Sex After Birth: When to Resume and Tips from a Pelvic Floor PT

You just pushed a mini human through a not-exactly-human-sized opening. Or maybe you had a cesarean delivery and you're recovering from surgery. Either way, there’s a new baby in your life demanding a lot of time and energy. And we’re talking about putting what where? And when?

We get it: Having sex after birth is quite possibly the very last thing on your mind, considering what your body has recently been through. Or you might be very much missing it and eager to re-engage. Either way, when you are fully recovered and ready — both physically and mentally — to be intimate again, there are ways to help reduce discomfort and reconnect with your partner when you resume sex postpartum.

Read on to learn about how soon you can have sex after delivery, what to expect, and tips to help you enjoy healthy and fulfilling sex after birth.

When Can You Have Sex After Birth?

There’s no set timeline, but most doctors recommend waiting at least six weeks after delivery to have sex, according to The American College Obstetricians and Gynecologists. Sometimes vaginal births can lead to tears in the perineum (the area between your rectum and vagina). Or you may be healing from an episiotomy, a surgical cut to widen the vaginal opening for delivery. Resuming intercourse too soon can increase your risk of infection. Six weeks gives your body the time it needs to heal from either a vaginal delivery or C-section. 

Most new moms have a six-week postpartum checkup. Typically, that’s when your ob-gyn can provide clearance for resuming sex. Talk to your doctor if you have questions about your specific situation and timing.

And remember: How soon you resume sex after childbirth isn’t just about physical healing. You may need more time to feel emotionally ready, so be patient with yourself.

Sex After Birth: What to Expect

It’s normal to experience some initial discomfort or pain during your first postpartum sex attempts. You may have lingering back aches from pregnancy. Your breasts may be enlarged and leaking from breastfeeding. Hormonal changes can have an impact as well. Estrogen levels drop after childbirth, which can make your vagina feel dry and irritated. In fact, nearly nine in 10 women report experiencing pain the first time they have sexual intercourse after childbirth. Everyone’s experience is different, but some common symptoms that might impact sex after birth include:

• Body aches and pains

• Vaginal dryness and pain (especially if you are breastfeeding)

• Weaker pelvic floor muscles

• Tender breasts

• Constipation

• Joint pain, especially in the low back and pelvis

• Scar numbness, including perineal and C-section incision scars

• Fatigue

• Low libido, or loss of sex drive

Make Postpartum Sex More Comfortable

Your body has been through a lot — in pregnancy, during labor, and in the days and weeks of taking care of a newborn since delivery. But with time, postpartum symptoms will improve and sex should become more comfortable and enjoyable. Here are some strategies that may help reduce pain and increase pleasure:

• Take it slow. Even with the green light from your healthcare provider, you might not feel like having sex yet — and that’s ok. Let go of any pressure or timeline and simply take things one day at a time. You may want to try to connect with your partner in other ways until you’re ready. If you have concerns about low libido or other symptoms, talk to your healthcare provider.

• Warm up for sex like you would for a workout. Gentle exercises that help open up the hips and promote relaxation of the pelvic floor may help reduce pain. You can try simple moves, such as child’s pose, inner thigh stretching, and squats.

• Use a lubricant. “It can be a game-changer if you have pain or discomfort during sex,” says Kandis Daroski, PT, DPT, a Hinge Health physical therapist who specializes in pelvic health. “Lubricants help reduce friction from vaginal dryness.”

• Try new positions. Your favorite sex position(s) before giving birth may feel less comfortable afterward. Modify your sex positions after birth to find versions that work better for you and your partner. If sex is painful, spooning or side-lying positions may be the most comfortable.

• Hit pause when it hurts. If you continue to have painful penetrative sex, it can turn the act into a “negative reinforcer.” Your nervous system will start to associate sex with discomfort and will be more likely to trigger pain in future encounters. Taking a temporary break can interrupt the negative reinforcement of painful sex and give you time to work on solutions. Explore other forms of intimacy: cuddling, kissing, and touching. This can calm your nervous system and help you connect with your partner.

