Why Your Post-Birth Body Doesn't Feel "Normal"

I've been sitting with this research study all morning… I happen to have super cool friends who do their PhDs in things like carbon capture an emissions, as well as gender studied and how long covid is represented on the dark web. (Forgive me folks if I’m getting it wrong). This morning, one such cool friend sent me this article written by their boss.

I need to talk about it because it articulates something I hear in nearly every postpartum consultation: "I thought this was just how it was supposed to be."

The study—conducted with 30 Swedish women living with second-degree vaginal tears—puts a name to something I've witnessed over and over in my practice: the gap between what women expect their post-birth bodies to do and what actually happens. They call it "normative chafing," and honestly, it's one of the most accurate descriptions of postpartum life I've come across.

The Problem with "Normal"

Here's what gets me: second-degree tears happen to 37-78% of people who give birth vaginally. They're common. And yet, we've somehow managed to make them invisible.

I’m guilty of this too! I believe I have even said the words, “everybody tears…” in my Beyond Birth calls.

One woman in the study described years of pain—pain going to the bathroom, pain with exercise, pain during sex—before she even realized it wasn't normal. She thought, "Well, I guess everyone feels like this after birth." The tragedy of that assumption haunts me.

What the research really highlights is that we've normalized post-birth suffering in a way we wouldn't accept for any other injury. Imagine telling someone recovering from an ACL tear, "Oh, just push through the pain and get back to running." We'd be horrified. But tell someone their pelvic floor is wrecked after birth? "That's just motherhood, honey."

The Three Misfits

The researchers identified three key areas where post-birth bodies collide with unrealistic expectations:

The Active Mother

Women described longing for active motherhood—walks with the stroller, carrying their babies in slings, playing on the playground, running after toddlers. But pelvic floor pain, heaviness, and leakage made these things genuinely difficult. One woman could walk maybe a kilometer before needing to lie down for hours.

What broke my heart was reading about her guilt. She couldn't carry her baby in a sling like she'd imagined, so her daughter spent most of her time in a baby bouncer. She felt useless. This wasn't laziness or weakness—it was a real physical limitation being interpreted as personal failure.

This is the core issue: we've linked good mothering to a functioning, pain-free body. And when your body doesn't cooperate, you internalize it as a reflection of your worth as a parent. That's devastating. And it's completely backwards.

The Fit Mama

Then there's the pressure to "get your body back"—the pressure to return to running, spinning classes, fitness routines. The research shows how women tried to adjust (walking instead of running, lower-impact activities) but felt frustrated by the loss of their pre-birth capacity.

What's important here is that many of these women identified as "active people." They weren't trying to return to their pre-baby body out of vanity. They were grieving the loss of something fundamental to their identity. They wanted to move their bodies the way they always had.

Some of them had to stop working out completely. Some could only do modified versions of activities they loved. And yes, some wanted to address weight gain—but the bigger piece was the loss of physical capability and the identity that came with it.

The Sexual Body

This is where I want to be really direct: the research found that postpartum sex after a second-degree tear often becomes painful, less pleasurable, and complicated by leakage.

And nobody's talking about it.

Well, we all know I am. But more of us need to!

Women described the tear changing the sensation, the fit, the entire experience of intercourse. Several women worried their vaginas looked "wrong" or "damaged." One woman wondered if she'd ever have a "functioning and good sex life" again at age 29.

Here's what infuriates me: the midwife/OB follow-up visit at 6-16 weeks is when these women were being asked about sexual activity, often with the implication that they should be "ready" to resume penetrative sex. Meanwhile, nobody was asking, "Are you in pain? Are you leaking? Do you have sensory changes?"

By even asking the question about sex, you are dismissing the issue, and many women will simply lie or not tell the whole truth because they don’t feel that being vulnerable would actually get them anywhere. They don’t trust that they will be listened to, so they live in pain (and without pleasure!)

The research calls out how we normalize genital pain and dysfunction as just something women "have to deal with." We position clitoral stimulation as an alternative—a backup plan—rather than exploring what would actually feel good in a changed body.

Why This Matters to My Practice

When I read this study, I kept thinking about the women I work with who come to pelvic floor physical therapy six months or two years postpartum, saying, "I thought it was just me."

We have rehabilitation pathways for third- and fourth-degree tears (severe anal sphincter injuries), but for second-degree tears—which happen to the majority of people who birth vaginally—we essentially say, "You had a follow-up visit, you're fine." And then women go home and suffer in silence, adjusting their lives around pain and leakage.

This is a failure of our healthcare system and our culture.

There is also something that is not directly mentioned in this article, but that has huge implications. Often, if you are breastfeeding, your estrogen levels decrease which leads to vaginal dryness… which leads to painful sex. Sometimes, just a topical estrogen can make a huge difference!

What I Actually Want to Say

Your post-birth body is not broken. It's changed. Those are different things.

A second-degree tear is an injury that deserves treatment, follow-up, and rehabilitation—not normalization and silence. If you're experiencing pelvic floor pain, heaviness, leakage, or changes to sensation during sex, that's not just "what it's like to be a mother."

That's also not something you have to accept as permanent.

Here's what actually works: pelvic floor physical therapy that includes a thorough assessment of your strength, length, and scar tissue. Yes, that means in standing. You also want to be sure that your physical therapist is not just doing manual work during a session and sending you on your way- but providing education for what you should do between visits.

Sometimes craniosacral work is necessary to calm your nervous system. Visceral mobilization can be a key component—your body just rearranged itself! Real assessment of what your scar tissue is doing. Education about what's happening in your body so you stop internalizing it as failure. And sometimes, just knowing that what you're experiencing is real and common and treatable can shift everything.

Beyond the physical work, there's grief work too. You may need to grieve the body you had before, the activities you can't do right now, the sex life that changed. That's not weakness—that's processing an actual loss. And that matters.

But know that just because you can’t right now. That does not mean you can’t forever. With the right help, you can.

And you will.

The Bigger Picture

What struck me most about this research is the concept of "normative chafing"—the ongoing friction between what women expect their post-birth bodies to do and what those bodies can actually do. That friction doesn't just hurt physically. It hurts psychologically, relationally, sexually, spiritually.

We've created a postpartum culture that demands active, functioning, sexy, fit bodies while simultaneously expecting mothers to be selfless, available, and infinitely capable. And when your body can't meet those demands after birth, you blame yourself.

That's not a body problem. That's a culture problem.

But all is not lost! We can change this. (Arguably, we are the only ones who can).

We can stop normalizing postpartum suffering. We can stop asking women to "just push through it." We can create real pathways for assessment, follow-up, and treatment. We can reframe postpartum recovery as something worthy of time, attention, and resources—not as something you should recover from in six weeks while also caring for a newborn and returning to work.

That's what I'm trying to build with Be Well Baby and the Beyond Birth Blueprint. Not just surviving. Thriving.

If you're experiencing postpartum pelvic floor dysfunction, pain, leakage, or changes in sexual sensation—whether it's been six weeks or six years—you deserve support. You deserve answers. You deserve to have your body feel like home again.

Let's talk about it. Let's normalize the conversation so the next woman doesn't spend years thinking she's the only one suffering.

Love,

Emily

Have you experienced a second-degree tear and the challenges described in this research? I'd love to hear your story. You're not alone, and what you're experiencing is real!