infrared, laser or radiofrequency, but these remain experimental for laxity – the FDA has warned that their safety and effectiveness for so-called ‘vaginal rejuvenation’ have not been established, so treat them as unproven rather than routine.6,7
While nobody wants to say it out loud, vaginas can be ruined by giving birth vaginally. Everyone hopes it won’t be them, but the truth is, it happens. The effects can be minor, but compared to what? If you can’t use your vagina the way you used to, it can impede some very intimate activities.
Not being able to have comfortable or pleasurable sex may not seem to your doctor to be a big issue, but it should be treated seriously. Urinating a little bit when you cough (stress urinary incontinence) is a big deal.
There is a big gap in how medicine has gone about treating women’s bodies, particularly after childbirth. There has been an attitude of, ‘Well, this is what happens when you have a baby, so deal with it.’
This dismissal of discomfort, pain, and the loss of enjoyment is not taken as seriously as it ought to be. If your doctor is not taking your concerns seriously or is saying there is nothing they can do, find another doctor.
New and novel treatments are coming out all the time that may help tighten and replace collagen deposits, which can improve symptoms. Some treatments to look up include:
- Radiofrequency
- Laser
- Infrared light
- Platelet-rich plasma (PRP)
- Pelvic physiotherapy
- Pelvic osteopathy
A word of caution before you spend money: of these, pelvic physiotherapy and osteopathy have the best evidence and the best safety record. The energy-based options – radiofrequency, laser and infrared – are still experimental for laxity, and the FDA has warned that their safety and effectiveness for so-called ‘vaginal rejuvenation’ have not been established. PRP is likewise unproven for this purpose. Ask any provider what the evidence actually shows before committing.
Vaginal dryness
Your vagina is likely to feel dry for a while after birth, probably several months, or even the entire time you breastfeed if you don’t get a period. This is because your vagina and vulva need oestrogen to stay plump, supple, and juicy, and prolactin – the hormone that stimulates your breast milk – blocks oestrogen for the most part.8
This can result in a dry, irritated or itchy vagina and vulva. While this is normal, it can be quite uncomfortable, so speak to your healthcare practitioner about your options. This may include using a vaginal moisturiser and possibly a product that contains oestrogen, which will act on local tissues to increase moisture production.9
When you’ve had a traumatic birth and surgeries
You can’t predict what your body is going to do when you are having a baby. You may be one of the lucky ones who bounce right back, or you may experience the terrible consequences of unforeseen complications that result in surgery and birth traumas.
A traumatic birth can leave your vagina and soul in tatters, and this can happen on the first, third, or seventh baby. There is no way to predict how the birth process will unfold.
Having prompt and proper medical care immediately after your birth is one of the best ways to help get better outcomes, since what happens to your body at the time, and how it’s managed, will dictate what happens later.
If your medical care is substandard, surgeries may have been performed inadequately, your surgeon may have been inexperienced, or you may have simply needed care that was not available or unattainable. It can sometimes be hard to see what’s happening during the chaos of a birth, and problems may not be picked up until later on when the dust settles.
A traumatic birth comes with scars that are more than physical, but your body will probably never be the same again.
Frequently asked questions
How long does it take for the vagina to heal after birth?
Most of the bruising, swelling and stretched feeling settles over the first three to four months. Some women heal faster, others take longer – particularly after tearing, an episiotomy or a difficult birth. If something still feels wrong after a few months, get it checked rather than waiting it out.
Will my vagina feel the same as it did before childbirth?
It may feel a little looser, and that can be permanent – but it does not mean comfortable, enjoyable sex is over. Pelvic floor work makes a real difference for most women. If laxity or pain is bothering you, a pelvic physiotherapist is the best first port of call.
Why is my vagina so dry after giving birth?
Breastfeeding keeps prolactin high, which holds oestrogen low, and low oestrogen leaves vaginal tissue thin and dry. This is normal and usually eases once your periods return. A vaginal moisturiser helps, and your doctor can prescribe local oestrogen if you need it.
Do laser or radiofrequency treatments fix vaginal laxity?
There is no good evidence that they do. The FDA has warned that energy-based ‘vaginal rejuvenation’ devices have not been shown to be safe or effective for laxity. Pelvic floor physiotherapy has far better evidence. If you are considering laser, radiofrequency or PRP, ask exactly what the research shows first.
This article is general information about recovering after birth, not medical advice. Healing varies enormously from one person to the next. If you have ongoing pain, urinary leakage, a tear that is not healing, or the emotional weight of a traumatic birth, please see your GP, midwife or a pelvic health physiotherapist – these problems are treatable, and you deserve to be taken seriously.
- Ripperda CM, Maldonado PA, Acevedo JF, et al. Vaginal estrogen: a dual-edged sword in postoperative healing of the vaginal wall. Menopause. 2017;24(7):838–849.
- Kahyaoglu Sut H, Balkanli Kaplan P. Effect of pelvic floor muscle exercise on pelvic floor muscle activity and voiding functions during pregnancy and the postpartum period. Neurourology and Urodynamics. 2016;35(3):417–422.
- Vasileva P, Strashilov S, Yordanov A. Postoperative management of postpartum perineal tears. Wound Medicine. 2019;27(1):100172.
- Hartinah A, Usman AN, Sartini, et al. Care for perineal tears in vaginal delivery: An update for midwife. Gaceta Sanitaria. 2021;35:S216–S220.
- Dietz HP, Stankiewicz M, Atan IK, Ferreira CW, Socha M. Vaginal laxity: what does this symptom mean?. International Urogynecology Journal. 2018;29(5):723–728.
- Villani F, Petre I, Buleu F, et al. Pelvic Floor Muscle Training vs. Vaginal Vibration Cone Therapy for Postpartum Dyspareunia and Vaginal Laxity. Medicina. 2024;61(1):23.
- Palacios S. Vaginal hyperlaxity syndrome: a new concept and challenge. Gynecological Endocrinology. 2018;34(5):360–362.
- Lev-Sagie A, Amsalem H, Gutman Y, Esh-Broder E, Daum H. Prevalence and Characteristics of Postpartum Vulvovaginal Atrophy and Lack of Association With Postpartum Dyspareunia. Journal of Lower Genital Tract Disease. 2020;24(4):411–416.
- Patterson J, Millheiser L, Krychman ML. Moisturizers, Lubricants, and Vulvar Hygiene Products: Issues, Answers, and Clinical Implications. Current Sexual Health Reports. 2016;8(4):213–221.
