Why We Should Look at Our Postpartum Vagina
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I looked at my vagina for the first time since giving birth the week before my 6-week postpartum checkup.
I'm so glad I did.
I won’t lie, this scared me a little. I had a third degree tear and many stitches along my perineum. The stitches eventually dissolved but they turned into bumpy granulation tissue. When I touched my perineum during showers, it felt swollen, tight, and irritated.
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Jenna Perkins, a Women's Health Nurse Practitioner at George Washington Hospital in DC, sees a lot of postpartum women, and she's a huge advocate for women looking at themselves with a mirror.
Perkins believes that when women can see all of themselves they can better advocate for their health, "because then, they can go and talk to other providers and say, 'I’m not okay. When you put that speculum in, you’re completely missing the fact that my labia are gone or that I’m so red.' Or just seeing that redness and being able to say, 'Okay, this is not in my head. This is not something that I made up because it’s real and I can see it.'”
Like Perkins's patients my symptoms were vague until I could actually see what was there. In those first postpartum weeks, I felt detached from such an intimate part of my body; one that ushered life into this world.
Ignoring it didn’t help, but attempting to look at it, I wondered, What mess was I going to see? Will I even recognize myself?
It was important that I took a good look at my vagina and its surrounding area before my OBGYN poked and prodded it. I wanted to see that flap of granulation tissue, which was still bleeding. I wanted to describe to the doctor the areas that still hurt and ask questions like, "Is it normal to feel stinging in this area when I go pee?" or "I feel pulling here when I sit cross-legged, will that go away?"
To my surprise, my vagina and its surroundings looked somewhat "normal." It didn't look like a stitched up mess I had envisioned in my head for the past month. My perineum looked intact, though it had accumulated scar tissue.
I was happy that it looked like a "normal-ish" vagina, but it was definitely still healing. Also, it didn't look like my vagina. I know because I've taken peeks over the years since college.
Reclaiming My Medical Experiences
To get pregnant, I had undergone years of medical and fertility treatment that left me feeling like I had little agency over my body. Too many fingers, speculums, catheters, needles, and surgical instruments have entered this body. None of which were pleasurable experiences, and at times even felt invasive.
Perkins notices practitioners in the OBGYN world take for granted informed consent. She's seen many women go through medical exams who weren't really given an option to say "no." She's observed how patients are told, "You’re going to feel my fingers," rather than being asked, "Is it okay if I check your cervix?"
"How many women have gone through decades of exams, sitting in stirrups, and they have no idea what’s happening on the other side of those sheets. Why?" Perkins asks.
As someone who sees a lot of postpartum women with pelvic and vulvar pain, Perkins says medical exams can be traumatizing especially for those who already experience pain. "[A]nything can cause trauma when it hurts. To be complicit in that is something I never want to do," she says.
Perkins hands a mirror to all her patients during pelvic exams: "The first time I did that with a patient, it just changed me. It felt like I was really consenting them, like I was really saying, 'You have full authority to stop me whenever you want. You have full authority to see what’s happening to you, and to really participate in this exam.’"
Mirror setup at Jenna Perkins’s office.
My OBGYN didn’t offer a mirror during my 6-week checkup, but I was one step ahead of the game. Exploring my genitalia before that appointment let me to feel like an active participant in my postpartum follow-up that included a pelvic exam.
Being the first to "poke and prod" myself (inside and out), instead of my doctor, inched me toward reconnecting with my body. It took away some of the shame I felt over how I delivered (vacuum assistance) and mild resentment over my son's big head.
My 6-week checkup raised no flags for my doctor. My uterus had returned to its pre-pregnancy size, and according to the OBGYN, my perineum healed really well. He had no concerns about my recovery, and he gave me the "green light" for exercise and sex.
I wasn't ready for either.
Because I looked at and probed the area beforehand, I was able to discuss my concerns without any vagueness. Although some of my issues weren't fully addressed, I felt good that I could articulate all of them.
I was doing my part as the patient and advocating for myself, which meant that I would eventually find the right providers who could address my specific postpartum concerns. And I did.
Medical mirror selfie?
Saying Hello on a Regular Basis
I look at my vagina often. This isn't about vanity. It's about keeping tabs on my personal and sexual health.
With my pelvic floor issues, scarring, and pelvic pain, it makes sense not to wait for those infrequent checkups to see if something is up. When the area acts up, changes, or feels irritated, I'm the first to know and see.
I believe we should all be doing this, especially postpartum women. Even those who delivered via C-section.
But more than looking for problems, why not get to know ourselves a bit better, especially after having that baby? Give yourself permission to look. Make it a date. Cozy up with her. Tell her "thanks" for the gifts she brings.
Have you looked at your postpartum vagina? What was that experience like for you? Did a perinatal health professional ever encourage you to look between your legs?
**Medical disclaimer: This post is provided as information and resource only. This information should not be used as a substitute for professional diagnosis, treatment, or advice. Always seek the guidance of your physician or other qualified health care provider with any questions you may have regarding your postpartum care and conditions.