Does your vagina/pelvic floor go back to normal after an assisted delivery (forcep and episiotomy) ?

[Flowerpower123456]

Hi, I wanted to ask a question about post partum recovery following an instrumental birth.

I’m currently 8 weeks post partum after a forcep and episiotomy delivery and also breastfeeding.

However I have noticed my pelvic floor being extremely weak and vagina seems a lot bigger , open and loose, my husband said that it was considerably wider during sex too. (He only told me as I asked)

This has been getting me incredibly down and upset the last few days. And was wondering if anyone else has been in a similar situation, usually people are tighter after episiotomy, so not sure why I’m looser?

If you have been in a similar position just wondering if you noticed an improvement in your pelvic floor/ vaginal looseness and how long did it take.

I have been referred to a pelvic floor physiotherapist by my GP but wanted to ask someone who has been through this and their experience.

Does the vagina become tighter and how tight, similar to pre organs by to close? and how long did it take?

I have read up on vaginoplasty surgery but want to avoid this if I can.

Thanks x

I had sections but from what I've read 8 weeks is still very soon and it takes time to return back to normal, maybe not totally like it was before but close.

I had epis, bad tear and ventouse. All went back to normal, it just takes a bit of time.

If things don’t seem to be improving in the coming months, see your GP. You can also see a women’s health physio.

nothing goes back to being exactly the same, there will always be changes to your pelvis and birth canal. the extent of changes will depend on your size, genetics of healing, and the size of the baby.
the purpose of the episiotomy repair is to bring the two edges of skin tissue that were cut back together so that they heal. the idea of "tighter" after suturing is antiquated and not medically appropriate (doubt any doctor/midwife would use this opportunity to tighten your perineum).
certainly give your body more time to heal and do your part with exercise to stay fit and healthy.

You're only 8 weeks PP - I'm amazed with you've even had sex!

It can take 6 months to a year to heal properly from an episiotomy (definitely took me nearly a year with my first). I'm 18 months PP with my second which was a fast birth and I tore, and only stopped having soreness during sex 3ish months ago. My vagina isn't as tight as it was before my second (although it did go back to pretty much the same after my first), again, result of a fast birth as I understand it, and I've not been on top of my pelvic floor exercises.

Do your pelvic floor exercises, and see where you are in a few months time. It's basically too early to tell. Also - be nice to yourself. Your body just created a human. It's going to be different, but what an amazing thing you've done.

8 weeks pp! I had no tears and mine was still massive at 8 weeks.

I wouldn't be asking Dh for any reviews until minimum 6 months! Your pelvic floor suffers greatly just from the extra weight of pregnancy, that's 9 months of stretching- it's not just the birth.

You need time to strengthen it and time for everything to heal. It's a fairly slow process. I would review it after a year unless you're having actual medical issues.

I had an epi and forceps with DD and then a third degree tear (surgical repair) with DS.

It takes a long time for your body to get over it all - not just your vagina but everything. I would say 18 months or two years even. At your stage I remember I still felt rather like my vagina and surrounding area had been hit by a bus! It all felt very wobbly and battered and floppy and weak.

But I am sitting here now 15 years later aged 50, its all quite springy still and definitely feels strong and solid. Not exactly as it was pre children mind you but definitely fine.

Do your pelvic floor exercises, all the post partum exercises that are recommended, when you can bring in some other exercise.

It takes time to get over it but it happens gradually.

Hi All, this is my first post so bear with me. I am 19 weeks postpartum after a forcep & episiotomy delivery to my second DD. I have a question about postpartum intimacy following an instrumental birth.

I’m 19, nearly 20 weeks postpartum after a forcep and episiotomy delivery as well as still breastfeeding. I had an emergency C-section with my first DD( 26months old) but healed really well and only ever needed paracetamol post op. I was comfortable and ready to be intimate with my husband pretty soon after DD’s birth. However I am struggling with intimacy after my second DD’s birth. I have a really supportive husband and he knows intimacy has to be at my pace and having tried to be intimate a few times feeling I was ready but unfortunately it led to excruciating pain. I feel normal down there and I’m pain free until we attempt intimacy. Is this normal to be experiencing this amount of pain this long after?

