Sex might be the last thing on your mind after you’ve had a baby or you might be ready to get back at it—both are totally normal and vary from person to person. It would be an understatement to say that carrying a baby and going through labor and delivery take a major toll on your health. Allowing yourself time to recover physically and emotionally is an important part of rebuilding the road to intimacy with your partner.
Even if you’re not in the mood right now, eventually, you will be again. Many people have lots of questions about what to expect with sex after pregnancy. We asked The Everymom readers to submit theirs for Origin Physical Therapy’s Clinical Director Liz Miracle to help answer. Liz is a physical therapist and women’s certified specialist with a master’s degree in physical therapy. Read on for her answers to all your postpartum sex questions.
1. Will sex feel different after I have a baby?
The short answer is: it might. There are a few reasons sex would feel different after childbirth. First, if you had a vaginal delivery, your pelvic floor muscles and vaginal canal could feel different from how they used to feel. They may not feel as strong as they did before or, on the flip side, they may feel tighter than they did before. Everyone is different.
If your pelvic floor muscles and vaginal canal are still healing from delivery or if you sustained a tear during vaginal delivery, sex may feel different. If this is the case for you and you’re bothered by it, you may want to talk to your doctor or consider seeing a physical therapist for pelvic floor therapy.
2. When can I have sex again after having a baby?
Many health care providers recommend waiting until your postpartum checkup, which usually takes place six weeks after you have the baby, to have sex. Usually, your physician will clear you for penetrative intercourse at your six-week follow-up (eight-week follow-up for C-sections), but everyone is different, so make sure to check with your doctor first.
3. Can I have sex sooner than six weeks after delivery?
This is a conversation to have with your doctor. If your physician clears you for sex, it is safe to try slowly. However, the cervix typically takes six weeks to close, and penetrative intercourse prior to closure of the cervix could cause life threatening complications like air embolism.
Of course, if you experience pain or bleeding—regardless of when you return to penetrative intercourse—stop and discuss with your doctor.
4. How long into the postpartum phase is it normal for sex to be painful or uncomfortable? Will it still be painful if I wait six weeks?
Penetrative intercourse may feel different or uncomfortable even if you wait six weeks. You might be a little sore at first, so Miracle recommended to go slow and use lubricant.
If you’re nervous about sex, Miracle also suggested first trying to slowly insert a smooth sex toy at your own pace. If that goes well, consider trying with a partner. If you have pain that you would rank as more than a 4 out of 10 on a level of discomfort, tell your doctor and consider pelvic floor therapy.
5. Does a fourth-degree tear from childbirth make postpartum sex more painful? Should some people wait longer than six weeks?
A fourth-degree tear essentially disrupts the muscle between the vagina and the anus, the perineum, and both anal sphincter muscles. It can be common to have more discomfort because of the injury to more muscles. Talk to your physician about your situation.
6. Will sex hurt after a C-section delivery?
Regardless of the mode of delivery, you still carry your baby for nine months. This alone can create changes to the pelvic floor muscles that may result in discomfort during sex.
If you’re producing breast milk, a lack of estrogen in the vaginal tissues may result in dryness/irritation.
7. When should I reach out to my doctor for help if sex is still painful after baby?
If your doctor gives you the OK for intercourse at your six-week follow-up but you’re still having pain that you’d rank as more than 4 out of 10 on a discomfort level, reach back out to your doctor or seek the care of a physical therapist.
8. How does breastfeeding affect libido and does it affect other things like dryness, etc.?
Because estrogen levels are lower while producing breast milk, you may experience a reduced libido. It can also lead to vaginal dryness. If lubricant is not helping and you’re experiencing this, consider discussing with your doctor whether or not topical estradiol to the vulva is right for you.
9. Do I need to use lubricant?
You only need to use lubricant if you’re having discomfort with intercourse. Miracle recommended water-based, glycerin-free lubricants without additives that create a warming sensation. Silicone lubricants are also an option, especially if you’re using silicone toys or having sex in the shower.
10. Should I be doing Kegels?
Immediately after vaginal delivery, you can start doing a small amount of tiny pelvic floor muscle contractions (around 10 percent of your maximum squeeze). This can help with swelling and with waking the muscles back up.
Miracle recommended seeing a pelvic floor physical therapist after your six-week checkup with your doctor before starting a more rigorous pelvic floor strengthening program since Kegels aren’t always the right choice for everyone.
11. Is it normal to have an extremely low libido, even 6+ months after baby? And what can I do about it?
Reduced libido can vary from person to person after having a baby, especially if you’re producing breast milk, your regular menstrual cycle has not returned, or you’re on a new/different hormonal birth control.
Since everyone is different, Miracle recommended discussing your personal concerns with your doctor. Some people may not be concerned at six months while others might find it problematic.
12. Postpartum sex was uncomfortable for me until I got my period back—is that normal?
Miracle said it sounds like this discomfort may have been due to a change in hormones, but once those hormones returned with a regular menstrual cycle, it improved. This is quite common due to the opening of the vagina, the vestibule, and lots of estrogen receptors.
People going through menopause sometimes note similar discomfort. If this is something you’ve experienced or are experiencing, consider talking with your doctor about a topical estradiol to the vulva.
13. How long until everything looks normal again down there?
There’s no correct answer to this question, as it will depend on the individual and on the birth experience. That said, if you’re concerned about the appearance of your vulva after giving birth, you should discuss it with your doctor.
14. When will I enjoy sex again? How can I make it more enjoyable?
People have different factors that play into sex drive and how they enjoy it. If discomfort is preventing you from pleasure, a physical therapist can help you work toward your goals of having pain-free intercourse. Miracle recommended working with an intimacy coach or sex therapist to help come up with ideas specific to individual needs.
15. Am I going to bleed the first time having sex after baby?
You may still be bleeding or have discharge, called lochia in the early postpartum period, but sex itself should not cause bleeding if you wait until you’re cleared by your doctor. If it does, you should stop and contact your doctor to let them know.