What are the causes of vaginal non-closure after childbirth?

In general, postpartum vaginal non-closure may be caused by delivery-related injuries, hormonal changes, pelvic floor muscle relaxation, vaginitis, or old perineal lacerations. Management depends on the specific situation. If physical discomfort occurs, it is recommended to seek medical attention promptly and follow the doctor's instructions for treatment.

1. Delivery injury: During childbirth, the fetus passing through the birth canal may cause excessive stretching or even tearing of the vaginal muscles and fascia. If these tissues fail to fully recover postpartum, vaginal non-closure may occur, often accompanied by a feeling of vaginal laxity. After the mother's body recovers (usually 42 days postpartum), pelvic floor muscle rehabilitation training is recommended to strengthen pelvic floor muscles and promote vaginal recovery.

2. Hormonal changes: Elevated estrogen and progesterone levels during pregnancy cause vaginal tissue relaxation. After childbirth, a sharp decline in hormone levels may result in slow recovery of vaginal elasticity, leading to vaginal non-closure. A balanced diet rich in protein and vitamins (e.g., lean meats, fish, fresh fruits, and vegetables) is recommended to provide nutritional support for bodily recovery and aid vaginal healing.

3. Pelvic floor muscle relaxation: Pelvic floor muscles may be damaged during childbirth, and early postpartum physical strain can lead to pelvic floor relaxation, resulting in inadequate support for the vagina and subsequent non-closure. This may be accompanied by urinary leakage and a sensation of pressure in the lower abdomen. Pelvic floor muscle exercises, such as Kegel exercises, are recommended under a doctor's guidance. Vaginal weights or other assistive devices may also be used to aid in strengthening the muscles.

4. Vaginitis: Postpartum immune function may be reduced, making the body more susceptible to pathogenic invasion and vaginitis. Inflammatory stimulation may cause vaginal mucosal congestion and edema, affecting the normal vaginal structure and causing non-closure, often accompanied by abnormal vaginal discharge, odor, and itching. Medications such as metronidazole suppositories, clotrimazole suppositories, or nitrofurantoin-nystatin vaginal soft capsules may be used as directed by a physician.

5. Old perineal laceration: Failure to properly suture perineal tears during delivery may result in poor wound healing and old lacerations, which can affect vaginal structure and lead to non-closure. Pain during sexual intercourse may also occur. Patients may consider surgical repair of perineal lacerations or vaginal tightening procedures under medical guidance to help restore perineal and vaginal anatomy and promote recovery.

It is recommended that postpartum women keep warm, rest adequately, and avoid excessive fatigue and physical exertion. Additionally, maintaining cleanliness and dryness of the perineal area is important to prevent infection.