I know there are much bigger problems and it may sound trivial but since having our second DD we have really gone through a rough adjustment period which has affected our relationship. I struggled a lot with my emotions/feelings since DD2’s birth & my husband has been my rock but we've definitely had it tough. We’ve had crisis talks with us both agreeing we love each other as neither of us want to separate. We will get through this rough patch & really start to enjoy our new family life as we adore our girls and our new family unit but I just feel this lack of intimacy is a small but vital part to us being a couple and not just mummy and daddy. Again I have a really supportive husband and there’s been no pressure on me to be intimate just to note.

any help/ advice on this would be greatly appreciated!!

Hi @Moocrewmummy sorry you haven’t had any replies. I think it’s because you’ve added your question to an old thread rather than starting a new one. If you start a new thread and copy your message across, I’m sure you’ll get some help.

It takes time, keep doing pelvic floor exercises regularly.

Id be tempted to tell dh his penis feels smaller. Serve him right for being too honest!

@Dash0Cal thank you! New to Mumsnet and I’d not even noticed thread date either!!

8 weeks is nothing. Your body is still healing. In my experience things don't go back to be identical to before, but the sort of issues you describe don't last.

Ive had 3 DC (vaginal births) and had an episiotomy with my first.
OP, if you can afford it, go and see a post-natal physiotherapist. I did 9 sessions after each of my births, starting at 6 weeks post partum, and it was life changing. I had to pay out-of-pocket after the birth of DC3 due to my health insurance changing, but it was worth every cent.

Even with the physio, it took me about 5 months for sex to feel ‘normal’ again after DC1 and the episiotomy healing. 2-3 months post-partum for the second two.

I’m 8-months post-partum after DC3 now. My pelvic floor is stronger than ever, and I can comfortably run, jump, sneeze, sex is great etc.

They can also help with abdominal separation if that’s an issue for you.

@Flowerpower123456 how are you getting on with this 9 months on?

Did you get any NHS (or private) pelvic physio follow up in the end? How are you feeling your pelvic floor strength is now? Do you have any other pelvic pain or wobbliness/hip weakness issues longer term?

This post came up because I am wondering whether there is a link between episiotomy deliveries & long term over tightness of some specific pelvic muscles (particularly obturator internus, which is connected to the lateral pelvic floor.

I had some postpartum pelvic physio early on, which helped at the time, but as hormones are dropping off in perimenopause, am finding all kinds of weakness & imbalance returning.

One site which I have found useful while I'm joining the dots on my resurfacing problems is the Pelvic Health Yogi on facebook. No vested interest in this one, and although she does offer paid online class programs, there is also a wealth of short free nuggets that she posts & quick moves which can help with releasing & strengthening pelvic muscles (both pelvic floor and wider hip, leg, core & back muscles which all work together to pull on the bones & nerves in the pelvis).

@Moocrewmummy I hope things have improved for you since you posted? Pelvic pain is really common after childbirth, and it doesn't even have to be from an instrumental delivery. Muscles can do funny things to try to 'protect' us when there's been medical trauma (which is pretty much any childbirth, let's be honest!). You might find that is some of the most bizarre stretches which could help release pelvic pain - think tongue and toes... I'm not kidding!

Anyway, the NHS only has limited resources to refer for pelvic physiotherapy, but try not to be fobbed off if you've not been referred to anyone yet - you would almost certainly benefit from it, and putting the time in now may help not to store up problems for when menopause hits!

Interested to hear how you've both got on with more time though? Hugs!

www.facebook.com/pelvichealthyogi2/

Eight weeks postpartum after a forceps delivery and episiotomy is still very early, even though it doesn’t feel like it when you’re living in your body every day.
What you’re describing is incredibly common after instrumental birth. There’s often a mix of trauma, swelling, muscle inhibition and altered sensation, which can all create the feeling of looseness or openness – even when things are actually healing normally. It doesn’t mean this is permanent.

The idea that an episiotomy makes things ‘tighter’ is a bit of a myth. The aim of the repair is to help tissue heal, not to change how things feel long term. For many women, pelvic floor strength and sensation improve gradually over months rather than weeks, especially when breastfeeding hormones are in the mix.

It’s really positive that you’ve been referred to a pelvic floor physio. That support can make a huge difference, particularly with reconnecting to the muscles rather than just doing generic squeezes. If you struggle to be seen quickly, I found having a simple, postnatal-specific plan to follow at home helpful as a short-term bridge, this is the one i used: https://wild-mama.co.uk/

I know it’s hard not to worry, but at eight weeks PP there is still a lot of healing ahead. You haven’t missed a window, and this doesn’t mean surgery will be needed. Be very kind to yourself – your body has been through a lot!