Sex After Birth...Is it Normal to Hurt?

Okay ladies, let's talk about sex. Not just sex, but sex after having a baby. You've just labored, pushed and birthed a baby either vaginally or cesarean and your body is forever changed.

So now you have to reacquaint yourself to your new body...."Hello mama body, how are you feeling today? Tired? Sore?"

No wonder the thought of having sex for most of us is the last activity we'd chose to do with our new body.

So why is sex after baby painful?

Statistics range from 9 out of 10 women experiencing pain the first time after birth, falling to one quarter of women suffering long-term painful sex. Other studies find 45% of women experience pain during sex after birth

Nearly one in ten women who had an episiotomy, tear or other forms of intervention during childbirth suffer from painful post-birth sex – that’s over 35,000 women a year!

Here are the tops reasons sex is painful after baby:

  1. Shy about our new bodies
  2. Breastfeeding
  3. Hormones & the thyroid
  4. Scarring
  5. Injured pelvic floor muscles

For many women the changes that occur to our bodies make us self conscious of how we look...stretch marks, soft tummies, wider vagina. Even though a women's body is beautiful after having a baby, many of us just aren't comfortable with these changes.

Breastfeeding changes the natural mucosal lining of the vagina and reduces the lubricant produced by the body when aroused.  This in combination with unbalanced estrogen levels from the body readjusting from pregnancy can cause the vagina to feel dry....leading to major friction during sex.

These on top of being sleep deprived and focusing 24/7 on a new baby can really reduce the sex drive we may once had.

Scarring occurs in tissue when it has been cut or torn.  So for those who tore during delivery, had an episiotomy or a cesarean the risk of painful sex is increased.  Why is this...because when scar tissue is less flexible or elastic than the surrounding tissue.  This becomes even more apparent when the scar does not heal properly and creates more scar tissue than necessary or binds down neighboring muscle.  So then when you go to stretch the scar it doesn't want to give and creates a pain response.

No matter how you delivered, your pelvic floor has been forever changed from pregnancy.  The weight it supported during pregnancy, the strain it felt during labor and the stretch it went through during delivery all play a role. "I had a c-section" you may say.  You're pelvic floor can still be affected depending on if you pushed before your transition to the c-section.  If you had a scheduled cesarian your risks are more linked to scarring, hormones, and past history of pelvic floor dysfunction.

This does not mean you can avoid painful sex by having a c-section!  There are more risks that come along with having major surgery, so please let this decision be medically based.  That is a whole different post...I have worked with many moms who never delivered vaginally but had horrific pain during sex.

So what can you do about it now?

First listen to your body...if it is painful, slow down, adjust your position, or just stop.  You don't want your body to associate pain with sex..this creates muscle guarding and increased anxiety....which are easily avoidable.

Then try some lubricant. Natural oils like coconut and olive oil can help boost the bodies natural moisture, but if you go with store bought always go with water based.  If you have sensitive skin, you may want to stick with organic brands like Sliquid.

Massage, massage, massage!!!

So think of yourself as an athlete returning to your sport after an injury.  [Not that I consider birthing an is a natural process for the female body] but bare with me.  An athlete with ice, heat, get a targeted massage, do targeted exercises for the injured area.  These help the body heal!  So why wouldn't you help your body heal by using targeted massage and exercises?

Take out that coconut or olive oil and gently massage your perineum (that tissue between the vagina and anus), especially if you have a scar.  If you have a c-section scar gently massage it and the surrounding tissue.

*Always wait for the scar to be fully closed before doing any massage*

Stretches and targeted pelvic floor awareness exercises helps your muscles find their groove again.  Because of the strain and stretch these tissues experience they loose some of their natural function to contract and may end of tightening up or weakening.

Reacquanting yourself to this area with breathing exercises to synchronize your diaphragms and create a new muscle memory will help bring back the sexual function of the pelvic floor.

Be aware though that KEGELS should not be done if you have tight pelvic floor muscles...this will only lead to more tension and more pain.

My best advice is to assessed by a women's health physical therapist who is trained in postnatal and pelvic floor care.  That way you will know exactly what your body needs!! No point in guessing when there are experts who can help!

Too many moms I have worked with waited months and even years experiencing pain with sex.  Don't wait, soreness and tenderness is totally normal the first few times you try.  But persistent, sharp, stabbing, burning, (I could go on here) is not!

Do yourself and your partner a favor and mention it the next time you see your provider. Or better yet find a local women's health PT near you..did I mention NH is a direct access state, so you can see a PT without a referral.  How cool is that!

Remember the only sensations you should be feeling during sex are pleasurable ones!