When she felt it was safe to see a doctor in early 2021, Harrison was told she had stage 2 uterine prolapse, meaning the uterus had fallen into the lower part of the vagina. It can feel like pressure in the vagina, and it is visible. Lose the baby weight; do pelvic floor exercises, her doctor instructed. Harrison followed through — “I did it.”
One day, a year later, “I feel something rubbing on my inner thigh and I’m like, What is going on? I go upstairs — and I’ve been through a lot of soreness and things that are not normal down there — and I see meat coming out of my vagina, and I freak out,” Harrison said. She got an emergency appointment. Her prolapse had progressed to stage 3, meaning the cervix was now protruding from the vagina. “I’m like, No, no, no, no. I’ve lost the weight. I’ve done the exercises. I’ve done what you said. It can’t get worse.” But it did.
Several times a week now, Harrison, who also has endometriosis, has to push her uterus pack into her body, and it has become retroverted, pointing backward instead of forward, causing back pain. She was fitted for two pessaries, a ring placed in the vagina to help support the pelvic organs, but they kept falling out. “It’s been a mental fight, because at this point, nothing’s working.” Her doctor said if she did nothing her prolapse could progress to stage 4, meaning the uterus falls outside the vagina. She could get a surgery to hold up her uterus, but the effects might be temporary, and getting pregnant again would be very risky, Harrison said. Now 37 years old, she is planning to have her uterus removed. She would not be able to carry children again, but she hopes it can improve her quality of life.
Pregnancy and childbirth have long-lasting impacts on a person’s body. While many people have simple recoveries don’t notice any changes to their vaginas and other pelvic organs (which include the cervix, uterus, bladder, urethra, and rectum), those who do may feel too embarrassed or ashamed to even talk to family and friends about it.
Pregnancy has the strange effect of being at once so public, a time in which the body is on display, and also deeply private. Some changes — stretch marks, deflated breasts, loose skin — are widely known and discussed. Celebrities and influencers share photos of these changes on their social media accounts in the name of body positivity, empowering people to embrace certain new features of their bodies. But no one shares pictures of their vaginas after birth. Postpartum recovery — mentally and physically — can be a lonely experience.
“I wasn’t informed about a lot of things I felt like I should have been told,” said Harrison, who is grappling with not being able to be pregnant again. “I feel I have let my husband down. I’ve let my son down; I cannot give him a sibling. … Having a uterus is all about feeling like a woman. That’s part of us — all the bleeding and all the craziness that comes with it, yes, it’s a lot, but it’s a part of me. And never in a million years would I have thought I’d have to give it up this early in life.”
I spoke with women around the country about the many ways the vagina and other pelvic organs can change after vaginal and C-section births. They told me about scar tissue from tearing in or around the vagina or from episiotomy (an incision made during birth) that can lead to tightness. (People can also have tightness after a C-section if the muscles become tense with hormone changes or postural changes.) Some had hormonal changes that caused dryness in the vagina that made sex uncomfortable or even painful. For others, sex positions that used to be pleasurable suddenly weren’t, making them feel out of touch with their bodies (although others said sex got better). Some felt their vaginas had endured trauma in childbirth, or were insecure about changes in the appearance of their vulva — such as the size of the labia, or new asymmetry, or seeing parts of their body that had fallen due to prolapse — and no longer thought of their genitals in the same way. Some can no longer wear tampons or menstrual cups because they slip out. Some suddenly found that their skin got irritated if they didn’t wear cotton underwear. Others queef much more than they used to. Some have incontinence and leak urine or feces when they exercise, cough, sneeze, or laugh.
The toll isn’t only physical, but mental as well. Over and over, women told me even though their OB-GYNs said they had healed by their six-week postpartum exams (this is typically when you are cleared to resume exercise and sex), they were now conscious of, and cautious about, their vaginas in a way they didn’t before childbirth. For some people, the changes led them not to trust their vaginas or their bodies anymore, and the lack of information and openness about it caused fear and shame. Even those who considered themselves informed about childbirth and recovery felt caught off guard.