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It may be surprising for a woman to experience discomfort of the vulva and vagina after a cesarean section 2. Since cesarean section means a baby is born through an incision in the abdomen, a woman may assume that surgery has spared her from any symptoms associated with vaginal delivery. While some instances of discomfort or swelling may be abnormal, very often there is a logical and benign explanation.
Regardless of the method of delivery, pregnancy itself can cause noticeable changes in the tissues of the vagina and external genitalia. Changes in hormone levels can cause increased vaginal discharge and a feeling of engorgement in the vagina and vulva. After delivery, it can take a little while for these changes to dissipate and for the sensitive vaginal tissue to return to its pre-pregnancy state.
It is important to remember that pregnancy itself exerts pressure on the pelvic structures, including the vagina. Even if a woman has scheduled a cesarean section, pressure from the growing uterus, baby, placenta, amniotic fluid and increased blood volume can all contribute to swelling of the vulva and vagina. In addition to swelling, many women notice increased vaginal discharge and even a darkening of the tissues of the vulva and vagina. These changes are normal and take a while to recede after delivery.
Unless a woman has undergone a scheduled cesarean section, it is important to remember that the process of labor itself can cause some swelling of the vagina. This is true even if labor fails to progress significantly. The pressure exerted by uterine contractions on the cervix and vagina is quite strong. This, along with increased blood flow to the pelvic region, often contributes to some swelling in and around the vulva and vagina.
One of the most difficult things for a pregnant woman to endure is making it to full cervical dilatation, yet not delivering vaginally. In this situation a woman experiences the compound difficulty of pushing and also of recovering from surgery. The second stage of labor, commonly known as the pushing stage, can cause some swelling of the vagina and external genitals. In addition to the inherent pressure of uterine contractions, forceful and repeated bearing down increases the burden on sensitive vaginal tissue.
Unsuccessful Attempt at Assisted Vaginal Delivery
An attempt by the physician at vaginal delivery to assist with the aid of forceps or a vacuum can cause swelling of the vagina and vulva. When this happens and a cesarean section ensues, a woman experiences many of the same discomforts in recovery that she would have felt with a vaginal delivery. In this case, it is important to follow the postoperative self-care instructions as well as many of those for after a routine vaginal delivery. This is especially true where hygiene is concerned. Of course, some swelling of the vagina in this instance is normal.
In sum, there are many harmless explanations for why a woman may still perceive vaginal swelling after having a cesarean section. Of course vaginal swelling after delivery seemingly unrelated to one of these explanations, especially if accompanied by pain, fever or unusual bleeding could be a cause for concern and should be promptly brought to the attention of a physician or nurse-midwife.
- Adriaanse, B. M. E, Natte, R., & Hellebrekers, B. W. J. (2013, November). Scar endometriosis after a cesarean section: a perhaps underestimated complication. Gynecological Surgery, 10(4), 279-284
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- Oh, E., Lee, L. W., Kang, J., Choi, S. Kim, K. & Lee, W. (2014, September). A surgeon’s perspective of abdominal wall endometriosis at a caesarean section incision: nine cases in a single institution. Surgery Research and Practice, (2014) 2014, 405-760
- Scar endometriosis. (n.d.)
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