Your Vagina is Not a Priority

I don’t know about you but my vagina is pretty important to me. Scrap that, it is fundamentally important to me. But it shouldn’t be, not now – not when you’re a Mum. Not when you’ve pushed kids out and it’s (hopefully) pinged back into something resembling your fanny of yesteryear. It’s negligible, non-essential (like those pesky sanitary products), dispensable almost – until you come to have another baby maybe – then it’s important again as they want you to use it to push out this next human being. Your vagina in this in-between time? Not important. Your belly is (those extra tyres cruelly ringed on the cover of the latest ‘Hate Your Body’ magazine assures you of that – ‘Look, celeb had a baby a year ago and her tummy is not like an ironing board, let’s humiliate her!’); your thighs are (“got back in your skinny jeans yet?”); your boobs (Good Lord you had better breastfeed – not too publicly though, we don’t want you flaunting yourself!)…but your nether regions? Trifling. Mattering not a jot. Not A Priority.

Maybe you’re glad that nobody talks about your ‘after-vagina’, I mean holy shit can you imagine what fresh hell of body-shaming those insidious rags would conjure up? I shudder. And yet I do think we should talk about postnatal vaginas. And I think we should own the conversation. Before we’re told how or what to think or feel about our bodies and the inevitable changes, I think we should be honest with each other and talk about what we want and need to feel confident in ourselves and our femininity after childbirth.

So, what does the conversation currently look like about our post-pushing hoo-ha? Hushed whispers about being ‘stitched up’ (in my opinion literally and figuratively, but I may need to expand on that another time) and giggles about peeing when you sneeze. But these whispers are slowly getting louder, as women realise that keeping silent is not doing us any favours. There have been a fair few articles recently about the French system of pelvic floor rehabilitation after childbirth. The Pool also recently published an article by Zoe Beaty about a controversial incontinence operation which has left many women in chronic pain and, in extreme cases, disabled.  Activist Kath Sansom is not whispering but shouting about this – and so she should; too often we are ignored and silenced when millions of us have suffered or will suffer in the future. It’s scandalous really. How many times have we heard ‘well, you have had a baby’? A friend of mine was told ‘you have to have a sense of humour about what’s happened to your body’ …Really?….REALLY?! I don’t know what happened to her body exactly (because we do not have those bloody conversations. We allude, not elucidate) but you can bet your (front) bottom dollar that the Ob-Gyn probably would not have had a sense of humour had it happened to them, which is maybe why a significant number of Obstetricians opt to have caesarean births.

It may surprise you that I am a natural birth advocate. Well, pro-choice at least, with a strong tendency toward vaginal birth. What concerns me is that not only are we not being given the whole picture about what childbirth can involve, but we are not given the necessary tools and care to look after ourselves, minimise damage and maximise healthy recovery. Which leads me to question why? Why is it still okay to trivialise women’s health, to cover-up, to downgrade fears, to place no importance on her physical recovery after-birth, when statistics show that she is likely to have sustained some bodily trauma which will sting in the short term and could cause long term debilitating issues? And then the answer smacks me in the face. Because we are not important. The refrain you will constantly hear is ‘All That Matter is a Healthy Baby’ -regardless of how it came out. And to you, the mother, in that moment, and forever more, of course that is all that matters. You are doing your utmost for your child in every moment. But who is doing their utmost for you? Who is looking after you and your health – physically and mentally? Postnatal mental health has also begun to receive more press recently – and so it should, this type of support is critical. Physical and mental health are intrinsically linked and there is evidence of a correlation between a negative birth experience and postnatal depression although this has not been fully explored as yet.

