Pregnancy sex gets a lot of attention, but post-baby sex is a completely different world to navigate. Whether you’re ready to jump back into the sack immediately after giving birth or you want to wait a while, when you do decide to go for it, postpartum sex pain can happen.
“Damage to the vaginal tissue during birth, along with postpartum hormone changes, can cause pain during sex, but it doesn’t happen to everyone,” birth educator and doula Sara Lyon tells Romper. “With patience and attention, it’s most often short-term and resolves within months after giving birth.”
The first time you have sex after you have a baby, it’s a whole thing. (*Waves hands wildly*) For me, I had this big, romantic scenario planned out — massage oil, candles, the whole nine yards. This was a celebration, after all. The candles were nice, but they didn’t stop me from fumbling through the whole encounter. Had I lost my mojo? No. I was just still recovering from housing a human for nine months and my body was totally different.
Postpartum sex pain can be ongoing or it can be situational, and it can feel different for everyone. It can feel like pressure, throbbing pain, soreness, heaviness, burning, or even lightning strikes in your vagina or pubic region. Dryness is also a common complaint during postpartum sex.
What Causes Postpartum Sex Pain?
Every birth is different — vaginal birth, VBAC, cesarean — and they can all cause postpartum sex pain, albeit for different reasons.
“Vaginal birth is very physically intense,” Lyon tells Romper. “We don’t give many opportunities to protect the vaginal tissue and promote healthy vaginal birth in the American healthcare system. The combination of swelling from medication and IV fluids, pushing on our backs, and coached, forceful pushing is a recipe for vaginal tissue damage like bruising and tearing.”
Physical therapist and owner of WiseBody PT, Patricia Ladis, along with her team member, physical therapist Lisa Sottung, tell Romper that women recovering from a C-section birth are also not immune to post-birth sex pain. “The pelvic girdle and the pelvic floor still undergo tremendous change and pressure with the pregnancy and post-surgical recovery,” they explain. “Many women also have C-sections following hours of labor and pushing. So this trauma and challenges to the tissues can leave you with imbalances that can make sex painful in postpartum.”
Lyon also explains that breastfeeding your baby can impact your post-birth sex experience as well. “Breastfeeding hormones trigger vaginal dryness, making sex uncomfortable and even painful. It’s kind of brilliant really, this natural disincentive to procreating when you have a nursing infant that needs your physical care to survive,” she says. “Remember that monogamy is a pretty new game and the idea that you would have a partner desiring or expecting intercourse so close to having a baby isn’t part of our primal programming. Many women find that sex becomes enjoyable again once they’ve finished breastfeeding.”
How To Cope With Postpartum Sex Pain
Postpartum sex pain is no joke, but there are ways that you can try to make things more comfortable for yourself.
“Patience is so important both psychologically and physiologically,” Lyon tells Romper. She explains that letting yourself “be in control of the actions” so that you “can relax and enjoy instead of bracing and dreading what’s coming” is key. Communicate your needs to your partner, “and don’t forget foreplay,” Lyon says. “It’s hard to find a window of time and enough energy for it when you have an infant, but it’s absolutely worth the effort. Your postpartum vagina needs to be wooed!”
Sometimes, just switching things up in the bedroom can be enough to alleviate your pain. “The use of lubrication, different positioning for pelvic comfort, and pressure off sensitive tissue,” Ladis and Sottung tell Romper. “Get creative with your partner and see if changing into a different position relieves the pressure/pain or not.”
Depending on what is causing your postpartum pain during sex, Ladis and Sottung recommend physical therapy and other natural remedies to address the problem. “Women's health/pelvic floor physical therapy can be very effective to reduce swelling, mobilize the scar tissue, evaluate for trigger points, recover muscle function, and return pelvic floor muscles to full range of motion and strength,” they explain. “The use of natural remedies to improve lubrication and hormonal balance can also be effective.”
If You’re In Pain, Speak Up. Your Doctor Can Help.
Ladis and Sottung recommend that all postpartum moms get evaluated by a physical therapist following their six-week OB-GYN appointment, which is typically when most are cleared to have sex. “Usually just a phone call to the OB/GYN reporting pain with intercourse will be enough for the patient to receive a referral for physical therapy,” they tell Romper.
If you experience pain with sex after giving birth, don’t be embarrassed to speak up and get help, even if your instinct is to just wait for the pain to go away. Ladis and Sottung tell Romper that “better education around the topic is needed” from doctors and hospitals where pelvic pain is concerned to help encourage women to be evaluated and treated. In their words: “Pain is never acceptable to have with sex and should be treated immediately.”
Your doctor may find that vaginal stitches or tears haven’t healed properly, or that there has been some other trauma causing painful sex. Vaginal dryness can also cause issues, and your doctor should have recommendations on lubrication to help. If it hurts, speak up — your healthcare provider can help come up with a plan to give you both relief and, hopefully, pleasure.
Patricia Ladis, PT, CBBA, Author of The Wise Woman's Guide to your Healthiest Pregnancy and Birth and founder of WiseBody PT
Lisa Sottung, PT, CSI, CFMT, OCS, Women's & Men's Health specialist at WiseBody PT
Sara Lyon, birthing expert, doula, author of The Birth Deck and You’ve Got This: Your Guide to Getting Comfortable with Labor