Your vagina is amazing!

Many women think they’ll ‘ruin’ their vagina if they have a vaginal birth, but it’s made for a baby to pass through.

Your vagina is a strong muscular tube that has the ability to enlarge and stretch in size to accommodate an erect penis and for a baby to pass through during birth. It’s directed backwards and upwards into the pelvis. The walls of the vagina are made up of folds of skin (called rugae) that give it extra surface area when smoothed or pressed out, allowing the vagina to expand to many times its normal capacity. The vagina has a plentiful blood supply, and this is why healing after any birth trauma is rapid.

The vagina is surrounded by a group of muscles known as the pelvic-floor muscles, and these are affected by both pregnancy and childbirth.

During pregnancy, the vagina starts to ready itself for birth, due to the influence of the hormones oestrogen and relaxin. Oestrogen increases the blood flow to the vagina, enabling it to become more stretchy and better able to expand during childbirth, and relaxin makes this process even easier.

There are many factors that influence the capacity your vagina has to stretch on D-day:

• The size of your baby.

• The tone and strength of your pelvic floor (Kegel exercises are very important during pregnancy).

• The circumstances of the birth.

For example: What was the position of your baby? How long did you push for? What position were you in during pushing? This can make an enormous difference. Was your delivery an assisted one (were forceps or vacuum used)?

• How many children have you previously had?

The thought of being cut or tearing in the perineal area during labour may be frightening for some of us. But research is showing more and more that tearing is actually preferable to routine cutting (episiotomy) of the perineum, as tears heal better, and in the end preserve the integrity of the pelvic floor.

Of course, avoiding tearing or cutting is preferable, and with appropriate positioning, little intervention and good coaching you can indeed birth with minimal trauma to the most private and sensitive part of your body. Tearing means that the vaginal tissue, usually between the lower vagina and rectum, tears. This can happen during a baby’s delivery. Tears may extend into the rectal muscles and sometimes go upwards, although both are unusual. These tears can be surgically repaired. Episiotomy, a deliberate surgical cut in the vagina, used to be done routinely to

avoid tears, but research has shown that episiotomy does not reduce the incidence of tears.

Not everyone will need to have a cut or face a vaginal tear. Many women have very elastic vaginal tissue, which can withstand the stretching that accompanies childbirth. No matter if you tear or not, or have an episiotomy, your vagina is going to be tender and uncomfortable after a possibly 3kg-plus baby has passed through. The area has been stretched and to some degree may be bruised.

The discomfort may increase when you cough, laugh or sneeze (as with a c-section scar). Practise good hygiene, and the pain should ease up and disappear as each day passes. Stitches usually dissolve between seven and 10 days.

PERINEAL HEALTH

• Wash your hands before and after you use the loo and changing pads.

• Use a prepared perineal spray or a soft plastic bottle to squeeze warm water over the area after you have used the toilet.

• Wipe and clean the vaginal area from front to back.

• Use a clean peripad at least every four to six hours.

• An ice pack frequently placed on the perineum in the first 24 hours following birth significantly reduces swelling and bruising. Try spraying a clean peripad with water and a few drops of tea tree oil and place in a plastic bag in the freezer – ready for use when you need it.

• After that, warmth either from a hot lamp placed near the perineum (20 to 30 minutes), or from sitting in shallow warm water with a handful of coarse salt, is very soothing. Do this twice a day for 20 minutes at a time. • Arnica D6 tablets thrice daily for two weeks post birth will speed up healing and decrease bruising.

• Be sure to take the prescribed pain and anti-inflammatory medication.

A slush pack can work wonders. To make a slush pack, simply put some crushed ice and a little water in a plastic bag and add several drops of rubbing alcohol (or drinking alcohol – it’s just to prevent the liquid freezing solid). You could use a surgical glove, a condom or a plastic bag. Apply the pack to the affected perineal area, even placing it some way into the opening of the vagina if that helps. Whether you have had an episiotomy or a tear, or given birth without any perineal trauma, Kegel exercises will help you regain the support and tone of the pelvic floor. Drink plenty of water to dilute your urine and prevent any stinging. This will also help prevent constipation, which could cause extra discomfort in the perineal area. If you find it’s sore to sit, cover an inflated child’s swimming ring with a clean pillow case, and sit on that. It’ll take some of the pressure off a very delicate spot.

If you still feel pain with sex some months after the birth, or if you experience urinary incontinence, you should see your doctor or midwife. ●

KEGEL EXERCISES WILL HELP YOU REGAIN THE SUPPORT AND TONE OF THE PELVIC FLOOR.