The Physiology of Postpartum Sex

Let me introduce to Sara Reardon, aka @the.vagina.whisperer on Insta, one of our researchers and contributors. Our mutual friend, Jessica Shortall, introduced us over the summer because of our upcoming deck for LMH on the pelvic floor. It was love at first phone call. 

Sara is writing a three-week series on postpartum physical therapy that you can relate to and apply easily to your life, experiential learning at its finest. This week is on sex and your body after childbirth. 

We want to hear from you in the comments. What was your experience like when it came to having sex after having your baby? What is not listed here that affected your intimacy after pregnancy and delivery? We're curious and love you.

Enjoy this mini-series!
R + S

“When can I start having sex again?” This is one of the most common questions after having a baby, only second to “When can I start working out?” There are a few things we want to get back to make us feel like normal human beings after having a baby, and being intimate and having sex with our partner is one of them.

Most women wait until after their 6-week physician check up to get the okay to return to intercourse. Some women may want to start having sex sooner than that, but I highly encourage you to let your body heal during that time.

You want to make sure vaginal bleeding has stopped and any scar tissue from an episiotomy or tear has healed. More severe tears or scars can take up to 6-12 months to heal. So be patient with your body and don’t push through any pain.

Learning how to perform gentle scar massage on the area starting 6 weeks after your delivery can help soften the tissue and promote faster healing. You can consult a pelvic physical therapist for advice.

Even if you did not have a vaginal delivery, C section scars can often be the culprit of painful intercourse. The vaginal muscles have decreased blood flow and may get too tense causing pain with sex. Seeing a pelvic physical therapist who can perform external scar massage and internal massage to the vaginal muscles can help improve blood flow. Using vaginal dilators (they looks like tampons of different sizes) can also help retrain the vaginal wall muscles to relax and promote blood flow to the area to help decrease pain.

Pain can also occur during sex because your vagina feels dry, like really dry. Like Sahara desert dry. Estrogen levels may not have returned to normal yet, especially if you are nursing or pumping, causing vaginal tissue to be thin, dry, and even prone to tearing. Use a water-soluble lubricant or natural oil like coconut oil (and lots of it!) during intercourse to help decrease friction. Staying super hydrated and performing gentle kegel exercises to help promote blood flow to the area can also help.

After pregnancy, labor, childbirth, and possibly nursing, our bodies (vaginas in particular) are often just not the same afterwards. Whether it is leaky boobs, saggy skin, stretch marks, weight gain, or a more relaxed vagina, body image issues are legit. You may never get to the point of viewing your new body as a badge of honor of motherhood, but take some time to allow it to recover and to accept some of the changes in this new season of life. Talking to other moms, staying active, and returning to a regular exercise routine can to help the process.

Lastly, you may have nooooo sex drive. You are exhausted, irritable, emotional, and in desperate need of a shower. "Doing your partner" is low on the list of priorities. Don’t push yourself to do something you don’t feel ready for, but do try taking small steps to stay connected with your partner. A frequent complaint from new moms is they often feel lonely and less connected to their partners. Being intimate is a great way to connect and can just entail having outercourse. 

The takeaway here is to be patient with yourself and your body as it heals.

You should return to sex at the pace that is comfortable for you. AND, painful intercourse is not normal! Talk to your doc and request to see a pelvic physical therapist who can help guide you on the path to pain-free and enjoyable sex.  

More next week!