So now that we know the physical differences between a vaginal birth and a cesarean we can delve deeper into what these differences mean.

Part 2 of What You Were Not Told About Birth is going to be all about how a vaginal delivery affects your short term pelvic health.

As I described in the Vaginal vs Cesarean blog post, during a vaginal delivery the baby descends into the vaginal canal, pressing on the cervix for dilation then on the pelvic floor to stretch and improve pliability of the tissue before actually birthing through the vagina (technically the introitus, which is the medical term for the opening of the vagina, if you wanted to know).

Most of us take a birth prep class learning the different medical interventions during delivery to help the mom cope with pain and help the baby out. But most of us don't learn how these interventions can affect our long term pelvic health (which is Part 3)

So sit back, get comfortable, because here we go....

A natural vaginal delivery is one that uses no medical intervention. For most moms this is the goal and if you want to know more about why, here's a great article to read.

However, having a natural delivery doesn't mean you won't experience birth injury or complications. This is not meant to scare you away from a natural delivery, because comparing all birth methods women with a non-instrument delivery have 30% less birth injury than instrument delivery. These findings do not include epidural side effects or injuries, which you can read more about here, but may increase the risk of instrumental delivery thus birth injury.

To get down and dirty, having a natural delivery, has the least amount of external variables that have risks and benefits. The more variables you add in the higher the risk of birth injury.

Immediately after a natural vaginal delivery your pelvic tissues are swollen, inflamed and sore.

Even if no major birth injury occurred during delivery, there are still micro injuries that happen as a result of the stretching of the tissue.

This micro trauma is influenced by the health of your pelvic tissues, the length of labor, your positioning during birth, and the amount of pushing you do.

Just like any trauma or injury to your body there are reactions within the tissue that cause inflammation and a cascade of pain mechanisms. This is all totally normal! The larger the injury or trauma the more severe the swelling, inflammation, tissue dysfunction and potential pain.

How does this influence your short term pelvic health?

Peeing and pooping can burn, be sore or painful.
- You may not be able to hold your pee or poop.
- Or you may not be able to let your pee or poop out.
The area will be sore or painful to touch.
It can be uncomfortable to sit down.
Altered sensations.
Weakness in surrounding areas.
You may not recognize your vagina.
You won't even want to consider sex.

This dysfunction escalates when there is tearing, instrumental or medical intervention.

Epidural headache
Pelvic joint pain - Sacroiliac joint or pubic symphysis
Coccyx pain
Nerve damage

The degree of tearing, episiotomy and any injury from forceps or vacuum assist delivery means the more tissue involved, more scar tissue developed, the longer the body heals.

For many women these short term affects gradually go away and don't seem to alter the quality of life.

However, these changes in the tissue last a lifetime and if not addressed can cause long term problems.

The simplest and most effective way to address these short term affects is by being informed about the risks, knowing your options, understanding your body and how your lifestyle can influence how your body will respond to labor and delivery, and preparing your body for birth with appropriate exercises and birth skill practice.

Of course there are other management tools for swelling, inflammation and pain, like soaking a menstrual pad in witch hazel and freezing it to wear, using witch hazel wipes for toileting, sitting on a backward Boppy, diluting honey and gently massaging into the healed scar (once the stitches are gone).

I understand that even being proactive, things can happen that are not within your control like if baby suddenly changes position, contractions are coming fast and furious making your labor super short and your body doesn't have as much time to prepare for pushing, or your life and your baby's life are threatened and an emergency cesarean is required.

Just know having prepared your body for the changes that occur with birth, even if the birth does not go as planned can make a world of difference in the long run.