One question that crossed my mind — and I imagine most other moms' minds too — during pregnancy, is whether or not my vagina would go back to normal after birth. And, if not, I was curious how it would be different. For those moms who've had to get an episiotomy, I can imagine "how does my vagina change after an episiotomy?" is something they Googled on multiple occasions.
According to What To Expect, the vagina is made for birth and actually prepares for birth the moment you became pregnant by releasing the hormones estrogen and relaxin. Comforting right? Estrogen increases blood flow to the vagina creating more tissue flexibility, and relaxin — like it sounds — helps the body relax and loosen up. The changes, however, don't stop there and will vary depending on the type of birth you have.
According to the National Health Service (NHS), some women naturally tear from birth, while others require an episiotomy, which is a cut between the vagina and anus. Immediately after either occurrence, there may be some stinging where the perineum cut was made. In the few weeks following the birth, it's not unusual for the vagina to feel more dry or for women to experience perineal pain or pain during sex. Additionally, urogynaecology consult at University College Hospital Dr. Suzy Elneil told NHS that that vagina can feel soft, looser, and even more open after birth. Luckily, any swelling or openness should start to reduce within just a few days after giving birth.
As far as the perineal pain, Mama Birth shared that the perineum has generally healed after six weeks, and any stitches from an episiotomy or tear should be healed as well. It's important to remember, especially if you've had a episiotomy, that many women are still sore or experience some discomfort on the perineum even past the six week mark. In which case, it may be a good idea to ease back into sex with more comfortable sex positions postpartum, and even practice tantric sex or use external stimulation until you feel less discomfort.
The aforementioned What To Expect article noted that a lot of the changes that occur to your vagina — short or long term — depend on factors like the size of your baby, genetics, length of delivery, and the amount of deliveries you've had. Regardless, it's very likely your vagina won't completely return to normal, episiotomy or not. You can take comfort in knowing, however, that the changes are generally not significant or even noticeable.