• Consider your mood. Baby blues in the first few days after childbirth are normal. Changing hormones, anxiety about caring for the baby, and lack of sleep all affect your emotions. But if the feelings of sadness or a depressed mood last for more than two weeks, it may be a sign of postpartum depression. Other signs include feelings of hopelessness or guilt, little interest in daily life, or having thoughts of harming yourself or others. Sometimes, reduced sexual desire may also be a symptom of postpartum depression. If you think you might have postpartum depression, talk to your healthcare provider.

• Communicate with your partner. Sex after pregnancy may be different — but different doesn’t mean bad. Be open about what feels good and what doesn’t, what you’re comfortable with and what concerns you. Honest communication can help put you on the path to a healthy, fulfilling sex life.

Pelvic Floor Physical Therapy for Postpartum Sex

If you continue to experience pain during sexual activity, or pelvic floor muscle problems are contributing to symptoms impacting your sex life, a pelvic floor physical therapist (PT) can help. Pregnancy, labor and delivery can stretch, weaken, or injure the pelvic floor muscles. A PT may recommend Kegels and other pelvic exercises to strengthen pelvic floor muscles, help improve sexual response, and tailor an exercise plan and modifications that are appropriate for you.

You can see a physical therapist in person or use a program like Hinge Health to access a PT who specializes in pelvic health via telehealth/video visit.

Pelvic floor physical therapy for pelvic pain and other symptoms is a comprehensive treatment that includes education, behavioral and lifestyle strategies, movement and exercise, and manual therapy.

To increase comfort during sex, your pelvic floor PT may recommend exercises including:

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Birth Control After Baby

If you’re not using a reliable birth control method, you can get pregnant very soon after having a baby, even if you’re exclusively breastfeeding. Family planning is important — whether you want to prevent a pregnancy or plan your next one. Many experts recommend waiting at least 18 months between pregnancies to give your body time to fully recover. In the meantime, using birth control methods is the best way to prevent pregnancy until you decide if and when to have another baby. Talk to your doctor about the best contraception options for you.

PT Tip: Take Your Time

“There’s no perfect time to get back to penetrative sex,” says Samantha Charlotin, PT, DPT, a Hinge Health pelvic floor physical therapist. “You don’t have to re-engage just because you have the green light from your provider.” You’re still adjusting to life with a new baby and hormonal changes. “It can be fun and enjoyable to focus on other ways to connect with your partner, both physically and emotionally, so both of you are fully ready when the time is right.”

How Hinge Health Can Help You

If you have pelvic pain or symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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2. Abraham, C. (2020, October). Experiencing Vaginal Dryness? Here’s What You Need to Know. Www.acog.org. https://www.acog.org/womens-health/experts-and-stories/the-latest/experiencing-vaginal-dryness-heres-what-you-need-to-know

3. Faisal‐Cury, A., Huang, H., Chan, Y., & Menezes, P. R. (2013). The Relationship Between Depressive/Anxiety Symptoms During Pregnancy/Postpartum and Sexual Life Decline after Delivery. The Journal of Sexual Medicine, 10(5), 1343–1349. doi:10.1111/jsm.12092

4. McDonald, E. A., Gartland, D., Small, R., & Brown, S. J. (2015). Dyspareunia and Childbirth. Obstetrical & Gynecological Survey, 70(5), 319–320. doi:10.1097/01.ogx.0000466340.51108.12

5. Office on Women's Health. (2021, February 17). Postpartum depression. Womenshealth.gov; U.S. Department of Health and Human Services. https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression

6. Postpartum Birth Control. (2023, April). Www.acog.org.https://www.acog.org/womens-health/faqs/postpartum-birth-control

7. Recovering from birth | Womenshealth.gov. (2016, December 14). Womenshealth.gov. https://www.womenshealth.gov/pregnancy/childbirth-and-beyond/recovering-birth

8. Sex after pregnancy: what you need to know. (2023, March). Www.marchofdimes.org. https://www.marchofdimes.org/find-support/topics/postpartum/sex-after-pregnancy-what-you-need-to-know