Childbirth can take its toll on the body. From excess pounds to stretch marks to vaginal changes, women may struggle to regain their pre-pregnancy body, if they can. Some women just never feel the same after childbirth. Although this post-childbirth negativity is not surprising, a recent study did find one surprisingly unhappy group: women who had an episiotomy.
What is an episiotomy?
Doctors may perform an episiotomy before childbirth. In this procedure, the doctor surgically cuts muscles, tissue, and skin between the vagina and anus, the area called the perineum, to enlarge the vaginal opening. The idea was that this larger opening would allow the baby to pass through the opening easier, resulting in less tearing and easier healing for the mother, with muscular and connective tissue still intact. Although this was once common practice, experts no longer recommend this procedure unless the baby is large, is in an abnormal position, or must be delivered quickly.
Are women concerned about body image after birth?
In a study involving sixty-nine women at high risk for muscle tears during their first childbirth, researchers used the Vaginal Changes Sexual and Body Esteem (VSBE) scale to determine how women felt after birth. The researchers discovered, luckily, that most women are still happy with their sex life and body esteem after childbirth. However, as it turns out, women were most unhappy with their vaginal changes and body esteem after an episiotomy. Although doctors may opt for the procedure to help limit tearing, thinking this may promote easier healing and have a more aesthetically-pleasing result, this does not seem to be the case. The researchers also discovered that older women may have more negative sexual and body esteem after childbirth, although this may have been skewed by a lower sample size of women over forty.
Why are women unhappy after an episiotomy?
The researchers believe there are two main reasons women are unhappy with their sex life and body image after an episiotomy: pain while healing and more attention on the area. With a surgical cut and sutures near the vaginal opening, women may be experiencing more pain than they may have with a natural tear, along with vaginal dryness. In addition, taking care of the cut and sutures simply brings more attention to the area. With women concentrating on this problem area, they may be noticing issues more, and it may also be making them feel less sexy. Often, it seems, negative perceptions about vaginal changes may be worse than the changes themselves.
How does the media affect body image after childbirth?
One problem the study authors ran into was the word "normal" on their questionnaire. They realized that with the wide variation in women's genitals, a better word may have been "unchanged" before and after childbirth. From media exposure, many women have determined that a "normal" vagina is tight with a trim, uniform labia. Women in the study may have compared their own genitals to this ideal and determined they did not fit the definition of normal. More education on the wide range of "normal" genitals in the world could potentially help these women boost their body image as they realize they actually do fit right into the normal range after all.
What can doctors do to help reduce negative body image after childbirth?
Skip the episiotomy
Although doctors once believed an episiotomy would be beneficial during childbirth, helping reduce tearing and improving aesthetics, this does not seem to be the case. Although there may still be situations where this procedure is medically necessary, for most women, an episiotomy could have a negative effect on sex life and body image.
Perform a vaginoplasty
Although in the past doctors would mainly perform a vaginoplasty if there was a medical problem, such as a pelvic floor dysfunction, more women are requesting this procedure for vaginal enhancement. Some women claim the vaginal tightening improves their sex life, along with helping reverse the stretching associated with childbirth.
Perform a labiaplasty
The labia minora may tear and stretch during childbirth, leaving it extended further beyond the labia majora. Doctors may perform surgery to reduce its size, bringing the labia minora more in line with the size of the labia majora. This procedure remains controversial as many women opt for the surgery for aesthetic reasons.
Perform vaginal rejuvenation injections
Vaginal injections have become a popular alternative to vaginal surgery. Using hyaluronic acid, these injections can help reduce dryness and adjust the size difference between the labia majora and the labia minora. As the hyaluronic acid holds moisture, it helps restore hydration to the gentials, reversing dryness which is a frequent complaint after childbirth. This moisture can also add volume to the labia majora, helping conceal more of the labia minora, better balancing their sizes to how they looked before childbirth.
Educate women about normal genitals
With images in the media and more attention on procedures such as labiaplasty, many women misunderstand what a normal vulva looks like. Although some may see the aesthetic ideal as tight and trim, there is huge variation from woman to woman. In a separate study, women were given more information about this variation before opting for a labiaplasty procedure. Armed with their greater knowledge, about a third of these women decided against the procedure, presumably feeling better about their own bodies.
Address weight gain and stretch marks
Vaginal changes are not the only concern women have after childbirth. Women may be concerned about the presence of stretch marks and about losing those extra pounds. Dermatologists and other doctors may recommend skin creams and other stretch mark treatments, along with diet and exercise advice for weight loss. For those stubborn last inches of body fat, deoxycholic acid injections or other fat removal treatments may help as well.
What doctors need to know about post-childbirth body image
One encouraging discovery from this study is that most women are happy with their sex lives and body image after giving birth. That said, with body image such a huge issue after childbirth for many women, doctors need to be aware. The study authors recommend VSBE questionnaires as a way to increase knowledge about body image after childbirth. Armed with more knowledge of what is going on in their patients' heads, doctors can help when needed, offering education and medical help to women in need.
Products for Vaginal Rejuvenation
Hyaluronic acid injectables for vaginal rejuvenation are available from Doctor Medica. These products help retain moisture to reverse vaginal dryness and adjust the look of the labia minora, and are suitable for use before and during menopause or after childbirth. Visit the website or contact a customer service representative to learn more about Desirial and Desirial Plus pre-filled syringes for vaginal rejuvenation.