Let me begin by saying that I passionately disagree with the six week “you’re clear to have sex” mark our medical providers have come to love. I’m not sure when this timeline was implemented, but I am almost certain it was a team of male doctors who decided on it. SIX WEEKS?! Some women bleed for six whole weeks after a vaginal birth, and their stitches may have only just dissolved. Cesarean birth mamas have had a major surgery and are nursing not only a baby, but their abdominal incision as well. But here you are, at your postpartum check-up, being told you are ready for coitus. And, if your partner is anything like my husband and honed in on that “you can’t have sex for six weeks” spiel they give you at the hospital, then when that six weeks hits, you wake up to an overly-enthusiastic man who has never remembered a single appointment in his life but is all of a sudden a steel trap of information regarding your postpartum schedule (and you even receive a text message later that day with a “how’d it go? <devious smiley face emoji>”).
At my appointment with my midwife, I found out I had a small spot next to where my stitches were that needed some extra time to heal so, luckily, I could push back “the date” another week. I write “luckily,” because, as mentioned above, I was absolutely terrified of sex after baby. A 7lb 4oz bowling ball had exited my vagina – the last thing I wanted was for something to enter it. I’m sorry if that is TMI, but it’s the truth. I will admit that I had sex for the first time just over seven weeks postpartum, but it took a glass of wine and I essentially said to my husband, “let’s get this over with,” as I grabbed the Costco-sized lube bottle he had purchased in preparation for this event. To him, this was Christmas morning; to me, I was about to rip off a band aid that had been adhering itself to my skin for four months – and yes, it was THAT painful. And, since pain causes fear, and fear magnifies pain, sex was something I did not look forward to for quite some time, and, all of a sudden, celibacy didn’t sound like such a bad idea. That wasn’t really an option, though, considering I’d like to have another child one day and, oh, I guess I’d like to keep my marriage from ceasing to exist.
Conveniently enough, my newborn class at The New Mom School had two subject matter experts come in and discuss both the physical and mental healing that is required during your postpartum experience, and how both of those can get in the way of our post-baby sex life. And while every woman is different, a lot of us feel scared, nervous, or even dread sex due to mental blocks or physical pain. Luckily, they were kind enough to answer some of my questions, and my hope is that they will help you navigate these waters if you find yourself dealing with anything mentioned above. First up, Whitney Sippl, DPT, WCS, CPT:
Q: Why does sex sometimes hurt after baby (for both vaginal and cesarean births)?
A: There are 3 common causes of painful sex after baby that apply to both vaginal and cesarean births. The first is vaginal dryness, which can happen for as long as you’re producing milk and up to three months after you’re done. Use lots of lube post baby to eliminate the friction discomfort that can happen from the dryness and if you still have pain it may be coming from either (or both!) of the next two causes. The second common cause of pain is pelvic floor muscle tightness, which can happen after either type of birth. You can think of it like tension or knots in your pelvic floor just like you could get tightness or knots in your shoulder or back that hurt when someone presses on it. That is essentially what is happening with penetration during intercourse. Seeing a pelvic floor physical therapist is your best bet to treat the tightness to eliminate the pain. The third big contributor to pain with intercourse is scar tissue restrictions, adhesions, or sensitivities that can happen at the perineal scar tissue or cesarean scar tissue. Scar massage can be very beneficial for this, which you can do on yourself or have a pelvic floor PT do it for you and teach you how to do it.
Q: How long should a woman “put up” with pain during sex after baby?
A: The first couple times may be uncomfortable, but after that sex should be fine with no pain or discomfort. We should NOT just live with painful intercourse. If it lasts for more than the first month of trying, then you should seek help from a pelvic floor physical therapist for assessment and treatment. Please go to someone with lots of experience and who offers at least an hour session so you can get the best and fastest results. Don’t wait too long because the longer the pain is there, the longer it takes the pain to go away. When we can treat it early we can get rid of the pain much faster.
Q: What can she do to enjoy/improve her post-baby sex life?
A: If you aren’t dealing with any pain or discomfort, then Kegels can be a great exercise to maintain good pelvic floor tone, awareness, blood flow, and strength – which are all great to have to enjoy intercourse. You can also try doing your Kegels during intercourse, which can help with clitoral stimulation and improve sensation and the ability to climax. Foreplay is also great to get some of your natural lubrication stimulated, especially if you are finding that you have some vaginal dryness post baby.
And now, Dr. Meredith Hansen, Psy. D.:
Q: What are some of the emotional or mental hurdles a new mom should expect to experience regarding sex after baby?
A: When it comes to sex, a new mom may experience the following:
- Feeling physically overstimulated by the end of a day spent holding and nursing baby, which can lead them to push their partner away.
- If there is resentment in the marriage, poor communication, or a lack of connection, you will not desire physical intimacy.
- Some couples stop having sex and stop talking about sex and in time it becomes more awkward to be physically close, so they just move into more of a friendship.
- Priorities change, and the energy women do have is put into baby, leaving little time for sex and intimacy.
Q: What can she do to combat those hurdles and connect with her partner once again?
It is important for couples to take care of their relationship – get help from a professional if needed, schedule date nights, and keep the lines of communication open. Couples also need to keep their sex life “breathing”, meaning that even if they are not having sex or not having it as often, they should be talking about it. For example, saying something like, “I miss being close to you, I can’t wait to have more energy again,” is a way to keep your sex life alive even if the frequency has decreased. In time, circumstances will shift, and you’ll feel comfortable reconnecting physically again.
Q: What is “normal,” and what may indicate the need for 3rd party help aka seeking assistance from someone like you?
It is normal to feel anxious about your sex life in the first few months after baby and for your desire to decrease. It is also normal for there to be changes in what pleases you, when you like to have sex, and how you like to have sex.
If there is resentment growing in your marriage; if you feel more distant from your husband since having a baby; if your husband does not seem to desire you; or if you argue or avoid one another more than you connect emotionally or physically, there may be deeper issues that require you to seek out couples counseling.
If you are struggling with postpartum depression or anxiety or are suffering from body image issues that keep you from being physically close with your husband, you may benefit from individual counseling.
All-in-all, it is always best to at least check in with a professional if you have questions rather than just ignoring the issues and hoping things get better in time.
There is no doubt that sex after baby looks different for every woman. Some women’s sex drive and physical abilities pick right up where they left off, while others (like myself) have difficulty getting back into the swing of things. Dr. Hansen mentions feeling physically overstimulated by the end of the day as one of the barriers in your sex life, and nothing has rung truer to me. By the time my daughter goes to bed, my touch tank is maxed out. Between snuggling, carrying, and breastfeeding my daughter, I sometimes cannot handle any more physical contact, which means my husband is perpetually on the short end of the stick. For us, it’s an area that takes a conscious effort, but an open dialogue, and mutual respect and empathy, are what keeps this particular subject from becoming a much bigger issue.
Just remember that sex shouldn’t hurt after the first couple of times; to keep your sex life “breathing”; to not be ashamed if you need to reach out to the professionals who are trained in these areas; and that the women in this New Mom School village are here to help you every step of the way.
Closing this computer to finally (his word, not mine) give my husband some attention (for 15 minutes before I go to bed),
Whitney Sippl, DPT, WCS, CPT: email@example.com
Dr. Meredith Hansen, Psy. D.: www.DrMeredithHansen.com