The postpartum period can come with many feelings, emotions and struggles. People are often surprised when they go see their doctor six weeks postpartum and are told “Things look great, you are cleared for sex!” For most people sex is the last thing on their mind, and that totally makes sense. A baby came out of their body! That is a lot for someone to experience.
They are also adjusting to a new routine with their little one that includes sleep deprivation and being a possible food source. Furthermore, consider the fact that they were pregnant for roughly forty weeks. their body went through a lot of changes during that time, so it will most likely take a similar amount of time to recover. So the first thing I tell every postpartum person is to be patient with yourself. Whatever you may be feeling just know that it’s common and you are not alone. If you don’t want to have sex, don’t feel pressured to do so, just because the doctor told you that from a physiological standpoint you are “good to go.”
Now if and when you do feel ready to attempt penetrative intercourse, keep a few things in mind. Lube is key. In my opinion, lube is always a good idea. But for postpartum people, lube is almost essential. This is primarily due to hormones. Hormonal changes after delivery can lead to a lack of vaginal lubrication. When you delivered your baby, your estrogen levels dropped substantially. Since your vulvar tissue relies on estrogen, this lack of estrogen can lead to vaginal dryness or pain with sex. Therefore, lube is necessary.. There are many good water based lubricants on the market. You can also consider a silicone lubricant, which often lasts longer than a water based lube. Or there are many hybrid (water and silicone) options. Some people like to use oil-based products or even coconut oil. Keep in mind that oils will degrade latex, so do not use it if you are using condoms as birth control unless your plan is to try to conceive another little one.
Other than lube, remember to go slow. If you had a c-section, an episiotomy or a perineal tear you may have scar tissue that can cause pain with intercourse. So slow and steady wins the race here folks. Sometimes it helps to start with a finger or a small dildo to see how things feel. If you find that things are painful or don’t feel quite right you are not alone! Keep in mind that pain with sex postpartum is very common. In a study of postpartum women in Australia, 64.3% of women reported sexual dysfunction in the first year following childbirth. In that same study, 39.4% reported pain with sex and 43.4% reported difficulty with lubrication. Other Research shows that 41-83% of new moms experience sexual dysfunction (low libido, pain with sex, not finding sex pleasurable) 2-3 months postpartum and 17-36% of new moms experience painful sex 6 months after birth.
Pain can be due to many things including scar tissue, hormonal changes and/or pelvic floor muscle dysfunction. Luckily there are many ways to treat painful sex so talk to your doctor. They can determine if medication or other procedures are warranted. They can also refer you to a pelvic floor physical therapist, who can help address any myofascial impairments that are contributing to your symptoms. If you are one of the many postpartum people that report a lack of libido and/or diminished sexual satisfaction. You may benefit from working with a psychologist/sex therapist or sex coach. You may need more than one provider to help.
Finally, it is important to remember that sex does not just mean penetration. Think of sex like an ice cream shop, there are a ton of flavors. Sex can include mutual masturbation, oral sex or erotic massage. Consider trying a new sex toy or two. Basically, there are plenty of ways to experience non-penetrative pleasure with your partner or alone. This means that you need to communicate what you want and what “flavors” you are in the mood for. Tell your partner how you are feeling and what you are up for. It often helps to start solo to find out what feels good before bringing your partner in. Take this as an opportunity to explore and get to know your body.
When someone decides to return to sex after having a baby is variable. Everyone is different, and getting into the groove of parenting may take precedent before you get your actual groove on. Be kind to yourself.
Written By: Rachel Gelman, pelvic floor therapist.
Kick off your sex life with In Tune, our card game for couples by Therapists.