Enjoying Sex After Childbirth

Read about the author Samantha Evans

The baby making part was fun and you may even have had more sex and better sex than you ever had before as your hormones played havoc with your body, turning you into a sex kitten, but few couples consider what their sex life will be like once their newest family member has arrived.

Many women notice that their sexual health changes after childbirth. Some are temporary, but other symptoms can leave lasting long term effects, esepcially after traumatic births. As the female body goes through many changes during pregnancy, the recovery to pre-pregnancy sexual health after childbirth can vary between each women.

Some women experience better sex after having children, others find their sex life is lacking due to exhaustion, physical changes to their body, the impact of birth trauma and hormonal changes.

However, by changing the way in which you have sex life to encompass these changes, most couples can continue to enjoy satisfying sex.

With time, patience, experimentation and using your imagination, you will soon be enjoying nights of passion (or whatever time of day you have sex) and probably making more babies too.

After giving birth, you’d think that no woman would want to have another baby – but the memory of the labour soon fades if it has been an uncomplicated delivery.

The general time frame that you wait before attempting to have sex recommended by midwives and doctors is 6 weeks, to ensure that everything has healed properly and to avoid putting yourself at risk of infection.

Some couples try earlier than 6 weeks, others wait for a longer period of time. It is understandable that some couples may be apprehensive about having sex after childbirth, but waiting too long can make getting back to having a normal sex life even harder.

Type of delivery

If you were fortunate enough to have a vaginal delivery without tearing or requiring an episiotomy (surgical cut to perineum to allow baby’s head to be born), you may feel everything is getting back to normal and want to have sex. Recovery can take longer if:

• you had a tear or have an episiotomy to allow any stitches to heal naturally
• an assisted birth using forceps or ventouse to allow bruising and swelling to subside
• breech birth
• long birth resulting in excessive bruising and perineal pain

Many women who have had a caesarean delivery believe that they can have sex earlier but should be considered to be in a similar position to women who have delivered vaginally. Even though their vagina has not gone through the birthing process, they still bleed post delivery following the delivery of the placenta.

Women who have a caesarian section need to consider their caesarean scar. Pressure on the wound can cause pain and some loss of sensation around the wound can occur, making it sensitive to touch. They should avoid sexual positions that exert pressure on their abdomens and over the wound site.

Caesarean sections can actually make vaginal intercourse more painful. There is a greater risk of surgical scarring around your uterus, and you are much more vulnerable to infection.

During and following a vaginal delivery, certain hormones that have built up throughout the pregnancy are released. Having a caesarian section means that these hormones are not released which can cause anorgasmia, a condition whereby you are unable to orgasm, regardless of what has happened in your vagina, which can impact upon your sexual function.

Changes to your body

Changes to your body such as a larger vagina, lack of vaginal tone, reduced vaginal lubrication and decreased sensation especially around the clitoris, perineal pain or pain during sex can occur following childbirth. Incontinence is often a problem that can occur after childbirth but though training your pelvic floor muscles you can alleviate this problem.

Do those pelvic floor exercises

Being incontinent after childbirth is not normal so seek help. Pelvic floor exercises should be done by every woman on a daily basis, not just after having a baby. Ensuring that your pelvic floor muscles are toned will help prevent urinary incontinence caused by the stretching of the pelvic floor during labour as well as making your orgasms feel more intense.

Pelvic floor exercises can be done anywhere, standing up, lying or sitting down. If you are unsure how to do pelvic floor exercises, seek advice from a women’s health physiotherapist.

The MUMMY MOT training course for physiotherapists trains physios to help new mothers get back to normal pelvic health after childbirth, including posture, pelvic floor, pelvic pain and sexual advice.

Products like Pericoach, a pelvic floor exerciser connected to an app on you phone can help you plot your progress in conjunction with advice from a clinican, such as a doctor, nurse or physiotherapist. You can find a registered clinician at Pericoach who can advise you about this product.

Squeezy app is another useful tool designed by a physiotherapist which reminds you to do your pelvic floor exercises too.

How to do pelvic floor exercises

Squeeze and draw in your anus at the same time and close and draw your vagina upwards too.
Do it quickly, tightening and releasing immediately. Then repeat slowly, holding as long as you feel comfortable but no longer than 10 seconds. Repeat each exercise 10 times, 4-6 times a day.

To make your life easier you could also use Lelo Luna Beads – pelvic floor exercisers containing weighted balls which move around as you go about your day and train the muscles to contract and relax.

