Pelvic Floor Problems that can occur after childbirth include:
- Distortion of the vagina or perineum (area between the vagina and anus)
- Heaviness or dragging sensation in the vagina
- Pain in the vagina or perineum that can also be associated with sexual intercourse
- Changes in appearance of the one or both of the labia (lips around the vagina)
- Incontinence of stools (faeces) or wind (flatus)
Is it normal to have problems after childbirth?
It is very common for women to experience some trauma to the pelvic floor and vagina during childbirth. The vast majority of women recover completely and have no ongoing problems in the long term although we would always recommend that women continue to do their pelvic floor exercises for life to help to prevent problems later in life such as incontinence or prolapse.
A small minority of women experience ongoing problems after childbirth including pain, scarring, or heaviness in the vagina that may be uncomfortable. This can also affect sexual function and cause great distress and therefore should not be ignored. Not all women require a surgical solution. Our care is individualised to your symptoms and expectations, as well as taking into account plans for future children.
Scarring or Distortion of the Vagina or Perineum
The majority of women experience some degree of stitching after childbirth, especially if it is after their first child. The stitches usually dissolve after approximately 4-6 weeks depending on the extent of the injury as well as the type of stitch used. The area continues to heal over a period of months after the delivery.
Normally, the vagina and perineum heal without any problems but in a minority of women, there can be scarring or distortion because the area has not healed perfectly. This may cause no symptoms at all, but can cause pain, especially during sexual intercourse, or lead to loss of confidence or libido.
Often this can be managed with a watch and wait approach, or using conservative measures such as vaginal dilators to break down any scar tissues, or stretch the vagina if there has been any narrowing or shortening. If this fails then the vagina and perineum can be refashioned.
Heaviness or dragging sensation in the vagina
It is quite common after childbirth to experience some feelings of heaviness in the vagina. This is caused by pelvic floor weakness that is usually temporary and make take up to a year after delivery to resolve. If the pelvic floor has been severely damaged then this feeling may persist or the vagina or cervix may come very close to or out of the entrance to the vagina. This is called a vaginal or uterine prolapse.
Changes in appearance of the labia
After childbirth the labia may be traumatised and one of the labia may be scarred or reduced in size when compared to the other. Labial enlargement can also occur after childbirth which may be on one or both sides.
If the labia are enlarged they can catch on clothing, or may wearing certain types of underwear uncomfortable. The appearance of enlarged or damaged labia may also affect personal confidence or libido and affect intimacy with a woman’s partner.
Incontinence of faeces or flatus
Rarely, childbirth can cause injury to the pelvic floor that is so severe that it may affect the muscles around the back passage, or anus. This muscle complex called the anal sphincter is responsible for preventing loss of stool (faeces) or wind (flatus) from the back passage. If this is damaged then women can suffer from incontinence of faeces and flatus.
This is an extremely distressing symptom and requires review by a pelvic floor specialist. In the majority of cases this can be managed conservatively with pelvic floor and anal spincter rehabilitation under the care of a specialist physiotherapist. It is uncommon for women with this condition to require a surgical solution.