After giving birth, the hormones in your body change quickly.
During pregnancy, your body has very high levels of the hormones oestrogen and progesterone. After the birth of your placenta (afterbirth) oestrogen and progesterone levels drop suddenly.
Some women notice they get hot flushes and vaginal dryness after giving birth. This is due to hormonal changes as your body adjusts to no longer being pregnant. It means that you might notice changes in your vagina and vulva even if you had a caesarean birth.
If dryness in your vagina makes sex uncomfortable, using a lubricant will help.
You can use this until the vaginal dryness improves. This usually happens when your oestrogen levels go back to what they were before you became pregnant.
Your oestrogen levels will usually have returned to normal when you have stopped breastfeeding and your periods return.
Find out more about vaginal dryness
Your perineum is the area of skin between the back of your vagina and your bottom. During labour and birth this area of skin stretches and may tear.
Your midwife or obstetrician may have needed to make a surgical cut in this area during the birth. This is known as an episiotomy.
After giving birth, this area may be sore and swollen. If you had stitches, it may feel very tender.
Keep your perineum clean by:
- frequently changing pads
- washing your hands
- daily bathing or showering to keep the perineal area clean
It is very important to do your pelvic floor exercises.
It is also important to manage your pain. Your obstetrician or GP may have prescribed you painkillers to help with the pain.
If you have not been given a prescription, paracetamol can help with the pain, and ibuprofen can help with pain and swelling. These are safe to take when breastfeeding.
But talk to your pharmacist first, especially if you are on other medicines. Always read the label.
If the pain is not improving contact your GP, midwife or obstetrician.
Non-urgent advice: Contact your GP or midwife if:
- you had stitches and the wound becomes open or starts to ooze green or smelly fluid, or
- you are in a lot of pain
Vaginal discharge or bleeding (lochia)
It's normal to have a bloody discharge from your vagina after giving birth. This will last for up to 6 weeks and is called lochia. This is your body’s way of getting rid of the extra blood and tissue that was in your womb during pregnancy.
The colour of the blood flow is bright red at first. This will change to brown and eventually to a yellow or whitish colour as the uterus heals.
It's normal to have an increased amount of blood or a darkening in the colour of the blood if you have been doing something strenuous. This may be a sign that you need to take it easy.
You can use a pad. Do not use a tampon or menstrual cup (moon cup) for postnatal bleeding. It is normally safe to use tampons when your regular periods are back.
Emergency action required: Go to your nearest maternity unit's emergency department, or call 112 or 999 if:
- you have heavy bleeding from your vagina, or are passing clots and you feel dizzy or weak
Urgent advice: Contact your midwife, public health nurse or GP immediately if:
- you notice your bleeding is getting heavier, or you are starting to pass clots
- your bleeding or discharge has an unpleasant smell
These can be signs of infection.
Pressure or bulge in vaginal area
Pelvic organ prolapse is when your womb, bowel or bladder bulges into your vagina.
Prolapse can happen when there is a weakness in the pelvic-supporting structures. This weakness allows one or more of the pelvic organs (bladder, uterus or bowel) to move down into the walls of the vagina.
The pelvic floor is often weak after pregnancy and childbirth. During pregnancy, hormones cause supporting tissues and ligaments to become lax or relaxed. It takes time for them to strengthen again after birth.
Non-urgent advice: Contact your GP, public health nurse or women's health physiotherapist if:
- you have symptoms of prolapse
Symptoms of prolapse include:
- feeling or seeing a bulge in your vagina
- an uncomfortable feeling or a feeling of pressure in your pelvis
- leaking of urine and difficulty holding onto urine when your bladder is full
- feeling that you cannot completely empty your bladder
- leaking of poo
- feeling that you cannot fully empty your bowel, when you finish a poo you feel like it has not all come out
- pain during sex or decreased sensation during sex
- aching pains in your lower tummy or your lower back
A prolapse is not dangerous, but it can cause pain or make you feel uncomfortable. Treatment is available.
Symptoms can usually be improved with pelvic floor exercises and lifestyle changes. But sometimes other medical or surgical treatment is needed.