It’s okay if you’re hesitant about being intimate again after giving birth. In fact, this feeling is really common. We spoke to experts to put together a not-your-mother’s guide on returning to sex.
Giving birth opens your life up to a whirlwind of changes, impacting absolutely everything — your schedule, your relationships, your physical and mental health, and your sex life.
Sex may be one of the last things on your mind for a while after having a baby. But somewhere in your postpartum journey, you will start thinking about it again. Maybe with excitement, maybe not. After all, research published in the Journal of Sexual Medicine in 2015 stated that almost two-thirds of people who have given birth have difficulty returning to sexual activity after having a baby, and almost three-quarters of new parents report feeling dissatisfied with their postpartum sex lives, with the top three barriers being a lack of sexual desire, difficulty achieving an orgasm, and trouble getting aroused.
“You’re probably going to be feeling a wide range of emotions about being intimate again — anxiety due to not having had sex for a while, fear of discomfort or pain, disconnection from your partner now that it’s not just the two of you anymore, and/or self-consciousness about your body,” Vanessa Marin, a licensed psychotherapist with 20 years of experience in the sex therapy field, told DailyOM for this article. “You may not be feeling wildly turned on or excited about being intimate, and that’s okay. What you’re looking for is an openness to starting to explore physical intimacy with your partner again.”
Feeling a little nervous about getting back on the horse, so to speak, is completely normal. To help ease your mind and get you to the starting line, we spoke with a few experts to learn the ins and outs (innuendo intended) of postpartum sex.
When Can You Start Having Sex Again?
Many OB-GYNs recommend waiting six weeks after giving birth, but Rebecca Booth, MD, board-certified obstetrician and gynecologist and co-founder of VENeffect skin care, whom DailyOM spoke with for this story, says it’s best to make this decision individually with your medical care team.
Giving yourself enough time to heal is essential. Waiting six weeks or more allows the uterus to shrink and the cervix to close, protecting against bacterial transfer and allowing everything down there to heal up (think perineal tears and vaginal lacerations), says Ashley Rawlins, DPT, physical therapist and clinical learning and development lead at Origin.
Adequate wait time is equally important for those who have given birth via cesarean section (C-section). The abdomen needs time to heal from the trauma of surgery, says Mary Jane Minkin, MD, a practicing gynecologist and clinical professor of obstetrics and gynecology at Yale University School of Medicine, whom DailyOM spoke with for this story.
But just because your recommended waiting time has passed, it doesn’t mean you have to start having sex again. “It’s totally okay to wait longer — as long as you need,” Rawlins stresses. “Postpartum healing looks different for everyone. If your body and mind are telling you to hold off, it’s important to honor yourself.”
Interested in learning more? Check out Strengthening Your Pelvic Floor
Will Sex Hurt After Having a Baby?
According to research, at least 85 percent of people who give birth vaginally will suffer some perineal trauma. Pain should ease as the injury heals. However, it’s super common for vulvar and vaginal pain to continue due to scar tissue, decreased vaginal moisture, or trauma to the pelvic floor muscle.
In short, having sex too soon after giving birth can exacerbate the normal pain you experience as you heal. Other factors, like vaginal dryness, can also play a role. We’ll get into this and give you some expert advice on what to do if you’re experiencing pain after an extended period of time a little later.
Using Contraception While Breastfeeding
Before we get into the good stuff, we need to talk about contraception. Whether or not your postpartum sex journey involves potentially having another child, using contraception is an important consideration, as in some cases short gaps between pregnancies are associated with a higher risk of complications. “You need contraception even one month after you deliver and even if you are breastfeeding,” says Dr. Minkin, who is the co-director of the Sexuality, Intimacy and Menopause for cancer survivors program at the Smilow Cancer Center.
Studies on birth control methods that use estrogen have generated some concern about hormone transfer to the baby, as well as negative impacts on breast milk volume and duration for those who are nursing. For that reason, nonhormonal birth control, like the copper intrauterine device (IUD), is ideal. Progestin-only forms of birth control are also a great option. Those include the hormonal IUD, certain oral pills, progestin-only vaginal rings, the hormonal implant, and progestin shots.
As far as barrier methods go, condoms are safe and effective (85 percent) to use postpartum. Spermicide can also be used, although it’s less effective (75 to 80 percent). Because the shape of the vagina and cervix have changed after giving birth, it’s best to consult your healthcare team before using cervical caps or diaphragms as your primary method of birth control.
If you have a partner with male anatomy, and you’re over having children, vasectomies are an extremely effective birth control option. (Vasectomies are reversible, but not always and not easily — so it’s not the best form of birth control if you and your partner are planning for more kids.)
10 Sex Tips for the Postpartum Newbie
Now that everything has changed in your life, sex may feel like a whole new world. And while that can be scary, it can also be incredibly exciting. To help you out, here are a few tips from the experts.
