By Dr. Nicole Cozean, Founder of PelvicSanity in Orange County, CA

Painful intercourse after a baby is common, but not normal, and not something you “just have to bear.”

Resuming sexual activity after a baby can be intimidating. More than half of women report pain with intercourse following childbirth. This occurs with both vaginal and C-section deliveries.

This isn’t something that typically resolves on its own either – 40% of women report ongoing pain with sexual activity even six months after delivery.

Many women may have already been experiencing some discomfort or pain with intimacy prior to pregnancy that only has gotten worse after delivery.

Pain with intercourse can rob intimacy of pleasure. It can strain relationships. The body may even learn to fear sexual activity and start to “guard” during moments of intimacy, making it even more difficult to enjoy a healthy sex life.

The good news? There’s absolutely help out there and every woman can regain a pleasurable, healthy sex life after having a baby!

The Six-Week OB Check-In Timeline is Arbitrary

Many women feel additional pressure because they’ve been ‘cleared’ by their OB at the six-week check in. This timeframe is completely arbitrary!

A lot of times this leaves us saying things like:

  • “I’ve been ‘cleared’ by my OB but I still don’t feel ready”
  • “I’ve been ‘cleared’ and we tried and it was terrible”
  • “I’m scared if it will ever be right again”

The additional pressure to get back to normal after that six-week check is real. And it doesn’t help your partner feels you’ve been given the green light…so what’s the problem?

The six-week clearance is important but it’s not a thorough check of your pelvic floor muscles (which are usually the root cause of painful sex after a baby).

The Pelvic Floor: What’s Going On?

The muscles of the pelvic floor are responsible for sexual function. They need to relax in order to allow penetration and contract for orgasm and pleasure. And after a childbirth – whether vaginal or C-section – they often aren’t able to function properly.

Contrary to popular belief these muscles usually aren’t “weak, loose or stretched out.” You don’t need to Kegel (in fact, that might be the worst thing to do).

These muscles are generally overly tight and strained from childbirth. This can make it difficult for them to allow penetration and is the cause of pain with intercourse. Left untreated, these muscles often end up causing pain, urinary or gut health symptoms or other pelvic health problems later.

(Problems with the pelvic floor muscles are also responsible for many other post-partum issues, including incontinence, low back pain, prolapse and pelvic pain).

Pelvic Floor Physical Therapy

Fortunately there are experts who specialize in resolving pelvic floor dysfunction so you can regain pain-free and pleasurable intimacy. A pelvic floor physical therapist can assess the pelvic floor, determine the underlying issue and begin working with you to resolve your pelvic floor dysfunction.

When looking for a physical therapist, make sure they:

  • Specialize exclusively in treating pelvic health issues
  • Provide hour-long, hands-on treatment sessions
  • Are looking at both the internal (pelvic floor muscles) and external factors (low back, hips, your posture, gait, and more!) at each visit
  • Aren’t just telling you to “Kegel” or hooking you up to a machine
  • Are “finding the why” of your pelvic floor issues for lasting relief.

If you’re local to Southern California, our team at PelvicSanity would love to work with you to resolve painful intercourse and any other pelvic health issues you might be having after childbirth!

Learn more about how we can help or schedule an evaluation here! 

Other Pelvic Health Issues

Painful sex isn’t the only thing pelvic floor physical therapy can help!

Other common post-partum issues include a diastasis recti (abdominal separation), prolapse, low back pain, incontinence, urinary urgency/frequency or constipation and gut health issues. If you’re experiencing any of these, pelvic physical therapy can help resolve both your symptoms and the underlying cause!

Pelvic PT can also address the aftereffects of the birth itself. We help mobilize C-section and episiotomy scars to make sure they don’t stick (or ‘adhere’) and cause symptoms. The tailbone is often painful or injured following delivery. Almost 90% of women have some degree of tearing during birth that needs to be addressed by a pelvic PT.

Other Post-Partum Intercourse Help

Lubrication can be extremely important for post-partum intercourse. Estrogen levels drop after childbirth and reduce the amount of natural lubrication. Using a lube (we recommend Slippery Stuff, Uberlube or Desert Harvest brands, depending on your needs) can make intercourse more pleasurable for both partners.

Spending more time with foreplay can also be important as you ease back into intimacy.

Addressing anxiety with your partner in an open way can make the return to sexual activity less stressful.

Remember, the underlying cause of painful intercourse – those pelvic floor muscles! – always needs to be addressed.

Communication around Intimacy

Open communication with your partner around post-partum intimacy is critical. Being able to talk about painful intercourse or fear around resuming sexual activity is important (you may want to have your partner read this article!).

You can also expand your definition of intimacy to include non-penetrative sexual activity or even non-sexual intimacy like cuddling.

You Deserve Pain-Free, Pleasurable Sexual Activity

Please don’t ever believe it “has to be this way” or that you need to just “have a glass of wine and try and relax.” Every mother deserves pain-free, pleasurable sexual activity. If you are struggling with painful intercourse (or any other pelvic health issues) make sure to get to a pelvic physical therapist for treatment!


About Dr. Nicole

Many new mothers struggle with post-partum issues after having a baby, often feeling frustrated, embarrassed, or unable to take care of themselves while trying to care for a little one. Dr. Nicole and her PelvicSanity team specialize in working with new moms, helping recover from delivery, resolve post-natal symptoms, and safely return to activities, exercise and intercourse. We want every woman to feel confident in her body and health after a baby – feel free to reach out to our team if you need help!