What Happens to the Vulva and Vagina After Birth - According to Experts

Despite an uptick in body positivity over the last several years, many people who've given birth still feel the pressure to "bounce back" fast. Often, that means losing weight, but there are other ways snapback culture puts pressure on postpartum parents to look the same as they did pre-pregnancy. For instance, most parents notice differences in the vulva and vagina after birth - it's normal, even among those who don't deliver vaginally. And too often, those changes can be a source of embarrassment, discomfort, and even shame.One reason for this discomfort is because what happens to the vulva and vagina after birth isn't talked about, especially when compared to less-taboo subjects like stretch marks. When they are talked about, all too often it's in the form of misinformed and, frankly, cruel jokes that center around the vagina getting "loose" after delivering a baby - a misogynistic myth.This is why it's crucial to talk about the short- and long-term changes to the vulva and vagina after giving birth. Knowing what to expect can prevent the insecurities that so many new parents end up confronting in silence, but it can also be comforting. In a time that's already so tough on mental health, it helps to know that many of these changes will reverse over time, says ob-gyn Taraneh Shirazian, MD.For more information, we asked Dr. Shirazian and other experts exactly how the vulva and vagina change after giving birth - aesthetically and otherwise. Read on to learn what's temporary and what may not be, plus what to do if you're feeling insecure.Experts Featured in This Article:Taraneh Shirazian, MD, is a board-certified gynecologist at NYU Langone and director of the Center for Fibroid Care.Erin Conway, MD, FACOG, is a board-certified physician specializing in obstetrics and gynecology.Laura Gleason, PT, DPT, is a physical therapist, pre/postnatal fitness instructor, and owner of Beyond the Bump Wellness.Alexis Parcells, MD, is a board-certified plastic surgeon at Parcells Plastic Surgery.Mary Jacobson, MD, is an ob-gyn, minimally invasive surgeon, and chief medical officer at telemedicine practice Alpha.Vagina and Vulva After BirthWhether you've already given birth, or you're getting ready to, your vagina and vulva may look and feel a bit different afterwards. Here are some of the most common changes to know about, according to experts. Swelling and SorenessAfter giving birth, the vulva becomes hypervascularized, "meaning there's a lot of blood flow to it," Dr. Shirazian says. This can lead to engorgement, swelling, or soreness, all of which may cause the labia majora and minora to look puffy for about six to 10 weeks postpartum, Dr. Shirazian says. If it lasts any longer than this, you can mention it to your doctor, but it should naturally subside over time.Labia DarkeningHigher levels of estrogen may also lead to labia darkening, whether you've given birth vaginally or via C-section. This symptom should also fade within six to 10 weeks, Dr. Shirazian says.Vaginal DrynessChanging estrogen levels are also linked to a reduction in your natural vaginal lubrication. This side effect should last about six to 12 weeks after giving birth, Dr. Shirazian says. Vaginal dryness affects everyone after delivery, regardless of whether you gave birth via C-section or vaginally, she adds. This may sound like no big deal, but it can actually be relatively uncomfortable, leading to itching or burning. It can also cause pain during intercourse, and people with more severe dryness may not be comfortable having vaginal intercourse at the six-week mark, which is when people usually get the green light to resume penetrative sex postpartum, Dr. Shirazian says.Healing From TearsApproximately 70 percent of pregnant people will experience vaginal tearing when giving birth, according to a 2020 study published in BMC Pregnancy and Childbirth. Less frequently (in about 8 percent of births), your doctor or midwife might make a small incision in the perineum (which connects the anus to the vaginal opening) to create more space for your baby to come through - a procedure called an episiotomy.Both tears and episiotomies "are typically repaired with dissolvable sutures," says Erin Conway, MD, FACOG. They can take up to 12 weeks to heal completely, depending on the severity. "In some cases, a scar may continue to cause discomfort with things such as sitting, wiping, or sex," says physical therapist Laura Gleason, PT, DPT. Dr. Conway says that up to eight percent of women self-report persistent perineal pain one year after delivery. If you're still experiencing discomfort more than 12 weeks after delivery, make sure to speak with your doctor. Dr. Conway specifically suggests asking about scar massage, which "can promote elasticity of the area and improve pain."Labia After Giving BirthJust like how your abdomen may change after having a baby, your labia may also change, Gleason says. Vaginal labor in particular stretches your tissue, which can cause aesthetic changes, especially if you deliver more than one child vaginally. For instance, your labia might become more elastic or appear more