1. Get Some Much-Needed Me Time
Paris-based midwife Hermine Eon says that some people have a hard time identifying with their bodies after giving birth, citing completely normal changes like loosening skin, cellulitis, a swollen tummy, and extra pounds. “You often hear, ‘I don’t feel attractive, it’s not my body, I don’t feel myself,’ and the social pressure to get back in shape is really high,” she tells DailyOM.
Rawlins adds that women often worry about changes to their vulvas and breasts, too. People who have just given birth are often anxious about changes in how sex can feel, both for themselves and for their partners. This can include a shift in how they relate to their breast and nipple area, which may be a cause of discomfort due to cracking, bleeding, and engorgement. If pelvic floor dysfunction is present, it’s common to be worried about leakage.
For many, feeling sexy is a prerequisite to sex. And, as mentioned above, that can be tough when your body has undergone changes and self-care seems to have taken up permanent residence on the back burner. The solution? Devote some of your precious downtime to yourself.
“Go for a massage or manicure to feel good, and take time to look after yourself,” Eon says. “The feeling of being desirable comes back easily if you have some time to pamper yourself a bit.”
2. Lube, Lube, and Did We Mention Lube?
Vaginal dryness is another common issue people face postpartum. A major contributing factor to vaginal dryness? Breastfeeding. According to Minkin, breastfeeding causes your ovaries to stop producing estrogen, which helps with vaginal moisture. Thankfully, we have the technology to overcome this problem. That’s right, we’re talking about that cheeky four-letter word: lube.
A quick 101 on lube: Water- and silicone-based lubes are safe to use with any kind of condom. However, oil-based lubes (which aren’t recommended for intercourse anyway) can cause latex to break down, so keep that in mind and stick to silicone-based lubricants instead.
There are plenty of lube and lube-adjacent options, from over-the-counter items such as long-acting vaginal moisturizers like Replens and Revaree to prescription items. According to Minkin, vaginal estrogen, which can also help with moisture and is available with a prescription, is safe to use while breastfeeding because only a negligible amount of estrogen enters your bloodstream as a result of usage. Your OB-GYN might have suggestions, too. Don’t hesitate to ask them!
3. Just Breathe
“Muscle tension and breath holding are common responses when you experience discomfort during sex,” Rawlins says. However, doing these things can actually make the pain worse. Instead, Rawlins recommends taking a moment (yes, your partner can wait!) to breathe; this will help to relax your body and release your pelvic floor muscles. That, plus taking things slowly to see what does — and doesn’t — feel good, communicating, and using lubricant, can make those initial postnatal forays in the bedroom better for both of you.
If pain during penetrative sex continues, talk to your healthcare team.
4. Power Up Your Pelvic Floor
Postpartum pelvic floor rehabilitation isn’t just important for combating urinary incontinence. Studies show that it can also help to alleviate sexual pain and dysfunction. You’ve probably heard of kegels, which are exercises that involve repeatedly contracting and expanding your pelvic floor muscles. While they have been proven to be an effective method for strengthening your pelvic floor, a review found that beginners have a difficult time knowing how to do them correctly.
For that reason, Rawlins, who specializes in pelvic floor muscle dysfunctions including pelvic pain, sexual dysfunction, and postpartum recovery, recommends working with a physical therapist after giving birth to optimize your sex life. Depending on your specific symptoms, your physical therapist will work with you to create a rehabilitation program to help you reach your goals.
5. Explore New Positions
“It’s so important to recognize that birth is a traumatic event for a body,” Marin says. “You will need time to heal physically and emotionally. A lot of people are shocked by how different sex feels physically [after giving birth]. What you used to like pre-pregnancy may not currently feel good for you.”
In other words, your go-to sex positions may not feel so great anymore, but don’t let that get you down. Get excited about finding your new favorites.
“For example, if your scar is tender after a cesarean, try positions that avoid direct contact with your abdomen, such as [on your] hands and knees or spooning,” Rawlins says. Or, if you’re experiencing some pelvic pain when your partner is in control, Eon recommends getting on top, so you can lead the depth of penetration and speed.
6. Broaden Your Definition of Sex
Remember, having sex doesn’t just mean “going all the way.” The goals here are to feel intimate with your partner and, well, get off. And anyone who’s making babies probably knows that there are plenty of ways to accomplish these things. So use them!
“We tend to put way too much of an emphasis on intercourse,” especially in male-female relationships, Marin says, “but that’s not the only way to have sex. The more options you have on the table, the more open you’ll feel to intimacy. Experiment with toys, keeping each other company while one partner masturbates, mutual masturbation, manual stimulation, and/or oral sex.”
7. Lovers to Enemies and Back Again
You may feel disconnected from your partner or resentful that your partner isn’t carrying their fair share of responsibilities. Feeling like you have less time in the day to do the things you enjoy and dealing with your own postpartum mental health issues can also be mood killers that your partner may not understand as well as you do.
