Got the All Clear, But Can I Really Re-Consummate This Relationship? Sex after Baby

The first six weeks after your baby is born are a major blur. Let’s be real: while there are magical moments, most of your days are filled with spit up, dirty diapers, milk stains, and sweats (don’t think we changed out of our workout clothes once!). Your home becomes a welcoming ground for friends, family, and all of those well-wishers who can’t wait to meet your little one.

And while you welcome a break from the routine (feed, burp, diaper, sleep), their presence can be beyond overwhelming. It’s not only the germs you see them bringing into your Purel-ed place or the gift that now requires a thank-you note (you could write a thank-you note for that cute onesie in your sleep!), but your energy level for entertaining is at an all-time low. It is not easy.

And to top it all off, your body still does not feel like your own. You’re still bleeding, your boobs are now enormous, and your belly still looks pregnant. (We have all been there. It is not fun one month after delivering, when that friendly neighbor says, “Any day now: you must be so excited!”). Additionally, you are now on pelvic rest—a.k.a. nothing in the vagina for six weeks post-delivery (whether or not your kid came out from below or through your belly). That includes no tampons and no sex.

So you make it through the first six weeks sleepless and sexless and go to your OB for the famous post-partum visit. She or he chats about life, how you are feeling, and how you are adjusting. They weigh you (ugh, still have 15 pounds to go) and examine your incisions (both abdominally and/or vaginally). Then they begin the discussion about birth control—pills versus patch, condoms versus IUD, or for those at the end of the baby line, tying your tubes versus tying his tubes (a.k.a. a vasectomy).

This subject transitions into “YOU are all good to go”; basically, you have the green light to have sex again. At this moment, you are probably thinking, Am I really ready to turn in my postpartum hospital-grade underwear? (Gotta admit, those are the best!) for my Hanky Pankys? Given your current state, sleepless and shaveless, it’s hard to imagine being intimate again.

Let us give you a quick preview… It’s as dry as the desert in summer down there, and no matter how much lubricant you use, you will still feel like you are being set on fire. We are here to say not to worry; while completely unpleasant, it is totally normal. In a large study of post-partum women, nearly 85% of women reported sexual problems at three months’ postpartum (See, you are not alone).

Your mind and body have gone through some pretty serious changes, and it will take time for things to go back to normal. And the good news is that for most it will go back to normal. Research shows that about 50% of women reported dyspareunia (medical way to say pain with sex) at two months post-partum. By 18 months postpartum, this number decreased to 24% (See, time does heal all wounds!).

Post-delivery, your estrogen levels plummet. This drop is not only caused by the delivery of your baby and placenta, but also by the rise in prolactin (the hormone that produces breast milk). Prolactin levels remain elevated post-partum to allow for the continued production of milk. With this high comes the persistent low of estrogen.

In addition to the mood changes, the hair changes, the skin changes, and the headaches that come with low estrogen, you can also welcome vaginal dryness. And not just the mild “Oh, KY Jelly or Astroglide can fix that” vaginal dryness…it’s a dryness that requires an army of products. Medically, we call it “atrophy” or “friable.” Due to “atrophy,” you can often see bleeding post-sex. Again, we are here to say that this is not uncommon.

In addition to the discomfort experienced with sex post-partum, a significant number of women report decreased libido. Nearly 60% of women reported a decreased libido at three months post-partum. Not surprisingly, they cited fatigue, discomfort, and fear of making a bad situation worse. Women who breastfeed were even more likely to report a decrease in libido than non-breastfeeding women; this is likely because those who don’t breastfeed have a faster return of their hormones to baseline. However, the difference did not persist for the long term (again, nothing lasts forever!).

Ways to combat this problem include lubricants and vaginal estrogen creams. So even without a major makeover, in most cases, things will get better. Now, if you sustained a serious tear or had a complication with your laceration or episiotomy, the situation might be a bit more complex. It may require you to sit out on the bench for a bit longer and apply a more comprehensive armamentarium of medications and products. But don’t worry. Even in the most serious cases, with the help of an OB/GYN, a pelvic surgeon, and in most cases, physical therapists, this team can help restore the situation back to normal (although you may need to consider having a C Section for your next child to avoid a repeat event if the situation was really bad).

Bottom line is that your bottom will heal—it just takes time. If you don’t feel like you, physically and emotionally, it is totally normal. Don’t be afraid to give your body and your brain time to rest; the postpartum period is no joke! But rest assured, with a little rest and assurance, you will be back in the game in no time.