Feeling loose after childbirth? What to do when it doesn’t feel the same down there

There is nothing as hurtful to a woman as her husband telling her at the peak of the intimate moment that she is loose down there. Grace faced it. Her husband went ahead to use a derogatory description and told her that her vagina had changed from a water pipe to a swimming pool and that he was tired of swimming.

“I was confused and hurt, I pushed him off and cried for the rest of the night,” Grace says, welling up with tears. She was yet to recover from her husband’s insensitive verbal diarrhoea.

Grace came to the Sexology Clinic the day after her ordeal. She is 29 and has been married to James for three years. They have one child who is three months.

“It was the first time we were attempting sex after I delivered the baby,” Grace explains, “tell me, does delivery of a baby leave one baggy down there?” she asks. 

That was an important question Grace. For one, it is important to note that the vagina is elastic. It stretches to allow for the passage of the baby and in the subsequent days after delivery, it goes back to shape for most women. 

There is, however, about a quarter of women who end up with a bit of looseness and distortion of the vagina. This happens irrespective of whether the delivery is vaginal or caesarean and so there is no reason to pressure your doctor to go through CS to preserve things down there. The reason for the looseness mostly arises from excessive pressure exerted on the pelvis during pregnancy which overstretches the structures there and does not go back to the original shape after delivery. Further, women who have had a traumatic vaginal delivery, especially those accompanied by the use of instruments have a higher risk of things not going back to shape compared to the majority who have normal vaginal births.

Of course, the more pregnancies one has the more the stretch on the pelvis so a higher number of children becomes a risk. The ability to regain the original shape is also affected by the age of the woman, the older the woman the lower the chances of regaining the original pelvic tightness. 

“So how does one know that they are loose so as to avoid the kind of embarrassment that I have been subjected to?” Grace questions.

A diagnosis of a loose pelvis leading to a roomy vagina can only be known months after delivery. It is expected that tissues will regenerate and full pelvic strength is regained after six weeks of delivery. Assessment of laxity should therefore only happen well after the six weeks. For most couples, it is actually the woman who notices that there is a problem. They feel nothing or very little pleasure during penetrative sex. Sex becomes unsatisfactory and they lose the desire for it altogether. This in return causes relationship disharmony. All this happens because the looseness of the vagina makes it difficult for erotic areas within it to be reached during intercourse.

In severe cases of laxity of the pelvis, the woman develops a feeling of something hanging down on the vagina. This is because the pelvic organs hang loosely in the vagina. This may be accompanied by difficulty in controlling urine or even stool because the organs holding them are no longer in shape to allow for easy voiding. 

I examined Grace. There was a bit of looseness. This could have resulted from the traumatic delivery. Her baby was big and it was impossible for her to push it out. The doctor intervened to save the life of the baby and pulled it out using instruments. In fact, Grace got pelvis was injured and she could not walk for two weeks.

“So how do we manage this, or is this the end of me and sex?” Grace asks.

The overall rule to avoiding and managing pregnancy-related vaginal looseness can be summarised in three words: pamper your pelvis. For one, learn and do pelvic exercises during pregnancy and especially in the third trimester. This makes the muscles and ligaments heal better after delivery. 

Secondly, delivery by a qualified person is important. It not only ensures your safety and that of the baby but also avoids long-term damage to tissues. In the recovery period, hormone creams can also be used to help with better healing of the vagina and pelvic structures.

Where some level of damage is noted, pelvic physiotherapy becomes quite important. 

“I think in my case damage happened during delivery and so I should have been put on physiotherapy,” Grace says absent-mindedly to which I nod in affirmation. Her doctor should have advised her on this.

In severe cases of looseness where pelvic organs are hanging on and distorting the vagina and where the passage of urine and stool are affected, intensive treatment is necessary. Surgery can be performed in such cases. There are also newer non-invasive methods of treatment using laser and radio waves but these may be expensive and unavailable to the majority.

With this understanding, Grace went through a treatment plan and got her pelvic and vaginal tightness back. Couple therapy helped to resolve the hard feelings that resulted from the experience, including her husband’s insensitive outbursts.