When time is short, and it will be after having a baby, try the Lelo Luna Smart Bead which offers a daily 5 minute plevic floor exerciser routine. Just pop the Smart Bead in and start contracting your PC muscles in repsonse to the vibration programme.

If you want both a vibrator and a pelvic floor exerciser, the MyStim range of vibrators are just for you. Combining vibratory power and electrical stimulation, these sex toys offer both sexual pleasure and pelvic floor exercises in one product.

If you are unsure if you are exercising your pelvic floor correctly, please contact a women’s health physiotherapist.

Vaginal Laxity

Many women often feel that their vagina feels different during sexual intercourse after childbirth.

A friend said her partner described it as” walking into the same room but the furniture has been moved around!”.

Exercising your pelvic floor can really improve any laxity in the vagina muscles. Also, using a constriction ring during sex can help make your partner’s erection feel bigger and firmer, too. Changing positions is a good idea, such as on top for deeper penetration and more control, although some women may feel self-conscious in this position.

Experimenting with different positions and concentrating on enjoying sexual intimacy and pleasure beyond penetration can help, such as bondage, sensory deprived sex, foreplay and oral sex.

Vaginal Dryness

During pregnancy and after childbirth, the vagina can feel drier and less lubricated due to the hormonal changes within the body and when breastfeeding, which can make sex feel painful or uncomfortable. Vaginal dryness can cause small tears and cuts within the vagina, increasing your risk of infection. During pregnancy, you can also become more prone to thrush, therefore using a sexual lubricant can help prevent this.

Often considered as being a failure if you need lubricant, vaginal lubrication is important for sex to feel pleasurable and comfortable, whatever your age, gender and sexual orientation.

Using an irritant free lubricant can also speed up the healing of any scar tissue post delivery, and you can use it to massage into scars to keep them for becoming sore, make the tissues more flexible and prevent vaginal tightness.

Ingredients really matter when it comes to your intimate health and sexual pleasure, especially if you have a vulva and vagina, but some products can also cause penile and anal irritation too. We only use, recommend and sell three brands, YES, SUTIL Luxe and Rich and ID Lube, a silicone brand. This is because we care about your intimate health and will never sell lubricants that contain irritating ingredients that include glycerin, glycols, parabens, dyes, perfume, alcohol, CBD, sorbitol or antibacterial ingredients. Research shows that these ingredients all impact upon the microbiome of the vagina, changing its delicate pH, which disrupts and destroys our friendly bacteria that keep our vaginas and vulvas happy, healthy, flexible and lubricated. This can lead to irritation, itching, stinging, burning and even thrush or bacterial vaginosis. You may also experience urethral irritation, cystitis and UTIs too

Just because a product is slippery does not mean it is suitable for intimate use or sex play, so do not reach for products from your kitchen or bathroom cupboards, they were never designed for intimate use! I find it frustrating when I hear midwives and GP recommend using olive oil, baby oil, Vaseline or KY!

The same goes for the ingredients in the lubricant on condoms. Many people think they have a latex allergy when they are actually experiencing irritation from the lube ingredients. If you’re using condoms as contraception, you may need to try a few different brands to find one that is suitable and fits comfortably, too. Size matters when it comes to condom compliance and comfort

What Lube should I choose?

Water-based lubricants are the closest to your own natural lubrication, they are easy to wash off, can be used for any sexual activity, used with any sex toy material including silicone toys and are condom compatible. Our lubricants are pH balanced, don’t leave any residue and can be reactivated during sex play with a little water if they begin to dry out
“Wish I had discovered Sutil Luxe years ago… really nice and will definitely buy again. It was so good, both me and my husband overslept this morning!”

SUTIL LUXE is a silky smooth water-based lubricant, made from botanical and organic ingredients, that moisturises, nourishes and soothes our most intimate areas, as well as lubricating for sexual pleasure. This fabulous water-based lubricant gently cushions and glides, blending seamlessly with your own natural lubrication, making you more lubricated during sex. It feels very natural, not intrusive like many other lubricants. Being water-based, it is easy to wash off, too.

Free from irritating ingredients and hormone free, it is perfect for anyone, including those not able to have hormone replacement therapy and post cancer treatment, not only as a sexual lubricant but also as a vaginal moisturiser and can be used with any sex toy or dilator.

Made with eco – certified ingredients, SUTIL is committed to creating natural and organic cosmetics that are not only great for your skin, but also derived from renewable resources and manufactured using environmentally friendly processes. Even the sleek tube is biodegradable.

