Episiotomy & Painful Sex After Birth (including vaginismus chat): Why It Still Hurts (And What Nobody Tells You)

I record this on the road in my van so sometimes you might hear outside noises such as right now a honking but it's we're going to begin so we're going to talk about this what is um you know an episiotomy for example and you know not just defining them as um bad but let's talk about what exists around them so first and foremost 86 percent that's how many first-time mums in in a big australian study said that sex hurt for the first time after they'd given birth So that's 86% said that pain existed in sex after birth.

And at 18 months, still nearly one in four had pain, which kind of demystifies, changes, undo, undoes some of the advice that is given around when and when it shouldn't be discomfort, when and when there shouldn't be discomfort.

So if you're actually experiencing this discomfort now, there's pain then you know it's not you it's not a you thing it doesn't mean that there might be something that needs more specific support it just probably is that there might be more time that is needed and just to know that you're not alone in this and I'm going to speak about my experience with that as well So, the episiotomy is the cut, okay? So, I want to talk about why, what it is, why it's still being done, far more, far more than it needs to be.

What it can do to sex for months and years, for some, afterwards.

I'm going to talk about my own story, and we're going to go wider because it's not just about the scar.

and how sex can hurt after having a baby and why and we're going to talk about the vestibule and we're going to talk about the pudendal nerve we're going to talk about vaginismus and we're going to talk about the hormones of breastfeeding which nobody mentions so here we are let's go into the basics because many of us go into birth without anyone explaining anything properly so the perineum is a bit between your vagina opening and the anus right And it's what sits on the floor.

I talk about this all the time.

In the ground floor, I describe it as the part of you that literally sits on the earth, skin to skin.

But under the skin, there's muscle, you know, parts of you.

So basically, we're speaking about how it's the bit that works with... you know, holding in your wee, responding when you're aroused.

It's the muscles that hold there.

Now, an episiotomy is a surgical, and that's the key word here.

It's not a tear.

We're not speaking to tears when we're talking about episiotomy.

We're talking about a surgical cut through that area, through the perineal area, that then, during birth, makes the wider opening.

And in the UK, it's done as part and parcel of birth.

And What that means is that it can change the vaginal opening because it can often angle it off to one side, usually your right and away from the anus.

So the NICE guidelines say that it should be cut at about 60 degrees from the midline so that once it's stitched, the angle is at least 45 degrees.

And I really want you to understand that an episiotomy is not a little thing.

Yeah, it goes through tissue.

It goes through skin, tissue, muscle.

It goes through a deep, deep, deep cut.

And basically, it's, I would say, they liken it to a second degree tear, but I would say that it's more than that.

But it's made on purpose, likely with scissors.

And sometimes, you know, it's often done before the tissue's had a chance to stretch in what would be deemed the natural way.