North American Registry of Midwives (NARM) Practice Exam

When do vaginal rugae typically return postpartum?

1. By the first week

2. By the second week

3. By the third week

4. By the fourth week

The correct answer is: By the third week

Vaginal rugae, which are the folds and ridges within the vagina, undergo changes during pregnancy due to hormonal influences and the physical changes that accompany childbirth. After delivery, these structures begin to return to their pre-pregnancy state. The typical timeline for the reappearance of vaginal rugae post-delivery is generally around three weeks. This timeframe allows for the necessary healing and restoration of the vaginal tissues as well as the resumption of the normal cyclic hormonal processes that encourage the reformation of the rugae. The first week postpartum is primarily characterized by healing, and while the rugae may begin to appear, they are not fully restored. By the second week, some changes may occur, but they are still not completely evident. By the fourth week, many women will notice a significant return of normal vagina rugae characteristics, but the three-week timeframe is often recognized as a pivotal point in this process. Overall, understanding this timeline is crucial for midwives in assessing postpartum recovery and providing appropriate care and guidance to new mothers during their recovery journey.