When to start having sex again
Perhaps the biggest question of all, though, is this: when? But, as is so often the case with all things postpartum, there is no one right answer – and certainly no set timeline. Indeed, as mom-of-two, Nikki, 33, points out, “expectations of sex drive, desire and comfort should not be rigid – even based on previous births – as things can be incredibly different each time.”
“With my first birth, I was comfortable having (gentle) intercourse at two weeks postpartum,” she says. “As soon as my small labial tear healed, really. Things were different with my second baby; although I had no tears and was arguably better physically – apart from still being on antibiotics after sepsis, that is – I was much more nervous. A traumatic birth made me fear a subsequent unplanned pregnancy and, although I did desire intercourse, the fear overrode this feeling, so we ended up waiting a month before even attempting sex.”
She adds: “The logistics of having sex with two children made it, and continues to make it, incredibly difficult – especially as the little one is very unpredictable when it comes to sleep, and has been very colicky, which means she always wants to be held. When my oldest was born, we were quite sexually active frequently, but I can count on one hand the number of times we have been sexually active since the youngest’s birth.”
Mom-of-one Emmy, 33, also waited around a month. “We had random sex in the kitchen because we fancied it,” she tells us. “I felt a little bit anxious that my stitches would split and it would really hurt but it was absolutely fine. A little sore, maybe – and all the changes down there meant it certainly felt weird for both of us – but not bad at all. However, we left it for a month before trying again after that because we were so exhausted grappling with a newborn!”
Postpartum sex can feel different
While there’s no set timeline when it comes to postpartum sex, most doctors recommend waiting around six weeks following a vaginal delivery, to give yourself time to recover (physically, at least). So that’s what Rose, 31, decided to do.
“I waited until my six week checkup because I was told to wait, but to be honest, I didn’t have the urge either as I also bled for six weeks,” she says.
“Once I had the all clear, I felt it was a matter of jumping back on the horse. I knew it wouldn’t be great at first but wanted to get that intimacy back in my relationship. Not sexy! I wasn’t excited, I was nervous – mainly because we had chosen to stop having sex during the pregnancy, as neither of us had really enjoyed it.”
Rose adds: “My god it was sore at first! Thank goodness for lube. We used a lot. After a few moments though – which felt like forever – it didn’t hurt. The next time we tried, it hurt a little at first then better and by the third time, it was back to normal and then, it was better. I’ve told all my gal pals this, it’s much better now. I don’t know why! Maybe it’s because I have a lot more sensation down there.”
Anais, 34, waited just a mite longer before getting back in the saddle, so to speak.
“I had sex about eight weeks after giving birth – just ahead of my son’s two month checkup. In my mind I thought it made sense as, if there were any concerns to raise, I knew I could do so during that appointment. Plus, I was dying to do the deed! However, if I hadn’t had a C-section I may have been more wary.”
There’s no set timeline, so trust your gut
Helen, 49, also had her first baby via caesarean, but she wound up waiting around three months before having sex again.
“Yes, my undercarriage remained intact, but there was still a major operation to heal and recover from – not to mention a 10lb baby to contend with,” she recalls. “I can vividly remember the midwife coming in three days after birth to discuss contraception, and at that point the thought of two house bricks firmly whacked together on my husband’s testicles sounded like the best option!”
She continues: “Sex was like a hurdle that needed to be addressed, but I waited until I finally felt… well, not sexy, but suitably back in one piece to attempt it. For me, it was like approaching a driving test or some other practical exam – but one thing led to another and, in just over a year, baby number two was on the way.”
Sarah, 56, similarly felt inclined to wait after her first baby.
“I remember looking aghast at the midwife when she asked about contraception at my six week checkup,” she says. “My first baby had seemingly destroyed all I knew about my lovely body; a stage four tear, with a forceps delivery, had literally torn me a new hole! Luckily I was delivered by a consultant obstetrician so he did a neat job at reconstruction. Plus, the baby was safe, so I just wanted to be myself again.
“My second baby came via another traumatic delivery, but this time I felt I was ready to try out my new scar tissue in the bedroom after six weeks. And my third came after a lovely vaginal delivery with zero stitches, so I was back at it after three week.”
She adds: “I never felt pressured to do so. It was natural to want to have time for me – and love without milk.”
Don’t feel pressured into postpartum sex
All of this may be reassuring for those women who’ve decided to wait a while before having postpartum sex. Women like Amaya, 32, who gave birth to twins earlier this year and still doesn’t feel ready to do the deed.
“We wanted to wait until my body recovered,” she says, “but it’s been 11 weeks and we’re still not ‘in the mood’ really. Plus there’s contraception to sort out because another baby on top of twins right now is not the plan! And when is there time?! We usually always have one (or two!) babies stuck to us.”
It’s become apparent that there are many different reasons why women choose to have postpartum sex when they do – be it down to desire, wanting to reclaim their old self, or something else entirely. The idea of pressure – either external or internal – also came up.
