No matter how it all shakes out, giving birth is hard and painful — and hella worth it. But that doesn't mean that certain "ouch" moments aren't specific to the way in which your little one arrived on this planet. Vaginal birth, for instance, has a tendency to bring with it tears and stitches you never thought possible of your lady parts. C-sections, on the other hand, result in an abdominal scar and restricted movement. But what about getting hot and heavy? You know intercourse can be iffy after a vaginal birth, but does sex hurt after a C-section?
"It depends," Dr. Rachel Gelman, physical therapist and branch director at Pelvic Health and Rehabilitation Center, tells Romper in an email interview. "Pain with sex after having a baby is very common, and sex in the postpartum period can be painful for women following either a vaginal or C-section delivery. Gelman explains that after delivery, a woman's estrogen levels are diminished and the vaginal tissue is mediated by estrogen. "This lack of estrogen can lead to vaginal dryness which can lead to pain with sex."
Plus, "If a woman was in labor for a long time before having a C-section, the pelvic floor muscles may still have been impacted. And if these muscles become dysfunctional, it can lead to pain with sex," she adds.
Gelman also says that a woman who had a C-section might experience pain during sex because a scar can be highly sensitive following delivery.
Kelley Kitley, founder of Serendipitous Psychotherapy and author of MY Self, tells Romper she knows all about that kind of pain. Not only has she personally had four C-sections, but as a women's mental health expert, she has discovered that many women report sex after a C-section can be just as painful as sex after a vaginal birth.
"The entire midsection of a woman’s body has gone through 'trauma' and it takes time to heal," Kitley says. "Pressure on the cervix, uterus, and vagina, can be painful and/or uncomfortable." She emphasizes that while pain is a case-by-case basis, many women who have C-sections not only experience vaginal bleeding and discharge, but the area just above the pubic bone is painful, stitched, and healing from the C-section incision.
According to the Pelvic Health & Rehab Center blog, a C-section scar can also cause a change in your posture, "a sort of 'pulling forward'" that might result in back pain. The scarring can also cause nearby muscles to develop trigger points that cause pain in the clitoris or urethra. Which could be a major "ouch" when you have sex. "In addition, the adjacent connective tissue can become restricted, also causing pain," the site noted.
The good news is that pain associated with having a C-section can be corrected. When it comes to sex, you can try new positions that allow for less pressure around your incision site. Healthline also suggested talking to your partner about certain fears you have regarding sex, as well as trying lubrication and foreplay in order to get things going down there. Kegel exercises are also important for strengthening your pelvic floor, whether you had a vaginal birth or C-section.
Consider that another reason you might be experiencing pain with sex could be related to breastfeeding. Gelman points out that for the same reason birth may result in pain during intercourse — a woman’s estrogen levels decline post-delivery — they will continue to be low during the postpartum period, especially if a woman is breastfeeding.
Of course if you have persistent pain that can't be solved with an over-the-counter remedy like personal lubricant, you may also want to speak with your healthcare provider about what could be going on down there. Conditions like a vaginal infection, pelvic inflammatory disease, or endometriosis could be to blame.
Check out Romper's new video series, Bearing The Motherload, where disagreeing parents from different sides of an issue sit down with a mediator and talk about how to support (and not judge) each other’s parenting perspectives. New episodes air Mondays on Facebook.