And so, back to your vagina. And how unimportant it is. After birth. Pre-birth it’s pretty important –as Gynaecology Expert bikini waxer Mel demonstrated in her Daily Mail article about the common shapes of fannies. But, after birth the brouhaha about your hoo-ha-ha disappears. Thankfully, what the antenatal teachers say is mostly true – vaginas are incredibly forgiving, and elastic, and generally ping back in to some kind of reassuringly similar shape and size. However, over 90% of women experience some sort of tearing in first-time childbirth – and about 4% of these can suffer significant tears (named 3^rd and 4^th degree tears) with about 15% have episiotomies (cut with scissors to get baby out). We’re constantly told that severe tears are rare – but 4% accounts for approximately 28,000 women in the UK every year and that is not considering women whose tears have been misdiagnosed – as a pelvic floor physiotherapist said to me “You’d be shocked how many women are walking around with incomplete sphincter muscles and they know nothing about it.” Say what-now? How can this be the case? Why isn’t proper training in recognising and repairing tears being undertaken? Oh yeah, that’s right, because your vagina is not a priority. We are not important. And at the same time, why are we not properly informed of the risks of incontinence or prolapse (which can happen after caesarean birth as well as vaginal birth) and educated about strengthening and protecting our core and pelvic floor to mitigate against this happening? Which, by the way, means avoiding strenuous exercise for quite some time – so that’s a big NO to Buggy-Fit classes.

Have you even heard of prolapse? I hadn’t. I didn’t have a clue what it was until I started doing my research.  So, ahem, it’s when your internal pelvic organs slip through your vagina. WTF? No one told me about that! Well, who’s gonna? ‘Congratulations! Beautiful baby! You’re healing just fine but, wait, in 5-20 years your insides might fall out. Ciao!’ Yet this happens to 40% of women. 40%!!! Nobody might want to tell us this, but they should.

There are many factors at play as to why we know so little: stoicism, secrecy, embarrassment, misplaced concern regarding not scaring new or would-be mothers. You may argue that this secrecy is to protect women, or that if you’d be told the reality of what happens after childbirth, you may not have done it.  I think we already have a lot of fear about the birth, and after-effects, but I am not sure pushing a message of everything ‘springing back to normal’ soon after the birth is helpful. And it also lets the medical community (or rather the powers that fund them) off the hook when it comes to our after-care. Which, as well as being deeply unjust to women whose quality of life might seriously deteriorate ( see Victoria Derbyshire here) is also short-sighted – as preventative measures could ease the burden on the NHS purse-strings in the long term. We should copy the French model without a doubt and we should put pressure on our Government to take our postnatal health seriously.

Early conversations with midwives about what a vagina will look like after birth, the degrees and effects of tearing, and how to minimise trauma and  – most importantly – advice on keeping your pelvic floor healthy and toned throughout pregnancy and beyond are what is needed. I don’t mean a flimsy leaflet shoved at you in the hazy hours after you’ve given birth, which let’s face it, means bugger all at that precise point. I mean proper face-to-face (or face-to-stitches!) chats and expert advice coming from a place of genuine concern for your long term welfare. And how about a proper 6 week check with an Obstetrician-Gynaecologist and a Pelvic Floor Physiotherapist followed by a course of pelvic floor physiotherapy? The return on investment? For you, at the very least a slightly less chuffed-up chuff, which just might see you right on the trampoline for a few more decades. Oh, and the knowledge that our society cares about us and our bodies and we are not just spent vessels once we have procreated. For the Government – reduced reliance and strain on the health services long-term. For the adult incontinence industry? Perhaps a decline in their soaring year-on-year profits (diddums Tena!) Let’s start a whisper campaign. And then let’s shout and stamp our feet! Why? Because your vagina IS a priority!

About L C Nicholl

LC Nicholl lives on the East Kent coast with her husband and young son. Currently working as a freelance consultant for a number of charities, LC has had a colourful and varied life which includes treading the boards, travelling  and working abroad, being a ski/beach bum and then, latterly, creating a successful career in the not-for-profit sector. She is passionate about feminism and women’s rights (in particular around pregnancy and birth), worker’s rights, environmental issues and the theatre. She is a lover of chocolate, dodgy dance moves and the Blaze of Glory soundtrack. Words that have been used to describe LC include ‘free-spirit’ ‘passionate’ and ‘feisty’.

You can follow her on Twitter, and she’s also helped set up a Postnatal Health Community

Image credit: Sophie Law