“I remember feeling very nervous,” says Helen. “I wondered if my poor battered vagina going to be ‘enough’ – more for my husband's needs than my own. Would he even want to ever have sex with me again? I was full of insecurities, which meant that sex was not necessarily for my enjoyment; it was more to make my husband feel wanted and needed.”
Elsewhere, Sarah says that, while her husband didn’t ever make her feel guilty about waiting, their friends often jokingly asked when she would be getting back to her “wifely duties”.
Nikki didn’t feel a sense of guilt per se, but she did find it hard dealing with the “knowledge that we both previously had a fairly strong sex drive.”
“I think with age and experience I have learnt to prioritize my needs more confidently, '' she continues. “I worried a lot more about what my partner thought after the first birth but now I feel more able to be totally open with him about my feelings and concerns.”
Anais, meanwhile, says she almost felt as if she were in competition with herself.
“I didn’t feel anxious or nervous but I did feel a weird sense of setting myself my own competitive target – only set by me,” she says. “I wouldn’t call it guilt; there was zero pressure from my partner. In fact, I wanted to do it more than he did!”
She adds: “Most new moms I’ve spoken to have hardly (if at all) had sex since birth – some as much as a year on. It’s perfectly normal that tiredness, weird new schedules and this new little life simply gets in the way. I do think that once you’re ready and in the right moment it can be a great experience to bring you back together and open up that part of your life that has been put on pause and may have felt missing – but don’t feel any self imposed pressure.”
Postpartum sex, according to the experts
So, what do the experts say? Well, no matter how your baby was delivered, the hormone rollercoaster that is motherhood (strap in tight, everyone!) can cause vaginal tissue to become thinner and more sensitive. Your vagina, uterus, and cervix will usually take some time to “return” to normal size, too. And if you’re breastfeeding, that can lower libido.
“It’s totally normal not to feel up to it for a while,” says Gemma Pilkington, a specialist women’s health physiotherapist with almost 20 years experience in clinical practice, and 16 in pelvic health. “Especially if you’re breastfeeding, as it can feel as if your body isn’t your own – plus there’s the fact that your body dials down its estrogen levels to stop it interfering with your milk supply.
“Throw in the fact that scar tissue – both perineal and C-section – and birth trauma can make muscles tense, and postpartum sex can be a nerve wracking experience. When you feel ready in yourself, I recommend using a good non-irritable lubricant (one which is water based, as well as paraben and glycerin free, such as the ‘yes’ brand), and make sure to breathe wide into your ribs to let go of any tension.
“Also, it doesn’t have to be all about penetration to begin with. Ease yourself in and start with something else; massage is a great way to reintroduce intimacy, for example.”
Marlies Mehta, a chartered physiotherapist and APPI Pilates instructor, adds: “There is no ‘right time’ to begin having sexual intercourse after childbirth; it is very much a personal choice and hugely reflective of your birth experience and how safe and secure you feel with your partner.
“We need to make our own narrative and take time to remember that our bodies changed every day for 40 weeks and need time to recover and heal. Sex can wait; if you’re not ready, you’re not ready – you will know in your gut when you are.”
Marlies adds that keeping an open dialogue is important, noting that it’s important to offer your partner the opportunity to voice any concerns they may have as well.
“Talking and sharing your experiences and anxieties with your partner, friends and other new parents really can help,” she says. “Because you’re not alone; most women suffer from anxiety about what intercourse will be like post delivery, and we need to talk more about why we feel like this.”
Feeling mentally and physically prepared for postpartum sex
If you’d like to do something to prepare your body for sex again – not just physically, but psychologically, too – then the POGP (Pelvic, Obstetric, Gynaelogical Physiotherapist Group) recommends the following:
Start to do your pelvic floor muscle exercises as soon as possible after delivery- see www.pogp.co.uk for instructions
Try to prepare for any activity where you may leak by tightening your pelvic floor muscles first.
Try not to rush straight to the toilet if you get a sudden urge. Try sitting down, waiting and using the pelvic floor muscles to calm the ‘urgency messages’ from your bladder or bowel down before you walk to the toilet. It is important to establish what is normal for you before you start to change your habit.
When you finish using the toilet, try to make sure you have finished emptying your bladder by sitting and waiting a little longer, relaxing your pelvic floor, deep breathing or tipping forwards and backwards on the toilet.
If any physical problems persist, seek a women’s health physiotherapist referral from your GP.
“Women’s bodies are one whole puzzle, and if we address and identify the pieces that are not quite fitting properly this will lessen anxiety about intercourse,” says Marlies.
“Knowledge is key to a successful recovery post delivery. And talking to your partner is important, so they can understand the changes that have happened to you and how you feel about intercourse.”
Perhaps the best advice to follow, though, is Emmy’s no-nonsense approach.
“Go with the flow, follow your doctor’s instructions if you have anything medically stopping you, don’t put pressure on it, and don’t ever let anyone make you feel embarrassed about anything; you’ve likely given birth in a room full of strangers, so you can handle anything!”
*pseudonyms used at contributors’ request.
https://gpphysiotherapy.co.uk/about/
Physiotherapy Surrey, London, Kent, Sussex | Physio Revolution