We also sell YES water-based lubricant made from organic and botanical ingredients that are not irritating. It is easy to wash off, safe to use for all sexual activities, pH balanced to that of the vagina flora, free from any smell, taste, colour and is non-staining.

Water-based lubricants can also be used during anal play.

Oil-based lubricant is longer lasting, but is not suitable for use with latex condoms. Do not use oil-based products that have never been designed for sexual use, as they will destroy condoms and your vagina and anal health.

Keep vegetable oils for your salad, baby oil for your body and petroleum jelly for your lips! If you’re prone to thrush, just use coconut oil in your cooking or on your skin.

YES Oil Based Lubricant is plant-based, free from any irritating ingredients, has a much thicker consistency, suitable for water play, great for anal play, highly moisturising to the skin and can be used with water-based lubricant to create a Double Glide effect. It can also be used to protect the delicate tissue of the vulva if you experience dryness, soreness or feel uncomfortable and is great to use when swimming in chlorinated or seawater which many cause irritation.

YESOB is great for perineal massage to help scar tissue post childbirth, too. However, it is not latex condom compatible if you are using condoms for contraception, so use SUTIL Rich or Luxe for massage as it is water-based.

If you want a longer lasting lube that is condom compatible, SUTIL Rich is ideal. Designed with a pH suitable for both anal and vaginal use, the new “Rich” formulation has enhanced viscosity to ease anal penetration and soothe dry, delicate tissues.

SUTIL Rich contains small amounts of Horny Goat Weed — a herbal aphrodisiac — that is added, along with Siberian Ginseng and Jujube nut. Traditionally, these herbs are used to increase strength, energy, stamina and vitality, but they also help to boost immune functions and have natural antibiotic and antiseptic properties to fight infection. Horny Goat Weed is also a vasodilator, which promotes blood flow and increases natural lubrication.

You can also use YES VM vaginal moisturiser as it is so soothing on the delicate tissues of the vagina and helps to restore the pH of the vagina which may become unbalanced, leading to vaginal infections.

Avoid using lubricants containing chemicals, which warm, cause tingling, dyes or flavouring which may cause an allergic reaction, such as itching or burning. If using latex condoms, only use water-based lubricants as oil-based products can degrade the latex, making them less effective.

Silicone lubricants are a great alternative, but cannot be used with silicone sex toys as it will degrade the silicone of the sex toy.

Breastfeeding, vaginal dryness and atrophy

Oestrogen levels drop following delivery and remain low for the first several months or longer when breastfeeding. This is because we produce prolactin, a protein that enables mammals (and birds), usually females, to produce milk. However, prolactin impacts upon oestrogen production which, in turn, impacts upon our vagina’s health and ability to secrete natural lubrication. In some women, this may result in vaginal dryness, vulval pain, dyspareunia and vaginal atrophy. It may also cause urinary symptoms such as dysuria, urgency, and frequency because we also have oestrogen receptors in our bladder and urethra and rely upon them to keep our bladder healthy too.

I find it so frustrating that the vast majority of new parents are not advised to use a good irritant free sexual lubricant post childbirth, especially if they are breastfeeding Many think there is something wrong with them when they don’t become wet, believing they are not aroused, others have sex, often painful sex, which then leaves their vagina and vulva feeling sore, itchy, and can even lead to thrush or cystitis.

I would love all midwives and GPs to advise their patients about the importance of using a good irritant free lubricant, not tell them to buy over the counter lubes, the vast majority of which contain irritating ingredients, tell them to use products from their kitchen or bathroom cupboard or prescribe them a product that contains irritating ingredients that do more harm than good!

For some, vaginal dryness is much more, it may be vaginal atrophy, and they may benefit from using vaginal oestrogen whilst they are breastfeeding. This needs to be discussed with your GP; however, a short course may be really beneficial for your vagina and bladder health and sex life.

Soreness and stitches

If you required stitches to repair a tear or episiotomy after childbirth, you may experience pain in your perineum. The stitches will heal over time, but need to be kept clean to prevent infection.

Take over the counter pain relief to ease any discomfort. Formation of scar tissue develops as the tissues heal which can feel uncomfortable or painful during sex. If this happens, speak to your GP. Depending on the extent of scarring, you may require revision of the scar tissue after childbirth, especially if it is affecting your sex life.

Filling condoms with water and freezing them is an age old trick I learnt from my nursing days many years ago, your very own vagina pop! This can feel very soothing to your sore perineum. If it is too painful to put it inside your vagina, try sitting on it on a towel as they will melt.

