Nelia DeAmaral, Registered Psychotherapist and Coach for Women, & Jenny Telfer-Crum, Pelvic Health Physiotherapist
Six weeks after you give birth, you will visit with your care provider. Maybe your care provider gives you a thumbs up to resume “normal activities” (including sex). Maybe your care provider checked that everything was healed, or maybe not. Were you or are you ready? Do you feel an obligation to become ready because your partner wants to be intimate again? Most women aren’t and if you are still finding yourself “not ready” a few months later, you are not alone. Partners often are given the impression that once the body is mostly healed, that sex can resume.
Let’s talk about what sex after baby is really like. This topic comes up over and over in our sessions with new moms, who are almost afraid to ask, but really want to know how to deal with this change in their relationship. Mostly everyone wants to know if they are normal, if things will be okay, and how to stay connected to their partner during this change.
If you aren’t quite ready, that’s okay. If you are looking for ways to return to intimacy after baby, we’ve listed that too! There are good reasons for how you feel. Below are some factors that might influence when you return to sexual activity with your partner, and some strategies for when and how you return to these activities.
Let’s start by setting some normal expectations for sex after baby. Your first several times being intimate again, will likely require lots of talking, adjusting, and flexibility. It will be a time of “figuring out” and “experimenting” - not hanging from the chandeliers (but it’s okay if it is!). So NO PRESSURE! You will likely need to slow everything down. Your body will feel different and it will be your first time being sexual with this new body & your first time being sexual as a mother! It’s important to take the pressure away that this will be amazing sex, or the sex you had before (at least initially).Your body has been through a major change, and your first few times of being intimate can feel awkward and different. Most partners are very happy to be supportive as you explore these new sensations and experiences.
It is common if…..
1. You feel Pain or Fear of pain or Tension in the pelvic area:
Your 6 week “go ahead” just means is that your tissues have the integrity needed to withstand the friction and stretching that occurs with intercourse. But vaginal tissues are sensitive after birth REGARDLESS of whether baby is born vaginally or by caesarean birth, whether you have stitches or not.
Imagine you pulled your bicep muscles in your arm lifting something – our first instinct is to bend the arm and hold it close to us. This is a guarding response to keep up safe and prevent further injury when our tissues are fragile and stretched. We rest the muscles for a couple of days, and without even thinking about it we will rub our arm where it hurts – this provides our tissues with normal sensory input (touch, friction, pressure) and helps us check in as to where any tenderness is and how it is changing. Then over the next week or two we will gradually start using our arm again to lift things, testing out how much we can lift. Within a couple of weeks you are pain free, doing your usual activities.
At the perineum and vagina, the same healing process occurs. First our muscles tighten in a guarding response to being stretched or torn (and in the case of caesarean births, tighten in response to neighbouring muscles being impacted). However, at the pelvic floor and perineum, we often don’t get the same normal input we do at other parts of our body. We aren’t often touching or rubbing this area apart from toileting, and women often don’t consciously relax the pelvic floor over time. So what we can have are tight and sensitive tissues around the entrance to the vagina.
Learning to relax your pelvic area again.
Fortunately, most women do very well with pelvic floor corrective exercises focusing on “reverse kegels”, which is teaching the pelvic floor how to RELAX appropriately. Gentle touch in this area can also help desensitize these tissues and bridge the gap between recovering from birth to returning to intercourse. Our Pelvic Health Physiotherapists can help identify where any tension or sensitivity is harboured in your muscles and how to work towards recovery. Research has shown that child birth, even with tissue trauma like an episiotomy, is not linked with long term impacts on sexual function.
How to talk to your partner: Talk to your partner about the worry, and keep talking even during sex. Notice when you tense up, practice relaxing with your breath, and ask for what you need (eg. slow down, pause, or stop for today).
Remove the pressure for penetration right away. Many women find it helpful to use lubricant, or have touch without penetration for arousal or even orgasm. Try a different position such as a position of power (ie. woman on top) to control rate and depth of penetration.
Some women experience physical and emotional trauma during birth, and despite their efforts, their body doesn’t feel safe letting go. A couple of sessions with a counsellor can help you sort through feelings of self-blame & anxiety. The WOMB offers specialized support for healing from a difficult birth.
2. You feel too exhausted to have sex
This doesn’t mean you don’t love your partner or that your relationship is doomed.
