Many women are afraid to have a child through the normal birthing process, fearing their vaginas might not contract to its original size afterwards. And their fears are not unfounded.
"After a while (following childbirth), the vagina will contract significantly, but not necessarily to what it was before," says Professor Horace Fletcher, gynaecologist and obstetrician at the University Hospital of the West Indies. "However, it will go back down so much that the change may not be noticeable."
It is for this reason that several women are choosing to do Caesarian sections. According to Fletcher, in countries like Brazil, the Caesarian rate is very high with some 70 per cent or so of women opting to do the procedure in order to avoid the stretching of their vaginas.
"Other research have found that after vaginal birth, there can be a stretching of the pelvic floor, affecting urination and the passing of stool," notes Fletcher. "However, most people agree that those reasons are not enough to have a Caesarian section and that this should only be done when absolutely necessary."
Dr Charles Rockhead, gynaecologist at the Ripon Surgi-Centre and the Amadeo Medical Group on Young Street in Spanish Town, explains that during a vaginal birth, the cervix opens up and the bony structure (the baby's head) comes down which can cause damage to the pelvic structure or muscles, whether directly or indirectly. This damage can then cause the vagina to lose its elasticity, thus becoming loose.
He was, however, quick to add that damage done is not dependent on the number of children a woman has, but on the type of labour she endures.
"The longer the labour, the more likely it is to cause damage," says Rockhead.
Fletcher agreed, adding that if the woman has a very traumatic delivery, such as a very large baby, or received a number of tears during delivery, then the vagina could remain stretched.
But, he says: "Most women's vaginas will come back to normal."
Four weeks after vaginal birth, the vagina should start moving back into shape, adds Fletcher.
However, in cases where the vagina does not contract significantly, he strongly recommends Kegel exercise, which he says is very effective. This consists of contracting and relaxing the muscles that form part of the pelvic floor in a similar manner to that of holding up the urine. He suggests that women do this as often as they remember, wherever they are.
However, if there is a significant damage or lax, he recommends a surgical procedure to tighten the vagina.
"This is a relatively easy procedure, but it should only be done if there is total lax or if the vagina is widely stretched.