It is recommended by some gynaecologists that using a slim vibrator to massage the scar tissue can help to stretch any tight skin and make the tissues more flexible. Using a vibrator such as PicoBong Zizo, LELO Liv v2, JeJoue Uma, Touch Wand, VUSH Peachy G-spot massager:“Jo Divine IMMY”:products/jo-divine-immy with lubricant daily can help the scar tissues heal more quickly, avoiding the need for further surgical intervention.

Oil based YES organic lubricant is excellent for massaging into any scar tissue to help it become flexible and promote healing too.

Following the repair of an episiotomy or vaginal tears, some women experience decreased sexual sensation in the scar tissues where the nerve endings have been cut, and the use of a vibrator can increase sensation to the perineum by stimulating the nerves and promoting good blood flow to the tissues.

Pain during sex

Sex should never feel painful, whether you have given birth or not. Most women abstain from having sex for 6 weeks as this is the general advice given by healthcare professionals, but there is no right time to commence having sex again.

An Australian study using information from The Maternal Health Study (2013) found that 41% of women attempted vaginal sex by 6 weeks post-partum, 65% by week 8 and 78% by 12 weeks, with 94% resuming sex by 6 months. The study found that 53% resumed sexual activity not involving penetrative sex, such as foreplay and manual masturbation, by 6 weeks.

The study found that women who either underwent a caesarean delivery or an assisted birth using forceps or ventouse, and those who had an episiotomy or sutured tear were less likely to have resumed sex after 6 weeks.

Of those women who did resume sex after 6 weeks, 43% had a caesarean section, 32% had a forceps assisted birth, 32% had an episiotomy and 35% had required sutures for a vaginal tear, compared to 60% of women who had a spontaneous vaginal birth with intact perineum.

In general, only 10% of all women who give birth for the first time will achieve a vaginal birth with an intact perineum. However, this does not prevent them from enjoying good sex.

How to ease your way back into the sack again

Talk to your partner

It is generally presumed that as being a new mother, any issues about resuming sexual intercourse after giving birth will revolve around the way in which you feel, but you need to be aware that your partner may have their own feelings of anxiety about sex too.

For many men, the thought of causing you physical pain can be off-putting and may affect their ability to want to have sex with you. They also worry that they won’t fit as well as they did before, due to the changing shape of your vagina. The effect of watching their partner in labour can impact upon some men, who may have performance problems when they have sex. Those couples who have a traumatic birth may find this puts strain upon their relationship, but seeking counselling can help.

Fear of getting pregnant again can prevent sex from happening, but by ensuring that you use reliable contraception and not keep your fingers crossed, you should be fine. Contrary to belief, breastfeeding does not offer contraceptive protection! Oil based lubes will destroy latex condoms.

By sharing your concerns with each other allows you to express exactly how you feel and talk about your fears and worries. Exploring how and what you both want from your physical relationship will make your sex life more pleasurable.

Take your time

Sex isn’t just sexual intercourse, it involves any form of pleasurable sexual activity, therefore don’t feel you have to have full penetrative sex the first time you attempt to have sex.

Just spending time getting comfortable with the idea by cuddling and touching each other will allow you both time to get used to the way your new body feels to your partner’s touch and, hopefully, will make you feel more relaxed.

If you feel self-conscious about your altered body shape – such as weight gain, stretch marks, caesarean scars and engorged breasts, try getting naked under the bed covers to build up your confidence again.

Most men enjoy the fact their partner has bigger breasts, even if only temporary, and recognise that the changes to your body are due to you both becoming parents.

Cuddling and touching offers the benefit of feeling nurtured and supported and allows you to connect with your partner.

Don’t rush

You do not have to wait for the 6-week check up before you resume sexual activity if you feel ready and your vagina feels comfortable. However, if you think sex will be painful before it has even happened, then it probably will be, as you tense your vagina. Feeling like this will not make having sex a pleasurable experience, so it is a good idea to allow time to ensure everything is healed properly.

Experiment with sex

Becoming new parents is exhausting and all you want to do is sleep. So avoid trying to have sex when you go to bed, as you’ll probably just fall asleep. By the time the evening arrives, you often feel tired, definitely not in the mood for sex and just want to collapse into bed.

Try having sex during the day when your baby is sleeping, and you have more energy if you can. Babies do tend to sleep a lot, but not always during the night!

If you cannot have sex during the day due to having other children, try going to bed when your children go to bed – but not to sleep!

