28 Dec He said what?!?!

I recently had a patient contact me wanting a pelvic floor assessment. She was quite upset when she phoned, and it came to light that she had had a baby 10 months previously, and it had taken awhile for her to resume a sexual relationship with her husband. She said it had been a bit uncomfortable to start with, but had settled down in the last few months. She thought everything seemed fine, possibly a little different to before she gave birth, but nothing too major.

She reported that one night, her husband started asking her if she thought her stitches had healed properly. She was a bit confused as to his meaning, and when she pushed him, he told her that sex felt different for him, that there was less friction, and perhaps she needed to work on her pelvic floor exercises. She stated that this was hard for him to say, and even harder for her to hear, but she was keen for a pelvic floor exercise program to try to rectify the situation.

I have also heard a work colleague state that she chose to have both of her children via caesarean section after she heard a mate of her husband’s refer to his wife as “bucket vagina”.

I can’t begin to tell you how much these stories make my heart ache.

I am appalled at these particular husband’s, as if it isn’t enough that your body goes through so much while you are pregnant and then giving birth. I have felt at my lowest point with my own self esteem after both of my pregnancies, you are tired, you are carrying extra weight, to start with you still look pregnant, your breasts are often leaking and I felt like I just wanted to curl up into a ball and cry.

To get over all these issues, and to resume a sexual relationship with your partner is a big deal, to then have him question the tightness of your vagina, makes me sad for us women as a species.

There are so many factors that contribute to the size of your vagina after giving birth that you have no control over; things like genetic factors, the birth weight of your baby, how long you were in second stage labour for and the number of children you have had.

There is one that we can control though, and that is doing your pelvic floor exercises. These muscles lose some tone after pregnancy and childbirth, and strengthening them will help to tighten you back up again. It will also help to prevent incontinence and prolapse. To contract these muscles you should squeeze and lift the ring of muscles around your back passage as if you are trying to stop yourself from passing wind. Your buttock muscles should stay relaxed.

So put a post it note on the bathroom mirror to remind yourself and start doing them twice a day, every time you brush your teeth often works well.

A good general guide is to aim for 10 x 10 second holds, and then 10 fast contractions. I find that most women after childbirth struggle to get anywhere near a 10 second hold, so just start with whatever you can do. Even if this means that you aren’t holding at all to start with. You can gradually build up your endurance over time. The key is consistency.

And remember, if you are unsure if you are contracting them correctly you should book an appointment with a women’s health physiotherapist for an assessment.

As to how to handle the moment when your partner has the audacity to say something like this to you, after you have pushed his child out of your vagina, you could always follow the lead of my patient, who retorted, “Maybe the problem isn’t that my vagina is bigger, perhaps the problem is that your penis has shrunk!”

Not necessarily helpful, but amusing all the same.