Assuming that your partner expects things to go right back to the way they were will only lead to resentment. Give them the opportunity to grow and change with you by talking about your thoughts on sex, which can include them taking on more responsibilities so you have energy for it.
“It is important to communicate openly with your partner about any changes in your preferences and needs, as they may have shifted,” Rawlins says. “By expressing your needs and preferences, and exploring together what feels comfortable and pleasurable, you can build confidence in your postpartum sexual function and deepen your connection with your partner.”
Think of this as a type of foreplay: a critical lead-up to sex that’ll make the whole experience more comfortable and enjoyable for everyone.
8. Make It a Date
Penciling a romp into your schedule may not sound like the sexiest thing to do, but hear us out. Between bath time, feeding, and burping, the moments when both you and your partner are completely free are precious few. If you really want to get serious about returning to intimacy, you may have to start making it a date, according to Dr. Booth. She says to set aside time for sex when you’re not feeling too tired or anxious, or are busy with feeding or otherwise caring for your baby.
Scheduling time for intimacy can also help you and your partner to avoid feeling neglected, giving you a chance to continually communicate exactly when you’re both ready and able to get down.
9. Take Matters Into Your Own Hands
Other mental and emotional hurdles can play a major role in someone’s hesitancy to start having sex again. “Sleep deprivation, hormonal changes, stress, worry, and fatigue may all have an impact on sexual desire after a baby,” Booth says. “Oxytocin is more of a platonic love hormone, similar to the heartwarming cuddling of a pet, and for a nursing mom this may dampen her libido.”
That’s not sexy! So to rev yourself up again, take matters into your own hands (if you know what we mean ... and we think you do). “Manual self-pleasure is a safe test to see how the brain and body are responding to sexual stimulation,” Booth says. And while using toys can be helpful, they may not be the best tool to start with because penetrative devices pose the same risks for bleeding and pain as penetrative sex.
Instead, Booth recommends stimulating yourself by other means. “Steamy romance novels or erotica are safe ways to get the body’s main sex organ back in play: the brain,” she says.
10. Take Your Time
Even if you’ve been cleared by your healthcare team to start having sex again, it’s important to listen to your body and acknowledge that the postpartum healing process is unique to every individual.
“If you feel that your body and mind need more time to recover, it is important to prioritize and honor yourself, rather than feel pressured to engage in sexual activity immediately,” Rawlins says.
And remember that you’re not alone. Every person who gives birth has some sort of postpartum journey back toward sex, and if you’re feeling let down by physical or emotional roadblocks, look to your healthcare team or a mental health professional for advice.
4 Signs You May Need to Hold Off on Sex After Having a Baby
When you hit the end of the waiting period your healthcare team set for you, you may wonder if your body is actually ready to start enjoying the wonders of sex again. There are a few important signs to be aware of.
1. Signs of Infection
Signs that you might have an infection down there include sudden increases or changes in pain or vaginal discharge, “particularly if you develop a foul or fishy smelling discharge,” Rawlins says. If you notice any of these symptoms, you should check in with your healthcare provider right away to get the proper treatment before carrying on.
2. Continued or Worsening Bleeding
You’re probably familiar with lochia, the normal bleeding that occurs in the first few weeks after giving birth. By the six-week mark, bleeding should be tapering off. But if you are still bleeding after six weeks or experience bleeding after returning to sex, your body may need more time to heal, according to Rawlins. Again, check in with your healthcare provider for advice on how to manage this.
3. Pain
As we mentioned above, pain is a very normal part of the postpartum healing process. However, if you’re still experiencing pain even after your medical team has cleared you to start having sex again, Rawlins recommends consulting a professional.
“If pain persists after delivery or if the return to sex is painful, a pelvic physical therapist is one of the best places to start,” Rawlins says. “They will help you understand what is causing your pain, and develop a treatment plan to help ease your symptoms so that sex continues to be enjoyable.”
4. Changes That Go Beyond Your Body
The physical changes that you’ve undergone are just a small part of the picture. “Pregnancy and childbirth fundamentally change the birthing person,” Rawlins stresses. “The biological changes are important, but we cannot forget about or dismiss the psychological and social changes that occur as well. For example, lack of sleep, life adjustments with your partner, and postpartum mood and anxiety disorders can impact your desire to return to sex."
Discuss any mood and desire concerns with your healthcare provider, and consider reaching out to a mental health professional who can give you extra support as you navigate this unique transition.
The Bottom Line
The most important step toward revitalizing and, yes, even improving your sex life after giving birth is to remember that the physical, mental, and emotional challenges you’re facing are normal. While it may feel like you’re the only person you know going through these (possibly awkward) hardships, you can rely on your partner or loved ones, as well as your healthcare team, who have probably seen it all.
Last thing we’ll say: Sex is something we do for fun. We should never pressure ourselves to have sex or follow anyone else’s timeline. Trust the process, and take the time you need to get to a place where you’re comfortable and enjoying yourself.
