Sexual Intimacy After Childbirth: When It Isn’t Like Before

For many women, having a baby is a long-awaited blessing. You have been carrying a baby for nine (or even 10) months; you might have been trying to become pregnant for a while; and your entire world changes from being a couple to being a family. Several weeks after delivering a baby, women can begin to resume sexual intimacy.

However, few women bounce back so quickly. Many women feel that their body has changed and have conflicting feelings about sexual intimacy. Here are some very common postpartum sexual concerns for women, as well as some tips to overcome them:

1. Directly following childbirth, women may be somewhat traumatized by the childbirth itself.

Cheryl Beck, Nursing Professor at the University of Connecticut, conducted a study and found that up to 34% of women experience some sort of trauma during childbirth (Beck 2008). Following childbirth, women may experience posttraumatic stress (PTSD) symptoms such as anxiety, panic, or insomnia.

This traumatic experience could lead to anxious feelings about your vagina in general, and it is not uncommon for women to be anxious about penetration. This type of anxiety may go away on its own once you resume intercourse, but if it doesn’t, it might be helpful to seek support from a therapist who specializes in PTSD.

2. New mothers are often exhausted, sleep-deprived, and fatigued.

Due to the feeding schedule and short sleeping periods of infants, many new parents only get two or three hours of sleep in a row. Fatigue for both mothers and fathers can lead to feelings of depression and relationship conflict. Decreased sleep can lead to increased arguing and feelings of irritability.

More relationship conflict can also make it less likely partners will feel like having sex. After a period of adjustment, many couples find that their amount of sleep increases and that they have adapted to the change. Try talking to a counselor if relationship issues persist.

3. Adjusting to a new role as a parent can make it difficult for partners to have the energy to fulfill each other’s needs as well as the new baby’s.

Many women embrace motherhood and put all their energy into being a loving, caring, fully engaged parent. At the end of the day, it may be somewhat challenging to transition back into the role of romantic partner.

It can help if both partners make it a goal to set aside quality time to spend together doing things that don’t involve your baby. Do a hobby or an activity you used to do together, and try to take advantage of a babysitter when the grandparents come to visit. Keeping up the romantic relationship will be paramount in the success of your growing family.

4. Postpartum depression can make it even more difficult to adjust to parenthood.

Postpartum depression occurs in approximately 15% of women. Symptoms of postpartum depression include lack of energy, fatigue, insomnia, loss of appetite, thoughts of suicide, or thoughts of harming one’s baby. Depression on any level decreases feelings of desire and interest in intimacy. If you are having these feelings, contact your doctor right away. Medications and therapy can significantly help.

5. After giving birth, you may not feel like being touched.

Having an infant cling to you for most of the day and night can be pleasant and fulfilling. However, many women do not wish to be touched further, especially on their breasts (if breastfeeding), once baby is asleep for the night. Instead, it might be far preferable to shower and have a few minutes to yourself.

In addition, women are receiving oxytocin from cuddling with the infant so they are less likely to need cuddling and intimacy from their partners. This feeling of not wanting to be touched usually improves after a few months when babies nurse less frequently, sleep through the night, and women have started to return to a more regular schedule.

6. A decrease in sexual desire is common, regardless of type of delivery.

Whether they gave birth by vaginal delivery or C-section, most women report a decrease in sexual desire. According to the website Healthline, a woman creates more estrogen in the first months of pregnancy than in the rest of her entire life combined. After giving birth, however, estrogen levels plummet very quickly to pre-pregnancy levels. Estrogen is an important hormone in sexual desire and arousal, and decrease in sexual desire is a common effect of the rapid decrease in these levels.

In addition to estrogen changes, prolactin, a hormone secreted in the brain that causes milk letdown, increases when you are breastfeeding. When prolactin is elevated, testosterone and estrogen is suppressed, causing low libido and vaginal dryness. The vaginal walls may become frail and narrow. Hormonal birth controls can also worsen vaginal dryness, so consider speaking to your doctor about non-hormonal birth controls such as an intrauterine device (IUD) in order to offset these issues.

7. Many women experience difficulty with arousal and orgasm after giving birth.

Due to lowered levels of estrogen, fatigue, possible depression, and constant contact with an infant, many women report lower levels of arousal. Try much more extended foreplay (45 minutes to an hour) to give yourself more time than usual to become aroused. And although lubricant can be good, give your body sufficient time to try to get lubricated on its own. Listen to your body if it is telling you it is not ready for intercourse just yet.

8) For many women, childbirth may involve an episiotomy, stitches, tearing, or C-section. Many women find that they are anxious about resuming sexual activity because of the physical trauma their bodies have been through. Additionally, some women experience urinary incontinence and flatulence as a result of childbirth. These two conditions, and the possible embarrassment related to them, can make some women avoid sex. These two issues usually resolve themselves after six months, so talk to your doctor if these are a concern for you.

9. Vaginal pain may occur with intercourse. 

Whether you give birth vaginally or by C-section, vaginal pain is likely to happen (most likely due to the hormone changes). The good news is that recent research from University of California San Francisco shows that childbirth does not appear to affect a woman’s long-term sexual functioning (Fehniger, J.E.).

As long as your medical provider has given you approval to resume sex, take it slow, make sure you are adequately lubricated, and rest assured that any pain should be significantly improved within a few months. Try using a silicone-based lubricant for vaginal dryness. Some women may benefit from a vaginal moisturizer or an estrogen cream.

In addition, having more sex will likely help. Vaginal atrophy, when the walls of the vagina narrow and thin, can occur after long periods of time without sex. Having more frequent intercourse will help the vagina bounce back into shape. Of course, speak to your medical provider if the discomfort does not improve after a few months.

Having a baby is a wonderful time, but sometimes, sexual problems can be embarrassing or leave women feeling like they are alone in their problem. I hope that this overview was helpful and that you receive the support you need to resume your intimate relationship after adding a new addition to your family.

Resources:

1. Beck, C., Watson, S. (2008). Impact of birth trauma on breast-feeding: A tale of two pathways. Nursing Research, 57(4). Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18641491
2. Fehniger, J. E., Brown, J.S., Creasman, J. M., Van Den Eeden, S. K., Thom, D. H., Subak, L. L., & Huang, A. J.  (2013, November 19). Childbirth and female sexual function later in life. Obstetrics and Gynecology, 122(5). Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24104776
3. Moore, K., Watson, K. (n.d.). What do you want to know about pregnancy? Healthline. Retrieved from https://www.healthline.com/health/pregnancy

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