It can be difficult to feel the desire to be intimate, when you are in the most exhausted state of your life! Early parenthood is a time of choosing between your various survival needs. Your frequency of sex will likely decrease because that’s what happens when we are exhausted!
Give yourself time. It is normal for babies to have erratic schedules. Sometimes more sleep isn’t an option, but studies show that meditation and relaxation can have similar benefits to more sleep. Try these simple, and short meditations for moms and meditation for sleep. Many partners experience feeling loved through intimacy. What other ways do you and your partner feel loved? Maybe something you each already do without words or touch?
3. You feel too stressed to have sex
The stress of being a new/new again mother is tremendous. You mind is busy and you might feel like you are constantly “on call” and ready to respond to your baby. Sexual arousal is governed by our parasympathetic nervous system, aka “rest and digest” system. When we are stressed, the increase in cortisol (stress hormone) decreases oxytocin (aka hormone of love). Stress also increases tension in the pelvic floor muscles - which can loop back up to tissue sensitivity.
Focusing on bringing down your overall stress levels might make a little more space for feelings of intimacy. Either way, it will help you cope with the challenges of mothering with greater compassion and presence. Simple awareness practices can help you see yourself with more compassion, which is a proven way to calm down the fight or flight. Try this meditation for stress and anxiety. You can do it anytime. It’s quick and you can even do it while you feed baby.
4. You feel touched out or too “called on” as an introverted mom
Being a mom, especially if you are an introvert, can leave you feeling like you have no time to be alone and recharge, which can be extremely draining. Some women don’t feel the need or desire to be touched especially because holding baby increases our oxytocin levels on it’s own, so you don’t feel you need to get that affection from your partner.
It might sound counter intuitive to building intimacy, but sometimes you might just need some time alone. You’ll be surprised how much even 20 minutes can help you feel like yourself again. Time alone is especially helpful if you can step away and allow your partner to parent in their own way and you have specific and set times when you can expect a break. Read more about ways your partner can support you in the article A Mind-Reading Guide for New Fathers.
5. You don’t really like your partner right now or you feel like he’s a roommate
The demands of the early months of parenting can leave you both feeling a little disconnected or unusually irritated with each other. Virtually everyone goes through this. Know that you are not alone. Find small ways to connect that are doable for both of you. Many couples find that a couple of sessions with a counsellor or coach can help get them on track with communication and bonding. The WOMB offers sessions for couples.
7. You don’t feel connected to your body, don’t love your body or wonder how your partner will love your body again: Who’s body is this anyway?
Maybe you feel like your body has gone from being yours to providing a function for your baby, whether it’s feeding or caring for baby in other ways. It’s ok not to love your body. Try making friends with your body. Treat it as you would a tired, hardworking friend. Be compassionate with yourself. Many clients describe the relationship to this new body as an acquaintance or even a distant “facebook friend”. Talk to other women. It will help you realize that “bouncing back” is a myth.
Some women find themselves hiding their bodies from their partners for fear of judgement. Talk to your partner about this. Honesty is a true form of intimacy. What if this stage was a chance to be loved when you aren’t perfect? Imagine allowing your partner to love you, just as you are right now? Intimacy is more profound when we allow ourselves to be seen in our imperfection. For more on embracing imperfection look up the work of Brene Brown, a renowned researcher on whole-hearted living.
8. Mood Changes
This is a complex interplay of the physical, social and psychological factors listed above. You will feel good again! Medication given to help aid in post partum depression (SSRIs) can also dampen arousal and desire. It’s normal to feel sad, anxious and not like yourself. If you find that you are feeling this way more often than not, seeking support can make all the difference. Even just feeling normal and being understood goes a long way.
Here are some quotes from fellow mothers in the Emerging Mothers Group in response to the question, “What would you tell your daughter at this stage of mothering if she felt as you do”?
“This experience makes you part of a community of women”
“Don’t be so hard on yourself”
“You are right where you need to be at this stage”
“You have done something amazing - a miracle. Give yourself time.”
“Let in your partner’s hugs. You don’t have to hide”
We hope this article was helpful. So much can be done to make this transition easier for women and families. Feel free to contact us to talk more or to book a time.
Nelia DeAmaral, RP
Registered Psychotherapist and Coach for Women
Jenny Telfer-Crum, PT
Pelvic Health Physiotherapist