wrinkly. Or it may become longer or hang differently, causing the labia minor (inner lips) to show from the labia majora (outer lips) - even if it didn't before. One outer lip might appear bigger than the other, or your lips might seem permanently puffier than before, says plastic surgeon Alexis Parcells, MD."This is completely normal," Dr. Parcells emphasizes. "No part of our body is completely symmetric, and this is the case with the labia as well. This is nothing to be ashamed of or afraid of." Gleason notes that aesthetic changes like this have a lot to do with genetics and how your tissue heals; the same reasons some people get stretch marks and loose skin on their abdomen after pregnancy and some don't. Hormones may play a role too. Estrogen levels take a dip after giving birth (breastfeeding keeps them low for about six months) and since estrogen plays a role in labial-tissue moisture and elasticity, once levels start to climb again, you may notice another change in appearance.Vaginal Canal After Giving BirthIf you delivered vaginally, the vaginal canal will have stretched and lengthened, and afterward it might feel different, although not "looser" necessarily, Gleason says. In fact, some people feel more tightness or discomfort in the vagina postbirth, a symptom caused by the pelvic-floor muscles becoming overactive and too tense. These changes can affect how it feels to put in a tampon or have penetrative sex, she explains. For the most part, the differences will be slight and not troublesome. But pelvic-floor physical therapy after birth is often a good idea, Gleason says, especially if you feel any pelvic muscle discomfort. (More on that later.)Pelvic-Floor Muscles After Giving BirthWhen you're pregnant, the fetus can put a lot of pressure on your pelvic-floor muscles, which support the bladder and vagina, and that can lead to weakness postpartum, says ob-gyn Mary Jacobson, MD. That weakness can lead to incontinence (leaking urine or, less commonly, feces). "It is fairly common for people to have mild incontinence right after delivery, but that should resolve in the first four weeks," Gleason says. "If it is more severe or persists, that is when you should seek help." Gleason suggests talking to your doctor if you experience symptoms like having to urinate all the time, not being able to fully empty your bladder, constipation, painful sex, pelvic pressure/prolapse, and pelvic pain."Sometimes I think our culture leads people to believe that we just have to deal with [incontinence], and that's kind of part of delivering a baby," says Gleason, who experienced incontinence after delivering her eldest child. But, she emphasizes, we shouldn't normalize this kind of treatment, and pelvic-floor physical therapy can really help.When Does the Vagina Go Back to "Normal"?Dr. Shirazian suggests giving temporary changes, including swelling, dryness, or an episiotomy scar that needs to heal, six months. If they don't resolve by then, or if they're interfering with your daily life (as is the case for issues like incontinence), mention them to your doctor.As for how long it takes for the vulva to completely heal, the time frame is about the same as it is for your stomach: a year or more, Dr. Shirazian says. "Be lenient on yourself and your body," Dr. Shirazian says. "If you have changes that persist and make you uncomfortable, let your doctor know, and ask about other therapies."How to Cope With Vaginal ChangesThere are treatments to help with physical discomfort, such as pelvic-floor therapy, and even options meant to address aesthetic changes. While Dr. Shirazian warns against procedures that claim to tighten the vagina (which are largely unsafe), a labiaplasty, for instance, can safely reduce the size or change the shape of your labia. This can help with physical discomfort - if a lip chafes against clothing, for instance - or make people feel better on a cosmetic level, Dr. Shirazian says. She suggests finding a reputable surgeon who operates regularly, and comes highly recommended by other patients."Also, keep in mind that if you're having more children, you may want to wait until your pregnancies are over to address the issue," she notes. Regardless of what you decide is the best choice for you, Dr. Shirazian also emphasizes the usefulness of connecting with other people who've given birth, because many are going through the same thing. "You're not alone," she says.- Additional reporting by Chandler PlanteMaressa Brown is a journalist, author, and astrologer. Her areas of expertise include writing, reporting, and editing lifestyle, pop culture, and parenting content that's both conversational and substantive. In addition to contributing to PS, she writes for a variety of consumer-facing publications including InStyle, Parents, and Shape, and was previously an editor at Cosmopolitan and CafeMom.Chandler Plante (she/her) is an assistant health and fitness editor for PS. She has over four years of professional journalism experience, previously working as an editorial assistant for People magazine and contributing to Ladygunn, Millie, and Bustle Digital Group. Related: The "Postpartum Cliff": A Phase We Don't Discuss Enough