woman after birth

There’s a lot going on in your nether regions post-birth. Here’s the information you need to make a good recovery…

Vagina

The truth is your vagina probably won’t go back to exactly its pre-birth self. But for most women it will be near enough that this shouldn’t be a problem.

It’s very common to worry about feeling loose…

After giving birth, it might look wider than it did before and could feel looser, softer and more open. It might also look and feel bruised or swollen. But all of this should settle in a few days.

You may also find that your vagina feels drier, especially if you are breastfeeding (NHS Choices, 2015a).

The next steps

It’s all about the pelvic floor exercises to make your vagina feel tighter again and prevent bladder problems. Here’s how:

  • Squeeze and draw in your anus and close up and draw your vagina upwards.
  • Do it quickly, tightening and releasing the muscles immediately then do it slowly, holding for as long as you can (but no more than 10 seconds).
  • Repeat each exercise 10 times, four to six times a day.
  • It might help to imagine you're stopping a poo, holding in a tampon, or stopping yourself from weeing. 

(NHS Choices, 2015a; Woodley et al, 2017)

If you feel like these exercises aren’t helping, speak to your GP. Postnatal incontinence is common in women who have just given birth (NHS Choices, 2015a; Woodley et al, 2017). You might need a referral to a physiotherapist if you get this. 

When it comes to dryness, a simple lubricant could help when you’re ready to have sex again. Here are some more tips on how you can get your old sex life back after birth.

Bleeding after birth

Straight after you’ve given birth, the bleeding from your vagina will be heavy. But over time it’ll become lighter and more brown than red (NHS Choices, 2015b).

Use super-absorbent maternity pads and make sure you change them regularly. Mums who are breastfeeding might have heavier and redder bleeding as breastfeeding makes the womb contract causing more blood.

The next steps

Most women stop bleeding around 12 weeks after birth (RCOG, 2016). If your bleeding isn’t lessening and you’re losing large blood clots, save your sanitary towels and show your midwife or health visitor.

You might get extremely heavy bleeding after birth. This must be treated quickly as it is a postnatal haemorrhage (RCOG, 2016). See more information here.

Stitches

If you had a tear or an episiotomy, the whole area around your vagina can feel sore. Difficult as this is, it should improve within six to 12 weeks (NHS Choices, 2015a).

You might have a small scar when the tear or cut has healed but stitches should dissolve by themselves.

"The main thing you want to watch for is infection, so look out for signs like stinging or an unpleasant odour."

The next steps

Crushed ice or gel pads or paracetamol or ibruprofen can help ease the pain. It’s also important to keep your stitches clean, changing pads regularly (with clean hands) and washing daily.

Your health visitor should ask you how you’re healing each time they see you (NICE, 2006). Do raise any concerns you have if they forget to ask.  

Weeing after giving birth

The idea of weeing for the first time after you have a baby can feel scary. First, it’s sore and second, you can’t really feel what you’re doing (NHS Choices, 2015b).

Let your midwife know if you’re finding going for a wee particularly difficult. If you haven’t gone six hours after giving birth, they might suggest a warm bath or shower (NICE, 2006).

The next steps

Drink plenty of water and ride it out for a few hours. If you still can’t go after a warm bath or shower and drinking plenty of water, you might have your bladder volume assessed. You could potentially need a catheter (NICE, 2006).

Urinary incontinence

After you’ve had a baby it’s very common to leak urine when you laugh, cough or sneeze.

The next steps

Again, it’s all about the pelvic floor exercises. But if you’re still suffering with incontinence issues three months after you’ve had your baby, speak to your GP. They should refer you to a physiotherapist. You can also visit the Bladder and Bowel Foundation website.

Piles

Piles (haemorrhoids) are very common after birth (NHS Choices, 2015b). They are swellings containing enlarged blood vessels found inside or around the bottom (NHS Choices, 2016).

The next steps

If you feel uncomfortable, let your midwife know and they can give you some ointment (NHS Choices, 2015b). If you experience bleeding or a severe, swollen or prolapsed pile, see your GP.  

Bowel movements

You might not need to poo for a few days after you have given birth, but don’t let yourself get constipated. If you’ve had stitches, you may be particularly concerned. Rest assured it’s very unlikely that you will break the stiches or open up the tear again.

The next steps

Eat plenty of fresh fruit, vegetables, salads, wholegrain cereals and wholemeal bread, and drink plenty of water (NHS Choices, 2015b). If necessary, you might be given a gentle laxative.

You might also feel better if you hold a pad of clean tissues over the stitches while doing a poo. If you’re worried that things aren’t getting easier, speak to your GP.

About 5% of women who have a vaginal delivery each year get faecal incontinence (Fernando et al, 2002). This is when you’re unable to control the passing of liquid (diarrhoea) or solid poo until you reach a toilet. Some people also involuntarily pass wind (Bladder and Bowel Community, 2014).

Whatever you do, don’t feel embarrassed about speaking to a health care professional about concerns you have around these issues.

This page was last reviewed in February 2018

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

Bladder and Bowel Community. (2014). Factsheet: Faecal incontinence. Solihull. Bladder and Bowel Foundation. Available from: https://www.bladderandbowel.org/wp-content/uploads/2017/05/BBC017_Faecal-Incontinence.pdf

Fernando RJ, Sultan AH, Radley S, Jones PW, Johanson RB. (2002). Management of obstetric and anal sphincter injury: a systematic review & national practice survey. BMC Health Services research. 2(1):9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC116576/ [Accessed 1st February 2018].

NHS Choices. (2015a). Vagina changes after childbirth. Available from: https://www.nhs.uk/Livewell/vagina-health/Pages/vagina-after-childbirth.aspx [Accessed 1st February 2018].

NHS Choices. (2015b). You and your body straight after birth. Available from: https://www.nhs.uk/conditions/pregnancy-and-baby/you-after-birth/  [Accessed 1st February 2018].

NHS Choices. (2016). Haemorrhoids (piles). Available from:  https://www.nhs.uk/conditions/piles-haemorrhoids/ [Accessed 1st February 2018].

RCOG (Royal College of Obstetricians and Gynaecologists). (2016) Heavy bleeding after birth (postpartum haemorrhage). Available from: https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-heavy-bleeding-after-birth-postpartum-haemorrhage.pdf [Accessed 1st February 2018].

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 Dec 22;12:CD007471. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007471.pub3/full [Accessed 1st February 2018].

Further reading

MacKenzie R, Clubb A. (2007) Faecal incontinence following childbirth. Nurs Times. 103(14):40-1. Available from: https://www.nursingtimes.net/faecal-incontinence-following-childbirth/201860.article [Accessed 1st February 2018]

NHS Choices. (2016) Your post-pregnancy body. Available from: https://www.nhs.uk/conditions/pregnancy-and-baby/your-body-after-childbirth/ [Accessed 1st February 2018]

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