Modern women are female warriors at home and in the boardroom. But one thing these wonder women don’t talk about, say doctors, is sex. In particular, postpartum sex, which can sometimes be painful. Add in hormonal rollercoasters and the stress of looking after a newborn, and you may never want mattress nookie again. Dr Michelle Chia from the DTAP Clinic Group sheds light on why making nookie after baby can hurt, and what couples can do to light that pre-baby bedroom fire again.
How soon after giving birth can I have sex?
It depends on how comfortable and ready you feel. From a medical perspective, it would be safe to wait at least six weeks. This allows time for your body to recover from the delivery process, for the cervix to go back to normal and for vaginal tears and repairs to heal adequately. You will probably have your postnatal check up in about four to six weeks so you can ask your doctor if you have any issues with your recovery.
Is there any danger in doing it too soon?
If you have stitches around the vaginal area that have not healed adequately, or had a particularly complex tear during the delivery that has not healed, sexual activity can cause wound breakdown and infection. This may delay or complicate the recovery process and may even require a second repair of the wound.
How common is postpartum sex pain?
The delivery of a baby is a major event in your life. It also involves several changes to your body. So it is not uncommon for you to face difficulties or feel pain when trying to have sex again after having given birth.
Why does this happen?
First and foremost, you will probably feel very sore down below, especially if there’s been a vaginal tear and repair. Going through a normal vaginal delivery will stretch your pelvic muscles quite a fair bit. On top of that, having a tear with stitches around an already sensitive region can make you even more sensitive and susceptible to pain.
Even if you delivered via C-section, you would be recovering from a major surgery with a surgical wound. Going through these major changes, or trying to recover from your C-section and dealing with the pain, soreness or fatigue can definitely affect your sex drive. This may make you fearful of trying to engage in sex again after giving birth, or cause you to lose interest in having sex.
Hormonal changes after pregnancy can lead to your vagina feeling dry and painful, especially if you are breastfeeding. This is due to the reduction of the female hormone called estrogen.
Emotional and psychological factors also play a large role in the challenges women face in having sex again after giving birth. Many women are trying to cope with the different changes that they are facing in their body, with many women feeling that they are a “less flattering” form of themselves after the whole delivery.
Facing the stress of caring for a newborn baby, together with the roller coaster of emotions can also definitely affect sexual desire.
Does breastfeeding make it worse?
Your breasts may be sore or engorged. Breastfeeding also leads to certain hormonal changes in the body. It causes a high level of a hormone called prolactin, which decreases the amount of estrogen in your body. This can lead to vaginal dryness and pain.
On top of this, hormonal changes during the postnatal period will lead to a drastic drop in estrogen and progesterone levels. This can lead to vaginal dryness and loss of libido. So in a sense, it may be more challenging for a breastfeeding mother to start having sex again after giving birth.
Does it make any difference if I had a C-section or a natural delivery?
Going through a natural delivery will predispose you to getting tears and stitches around the vaginal area. This leaves it sore or painful when attempting sex — even after it has healed.
On the other hand, a Caesarean section is major surgery. Women who go through it will have a surgical wound to care for as well as post-operative pain. The recovery time for a C-section may also be longer compared to a natural delivery. Even though having a C-section may not necessarily lead to pain around the vaginal area, having a recovering surgical scar can contribute to pain or discomfort during intimacy.
What do you tell patients who seek help?
Take things slow, and only resume sex when you feel mentally and physically ready. Do not feel pressured into resuming sex if you feel that you have not adequately recovered.
What can I do to help myself enjoy sex more?
Firstly, ensure you are in a relaxed environment. Try taking a warm bath beforehand, and go slow at the start. Using lubrication can help ease the dryness and the pain. Some women may find that their vaginal muscles are more lax after childbirth. Kegel exercises can strengthen your pelvic muscles and help ease discomfort. However, if your symptoms persist or do not improve, please see your doctor.
What can my husband do?
Be patient and understanding. Do not pressure your wife into resuming sex too soon. Take it slow and ensure she is comfortable is important. If the wife is uncomfortable, the couple can also engage in other acts of intimacy to maintain their close relationship.