8 Secrets You Should Know About Postpartum Sex

At San Francisco Birth Center, a highlight of every week is New Parents Group. It’s a time when new parents get honest about what’s going well and what’s been challenging.

A few weeks ago, the group had an enlightening conversation about postpartum sex, including lack of desire and pain for months after birth. The discussion started timidly, but as soon as one parent admitted to struggling, all the other group members dove into the discussion.

Some moms were worried that they had zero to little interest in sexual intimacy, while others expressed concerns about extreme pain during intercourse. All of the group’s participants were well beyond six weeks postpartum, which is often viewed as a magical indicator of sexual readiness. (Spoiler alert: There’s nothing magical about six weeks.)

The New Parents Group voiced feelings of guilt, disappointment, fear, and shame. They were disheartened and wondered aloud, “What’s wrong with me?”

The answer is nothing. Nothing is wrong with you!

In the birth community, we talk a lot about what’s normal and what’s not. And for some topics, there is a wide range of normal. Sex after giving birth is one of those areas.

You could feel ready for sex a couple of weeks after your baby is born. NORMAL! Or the thought of having sex might still terrify you at eight weeks, twelve weeks or 6 months out. ALSO NORMAL!

Given the reaction to this topic at New Parents Group, we wanted to share some information about sexual desire and discomfort. Here are 8 things you should know about postpartum sex.

1. The six-week timeline is completely arbitrary

Part of standard postpartum care is a visit about six weeks after the birth of your baby. Many people commonly think of this appointment as a chance to get the “go-ahead” to have sex again.

The truth is there is no evidence that supports waiting six weeks. It is only custom. Before resuming penetrative sex, these three things should be true:

You’ve stopped bleeding.
You don’t feel pain.
You are in the mood.

These criteria line up differently for different people, and that’s OK.

One of our SF Birth Center clients said she viewed the six-week postpartum appointment as a physical milestone. “I knew I was physically healed and could have sex if I was ready,” she shared. “I was not bleeding, I did not have to sit on a donut anymore, and I was not swollen. The six-week appointment was an anchor for my own healing.”

However…

2. Physical, emotional, and mental readiness vary

During that six-week follow-up appointment, one of our midwives will likely do a pelvic exam. Although we are checking with our fingers for prolapse and healing, one of our goals is to help our clients by checking for pain.

One client told us she found this exam to be helpful because it gave her reference points and allowed her to feel less intimidated about intercourse. We explain where our fingers are, how many fingers we’re using, and ask whether you’re feeling pain.

If, after this exam, you feel no pain, you can view this six-week follow-up as a physical benchmark that might mean you’re ready for sex again. Even if that’s true for you, mental and emotional readiness may take longer. Again, that’s normal, and you shouldn’t feel guilty if your head or your heart is not in it yet.

3. Decreased libido is common

No matter what type of birth you had, sexual desire can be fleeting in the postpartum period. When taking care of a newborn, there will be stress, sleep deprivation, and hormones at play. It’s difficult to adjust to your new life as a parent.

Your mental health can also affect libido. Postpartum anxiety and depression are common, or maybe you had mental health struggles before giving birth.

Another frequent factor in level of sexual desire is your physical body. Your belly and your breasts might look vastly different than they did before growing, birthing, and feeding a tiny human.

One of our clients said, during pregnancy, when she pictured herself as a mom, she was desirable and perfect. But during the postpartum time, she found that her negative feelings about her body played into her libido.

In addition, the body’s sexual organs may look and feel differently postpartum, and it might even take a while to understand what those differences are.

4. Pain happens for various reasons

Pain during sex can happen after any type of birth. One of the most common reasons for discomfort during sex after giving birth is vaginal dryness, often caused by hormones.

According to La Leche League, low levels of estrogen are normal for about two months after giving birth. Breastfeeding extends this reduced amount of estrogen, sometimes resulting in dryness, tightness, and tenderness.

One of our SF Birth Center clients reported that her first few attempts at having penetrative sex after birth were extremely painful. “It was so much more than dryness,” she said. “The pain for me was like a vice, and I couldn’t tolerate any pressure. It felt as though my muscles tightened up.”

Aside from hormonal influences, pain during penetrative sex can be the result of wounds that are still healing or scar tissue that isn’t as pliable.

5. Breastfeeding has multiple effects on postpartum sex

Breastfeeding and decreased estrogen can make the vagina dry, tight, and tender. But there are other hormones at play when you’re breastfeeding, too.

Oxytocin is the hormone that triggers the milk ejection reflex. You may have heard oxytocin called “the love hormone.” That’s because it’s released in men and women at the time of orgasm. So, that means you could leak milk. Good news is this is short term!
Prolactin helps with milk production, but can also impact the hormonal cascade that happens during lovemaking. Prolactin counteracts dopamine, which helps with sexual arousal and gratification. Therefore, prolactin can actually lower your libido.
Testosterone also affects sexual desire. While testosterone is often considered a male hormone, it is naturally occurring in both men and women. It plays a role in women’s overall libido. Testosterone levels drop during breastfeeding, thereby decreasing sexual desire.

One last point about breastfeeding that’s not related to hormones: Some moms say breastfeeding makes them feel “touched out.” This can make physical intimacy with a partner less appealing.

6. Communication is key

Some of our clients who find postpartum sex to be painful report being afraid that they’re letting their partners down. You should know that there’s nothing wrong with you if sex is uncomfortable. It just takes time for your body to heal and for hormones to regulate.

Many folks do not expect for postpartum sex to be painful. They can be quite surprised by discomfort, especially if they had a relatively simple vaginal birth with no tearing.

Non-birthing partners should be supportive, never pressuring the birthing parent to resume penetrative sex. Explore ways to be intimate, physically and otherwise, that don’t involve intercourse. When you are ready to try again, go at a slow pace and talk about how it feels.

7. Be kind to yourself and your partner

Remember — your postpartum body will look and feel different than your pre-pregnancy figure. It’s OK to take some time to get to know your new postpartum body.

One of our clients had this tip: Give yourself permission to masturbate. Don’t feel guilty about it. Talk to your partner about it and, since he might also feel guilt, tell him you don’t mind if he masturbates.

Another piece of wisdom from a client is that sex isn’t going to look the way it did before having a baby. Have grace with each other and try to be one another’s safe space where no topic is off limits.

8. Seek professional help if you need it

For some folks, it can take up to six months postpartum to feel back to normal when it comes to sexual desire and physical comfort during intercourse.

At any time during your postpartum journey, whether it’s been more or less than six months, it’s OK to ask for help with these struggles.

The best indicator of when to talk to a healthcare provider is if something is negatively impacting you, regardless of timeline. So if you as the birthing parent feel as though pain during intercourse or decreased sexual desire is having a significant negative effect on your life, please bring up your concerns to your healthcare provider.

Meta description: After giving birth, it’s incredibly common to experience pain during sex or a lack of sexual desire. Learn how to let go of any guilt or shame you may be feeling!