Your New Body

Changes to your body may make you feel self conscious but your partner created your baby with love and they love you, wobbly bits and all. Leaking breasts can be off putting for you both, so wear your nursing bras and keep them out of bounds! There are many other erogeneous parts of your body to be stimulated from your ears and neck, to enjoying a back massage or foot rub!

Sex isn’t about the act of intercourse but just being intimate through kissing, cuddling and talking to each other.

Be imaginative

After giving birth, sex will probably feel very different to how it felt previously.

When attempting to have sex for the first time, it may feel painful or uncomfortable. If this happens, try experimenting with a clitoral vibrator or manual masturbation to help you become relaxed about having penetrative sex. This will enable you to reach orgasm and boost your libido, often decreased after childbirth due to hormonal changes and exhaustion.

Allowing your partner to use a sex toy on you or letting them watch, even if you are unable to have penetrative sex, will enable you both to still enjoy great sexual pleasure.

Consider treating your partner to their own sex toy, such as a male masturbator so they can enjoy the fun too, even if you are unable to have full penetrative sex. Once you are back into the swing of having sex you can incorporate using sex toys into your sexual relationship to spice things up!

If you want to have penetrative sex but find it uncomfortable, try using a slim vibrator or dildo to help you relax your vaginal muscles. Anticipating that sex will be painful, your vaginal muscles will tighten, making penetration difficult or impossible.

A vibrator can help both you and the muscles of your vagina to relax and stimulate vaginal lubrication too. It can also help increase sensation in the genital area and perineum, often reduced after childbirth due to perineal tearing or episiotomy scars.

Always choose well-made sex toys constructed from skin safe materials such as silicone, glass and metal from reputable manufacturers. Some sex toys are made from rubber, latex and jelly which are porous, absorb bacteria, making them difficult to clean and may also trigger an allergic reaction in some people.

Make sure you use contraception

Having a birth control plan in place before you have your baby is important if you do not want any surprises in 9 months’ time.

Breastfeeding does not offers contraceptive protection.

Even though you may not have had your first period since giving birth, you can still get pregnant, so ensure you or your partner stocks up on condoms or see your GP about taking the contraceptive pill or other forms of contraception. All oil based products including YESOB will destroy latex condoms.

Be honest with your partner about when you are feeling ready to have sex again. Most partners will be patient but don’t put it off for too long, as the longer you wait, the harder it may be to resume normal sexual activity.

Post natal depression

Some women experience feelings of depression following childbirth, especially women who have experienced birth trauma, which can affect their sex life. NHS data suggests up to 15% of women suffer antenatal depression but this figure could be higher. If you think this may be a problem, seek medical advice.

If the lack of sex becomes an issue between you, make time to talk about the way you feel and why. Don’t let it become a problem within your relationship.

If you have tried having sex and it is still painful or uncomfortable, seek advice from your GP. You may require surgery to revise the scar tissue left after having vaginal tearing or your episiotomy sutured.

If the issue is anxiety about having sex, counselling may be offered to enable you to overcome this problem and enjoy pleasurable sexual intercourse again.

Birth Trauma

If you have experienced a traumatic birth, seek advice as many women don’t realise the symptoms they have having are related to their birthing experience. Early intervention makes recovery more successful so please tell your GP, you do not have to live with painful sex, urinary or faecal incontinence. Having recontructive surgery and treatment from a womens health physiotherapist can help you return to normal.

The Mummy MOT can offer help and advice to help you overcome these issues too.

Counselling can also help you overcome the trauma of your delivery too so seek help.

Whatever you do, don’t let sex become an issue after childbirth – there are many ways in which you can ensure that it continues to be pleasurable and fun!

At Jo Divine we believe that sexual health and sexual pleasure go hand in hand and have created a health brochure with suitable products to help people with sexual issues. Working with medical professionals, we hope to encourage patients and HCPs alike in talking more freely about sexual problems. A health issue doesn’t mean your sex life will have to stop!

Useful websites:
Birth Trauma Association: www.birthtraumaassociation.org.uk
Pelvic, Obstetric and Gynaecology Physiotherapy: https://pogp.csp.org.uk/
College of Sexual and Relationships Therapists: www.cosrt.org.uk
The Mummy MOT : www.themummymot.com
The Institute of Psychosexual Medicine : https://www.ipm.org.uk/
Contempory Institute of Sexology : https://www.theinstituteofsexology.org/
Pink Therapy :http://www.pinktherapy.com/
Aoife Drury :https://drurytherapy.com/
Royal College of Obstetrics and Gynaecology
Royal College of Midwives