What happens to the vagina during the postpartum period?

Dr Beata Makowska: The puerperium is the time for the vagina to return to its pre-pregnancy state. The mucous membrane shrinks, its micro-injuries regenerate, the pelvic floor muscles damaged during childbirth are repaired and, if it was performed, the perineal incision heals. In some cases, if a perineal incision was not necessary or the perineal rupture is minor, the vagina returns to normal after childbirth and regenerates quickly. The natural healing time can take up to two weeks.

What does the vagina usually look like after childbirth? Unfortunately, it is quite often the case that the vagina does not shrink properly and its walls remain flaccid, the mucous membrane dry, which can be the cause of more frequent inflammation, problems with incontinence and lack of sexual satisfaction for both partners. It is then worth considering aesthetic gynaecology treatments for post-partum rehabilitation.

Can the effects of childbirth somehow be prevented?

Stretching exercises for the pelvic tissues should be done during pregnancy. You can find out how to do these during a class at the birthing school. The specialists in the classes will show you exercises that are worthwhile and will help you prepare for the birth. In this way, you can prevent some irreversible changes after pregnancy.

When is a perineal incision needed during childbirth?

The perineal incision used to be one of the most common procedures performed during natural childbirth, particularly common in women giving birth for the first time. However, there is now a move towards it being a procedure that is only performed when necessary. Such situations include those where there is an increasing risk to the baby or mother, such as shoulder dystocia, operative birth (the need for forceps or obstetric vacuum) or the need to shorten the birth due to the condition of the mother or baby. However, in none of these situations is this procedure required. In the past, the perineal incision was thought to protect against greater injury, but this argument is not supported by statistics. Some, but rarely used perineal incision directions even increase such risks.

Is it possible to benefit from aesthetic gynaecology treatments after a perineal incision?

The perineal incision has no bearing on the decision to perform a cosmetic gynaecology procedure. Quite often, the incision itself can have such consequences, the elimination of which will require an aesthetic gynaecology procedure. I would like to point out that although these procedures affect aesthetics, especially in the case of post-partum rehabilitation, so their most important aim is to improve intimate comfort and sometimes even to regain it. They will enable the vulva after childbirth to return to its former state and to feel pleasure again.

Can the vagina return to its pre-partum state on its own?

If the baby was small and the patient took care of the vagina during pregnancy, there is a chance that during the postpartum period the vagina will regenerate itself to its pre-pregnancy state. Usually, unfortunately, the vagina remains wider than before pregnancy.

Can a 'loose' vagina be exercised?

Loose vagina syndrome is an indication for Kegel muscle exercises. This is a very good method for a loose vagina to reach its pre-partum state. How quickly you feel the changes depends on the regularity and intensity of the exercises and how big the tissue changes are. It is a very individual matter. Unfortunately, for some women, exercise alone may not be enough to achieve the desired effect.

What to do if Kegel muscle exercises do not work?

The best thing to do is to visit a clinic dealing with aesthetic medicine, at Invimed in Gdynia we perform such procedures. During the consultation, the gynaecologist will suggest a procedure which will be the most effective for the given patient and will solve the problem of a loose vagina after childbirth.

Which treatment can be most effective after childbirth?

Each of us is different, we may have different complaints, the birth may have had a different course and different outcomes. The most effective treatment is always decided by the doctor during the initial consultation. However, most often, for women after childbirth, a very effective treatment is vaginal revitalisation with the Mona Lisa Touch laser.

Can aesthetic treatments help with postpartum incontinence?

The Mona Lisa Touch laser treatment is effective for vaginal relaxation syndrome, as well as for incontinence problems. The doctor is able to select the appropriate head for the condition, as well as choosing the correct laser beam parameters.

Why are cosmetic gynaecology procedures said to be 'minimally invasive'?

The Mona Lisa Touch laser treatment is a minimally invasive procedure as it requires no special anaesthesia, no operating theatre, is painless and effective, while there is very little chance of complications. Occasionally, slight discomfort may occur during the procedure. Also after the procedure, the patient does not feel any pain, sometimes a slight vaginal itching and mild discharge may occur. However, immediately after the procedure, the patient can return to her normal life.

And the Vaginal Narrower procedure?

The insertion of Vaginal Narrower threads is a more invasive procedure. Local or general anaesthesia is required. The continuity of the tissues is interrupted. A foreign body (thread) remains in the body. Recovery takes several days, and complications in the form of haematoma, inflammation or pain may occur.

What symptoms after aesthetic gynaecology procedures should be of concern?

If you develop pain, heavy discharge, vaginal itching or an elevated temperature after a cosmetic gynaecology procedure, you should see your doctor immediately.

How soon after the aesthetic procedure can intercourse begin?

After treatment with the Mona Lisa Touch laser, sexual abstinence is recommended for one week, as this is how long the healing process takes. In the case of other procedures, such as the insertion of Vaginal Narrower threads, the period of convalescence takes at least two weeks, depending on the patient's individual ability to regenerate her tissues, as well as whether there are any complications.

Why take advantage of aesthetic gynaecology treatments at InviMed in Gdynia?

At Invimed clinics, aesthetic gynaecology procedures are performed by qualified staff who are constantly improving their qualifications and keeping up to date with medical knowledge. Treatments are performed with modern equipment. Additionally, Invimed Gdynia is a small clinic - we ensure anonymity, intimacy and a friendly atmosphere.

Thank you for the interview!

You can read more about the aesthetic gynaecology treatments carried out at the Invimed clinic in Gdynia at: Aesthetic gynaecology at Invimed Gdynia.

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Dr n. med. Beata Makowska

Gynaecologist-obstetrician with many years of experience, expert in the field of infertility treatment and aesthetic gynaecology, doctor for couples at the Invimed clinic in Gdynia. Member of the Polish Gynaecological Society (PTG).