Returning to sex & intimacy postpartum
Returning to sex and intimacy after having a baby is an area many women may feel scared or nervous. You may be concerned about pain, how it will feel, or you may have no desire and wonder if your desire will ever return. There is no such thing as TMI here and we are going to talk about it!
First, we must recognize that sex and intimacy are not the same thing, and that intimacy can mean many different things to women.
Intimacy could be holding hands with your spouse while going on a walk with the kids, a passionate kiss shared on a date night, or it could be having scheduled sex during naptime.
We also must recognize that what intimacy means will likely evolve over different life stages and in different seasons. This completely normal and expected!
What individuals desire when it comes to sex and intimacy can be unique and evolving during the postpartum journey.
During the postpartum period a woman can be experiencing hormone fluctuations, bodily changes, stressors of various kinds, sleep deprivation, birth trauma, life role changes, and many more. All of these can impact a woman’s desire, arousal and enjoyment of sex and intimacy.
So, before we jump into the physical, our first recommendation when it comes to returning to sex and intimacy postpartum, is having clear, honest and vulnerable conversations with your partner.
Discuss how you both are feeling and your desired outcomes when it comes to returning to sex and intimacy. This is a great time to have this conversation if you have never discussed it before together! Communication is a crucial building block of relational intimacy, and the postpartum period can be a time where couples feed strained in their communication. Make time to start an open conversation with your partner about returning to sex and intimacy and recognize that your desires and your partner’s desires will change over time so continued communication and intentionality are necessary!
Now let’s talk some more practical tips…
01.
First make sure that you are medically cleared for returning to sex. This does not mean that you need to immediately jump into bed after your 6-week appointment (unless you want to!) but you do want to ensure that if you have any sutures either from vaginal tearing or had a c-section, that you have appropriate wound closure and healing.
02.
Whether you have a vaginal birth or a c-section, you may experience changes to your pelvic floor and it’s function postpartum. It is not uncommon for women to experience vaginal dryness, especially if they are lactating when estrogen levels are lower in the body. Because of this, you will likely want to have a lubricant that you enjoy utilizing during foreplay and penetrative intercourse.
03.
If you are lactating, you may want to consider wearing a bra to allow for increased support of your breasts and you may want nursing pads as some women get a milk let down during orgasm. It may be helpful to nurse or pump prior to make you feel more comfortable if your breasts are full and know that you may need try positions that do not put pressure on your breasts due to sensitivity. Lastly, early on, for some women their breasts are tender and ensure that if your breasts or any other areas of your body are “off limits” for intimacy at the time, make sure you communicate that with your partner. Again, all back to communication!
04.
Finally, if you are experiencing pain with sex and intimacy, please know that you are not alone. 10-20% of U.S. women experience pain with sex but while pain is common, it is not normal. You do not have to live with painful sex. We encourage you to seek collaborative care from an inter- disciplinary team which could include medical providers, mental health providers and pelvic floor therapists to help address the root causes of your pain and help you get to the sex life that you are wanting!
At the end of the day, pain with sex and intimacy is common but it is not normal, and it can be treated. If you are experiencing dyspareunia (pain with sex), please know that you are not alone and we can help you have sexual experiences that you desire without pain!
Hill DA, Taylor CA. Dyspareunia in Women. Am Fam Physician. 2021 May 15;103(10):597-604. PMID: 33983001.