Does birth affect the vagina?
Save the beaver have a Caesar? Can childbirth cause incontinence? A midwife puts it in perspective.
"Save the beaver, have a Caesar" is one of those inflammatory slogans tossed around about childbirth, along with ‘You're not a real mother unless you've had natural birth’.
But this slogan highlights real fears that women have:
The answers to these questions depend on many factors which are different for each woman, but here are some general points.
- Will I look the same after childbirth?
- Does natural birth cause incontinence?
- Will I be as tight and will it affect my sex life?
The dreaded pee sneeze
The biggest strain on the pelvic floor muscles come from pregnancy and not birth. Nine months of growth and pressure, regardless of delivery type, will affect how these muscles function.
Research¹ shows, 184 women who delivered by Caesarean section were compared with 100 who delivered vaginally, and there was no significant difference in symptoms of incontinence.
Kegel muscle exercises are a must for every woman who is pregnant or has had children to tone the pelvic floor and vaginal muscles.
The marvel of vaginal anatomy
The vagina is a muscular tube, it has many folds which allow it to expand during sex and childbirth. There are very few changes to the internal vaginal structure after birth as it's designed to stretch and return to its original state.
Many women are worried about tightness, this is unfortunately a nasty societal pressure placed on women. Logically it does not make sense that tighter is better, when one sees that the physiological response of the vagina during sexual arousal, is to in fact expand and lengthen. Ask any woman suffering from 'vaginismis' if a tight vagina is a blessing or rather a painful hindrance during sex.
Position, position, position
While the process of the baby coming down the birth canal should cause no lasting damage or structural changes to the internal vaginal structure, the way in which the baby is delivered can affect the vaginal opening. This has an impact on the appearance and sexual function post childbirth.
Tearing, stitches and episiotomies all leave scar tissue which can be painful during intercourse. Research² shows that lying on your back and pushing against gravity lengthens the second stage of labour and increases the chances of tearing and episiotomies.
Upright or lateral (lying on your side) positions are associated with less vaginal opening damage. Finding a caregiver willing to allow you to birth in a position comfortable to you and not for their own convenience may be the best thing you ever do to protect your vagina.
Breathe the baby out
Coached pushing during the birth stage can also cause damage. The muscles of the uterus are amazingly strong, they can birth the baby with no assistance from the mother as demonstrated by women giving birth who are in a coma. Holding your breath and pushing actually hinders these muscles as they make the mother tense, they reduce blood flow to the area and can cause foetal distress.
As a rule of thumb, if your face is tense, your bum and vaginal canal muscles are tense, making it harder for the baby to come out. The best way to help the muscles get enough oxygen is breathing the baby out and practising being relaxed during the birth stage, as advocated by hypnobirthing, yoga and other calm birth approaches. This helps the muscles work effectively to open and accommodate the baby as they were designed to do and reduces damage to the area and tears to the vaginal opening.
So while the type of birth you have should not have any impact on your ‘beaver’, you might want to remember these things. Protect yourself if you do have natural birth and let your body work as it was designed to.
1. Lal, M. et al (2003)Does Caesarean delivery prevent anal incontinence? Obstetrics and Gynecology;101: 305–312.
2. Gupta JK, Hofmeyr GJ, Smyth R. Position in the second stage of labour for women without epidural anaesthesia. Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD002006. DOI: 10.1002/14651858.CD002006.pub2.
How did birth (natural or Caesarean) affect your body?