Sex after childbirth: everything you need to know

How soon can you have sex after having a baby? When should birth control be resumed? What if you feel pain during sex? These are common new parent concerns. File / Getty Images

To all new and prospective parents worried about sex (and not having enough of it): “You’re not alone.”

That’s the message from Natalie Rosen, a Halifax-based couples’ therapist and researcher at Dalhousie University, who recently led two studies on the sex lives of North American couples transitioning into parenthood.

Her latest work, published this month in The Journal of Sexual Medicine, takes a look at the top sexual stresses linked to a new baby in the bedroom.

It’s no secret sex is usually the last thing on a mom’s mind after giving birth. She’s likely exhausted and might be so sore she can barely sit.

Dads, according to Rosen’s findings, tend to be more worried about their partners’ lowered libidos and heightened mood swings (both are normal, by the way). The “baby blues” affect up to 80 per cent of women. It’s a response to the major drop in estrogen and progesterone following labour.  If the irritability persists, it may be a sign of postpartum depression.

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READ MORE: ‘I was so raw and so open’: Mother’s post on postpartum goes viral

Another common query for couples is when to resume birth control. The answer, according to experts, is right away. Don’t be fooled into believing breastfeeding will protect you. You can still ovulate even before your first menstrual cycle.

Here’s how the other sex troubles break down by gender, based on a survey of 239 new-parent couples of healthy infants aged three to 12 months old:

New mothers’ top 10 sexual concerns

  1. Frequency and body image (tie) — 96%
  2. Lack of time — 93%
  3. Sleep deprivation — 93%
  4. Physical recovery — 92%
  5. Sore breasts — 92%
  6. Less sexual desire than partner — 91%
  7.  Mood swings — 89%
  8.  Not knowing when it’s OK to have sex again — 87%
  9.  When to resume birth control — 84%
  10.  How they view their sexuality now that they’re a parent — 78%

New fathers’ top 10 sexual concerns

  1.  Partner’s mood swings — 92%
  2.  Frequency —  92%
  3.  Partner has less desire — 91%
  4.  Partner’s sore breasts and body image (tie) — 91%
  5.  When is it OK to have sex again and sleep deprivation (tie) — 89%
  6.  Lack of time due to child-rearing duties — 88%
  7.  When to resume birth control — 87%
  8.  How they view their partner’s sexuality now that she’s a parent — 83%
  9.  Vaginal dryness — 81%
  10.  How to get or show affection when intercourse isn’t happening — 76%

Nearly 90 per cent of those surveyed reported 10 or more different concerns about sex after childbirth. All that distress can take a toll on a relationship.

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Can empathy be bad for your sex life?

Rosen’s other recent study, published this summer in the Journal of Sex and Marital Therapyfound that as beneficial as a father’s empathy is in most cases — it can sometimes backfire and actually lower a woman’s desire.

The reasoning is that when sex is avoided, it could come off as being no longer important. A woman, especially one who’s getting used to her new body, may feel less desirable when her partner doesn’t bring it up.

The best thing you can do is communicate with your partner and perhaps adjust expectations accordingly.

When can you start having sex after having a baby?

Having sex too soon can not only be painful for a woman but also increases her risk of infection, says UBC nursing professor Wendy Hall.

Hall, who specializes in maternal child health, recommends women use a mirror to see if stitches have fallen off before having sex. She’s seen sutures broken apart when intercourse happened just a few days after childbirth.

She also advises couples to wait for the post-childbirth discharge (called lochia) to subside and change from red to white. This signifies the area where the placenta was attached has healed.

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Recovery time can vary.

A 2013 study published in BJOG: An International Journal of Obstetrics and Gynaecology found that:

  • 41% of women resumed sex six weeks after childbirth
  • 65% of women by eight weeks
  • 78% by 12 weeks.
  • 94% by six months.

The healing time is generally less for vaginal births (if there’s no tearing or surgical cuts) than a C-section, which is a major abdominal surgery.

It’s not a bad idea to wait for your six-week check-up to get the all-clear from your doctor, Hall says. But even once you have that, sexologist Jessica O’Reilly points out that just because you might be physically ready doesn’t mean you need to have sex.

“There are emotional and practical considerations and you’re the ultimate expert,” O’Reilly says.

What to do while you wait

Rather than count the days, remember you can still be intimate without intercourse.

READ MORE: A family therapist’s 8 secrets to a happy and lasting relationship

She encourages women to ask their doctor when they can get back to a fitness routine, because studies show “exercise is essential to boosting your mood, improving your sexual response, increasing energy levels, promoting restful sleep and of course, revving up your libido.”

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Post-baby pain

Hall warns that when couples do feel ready to have sex again, they should be cautious about certain positions. Missionary may not be the most comfortable at first.

Partners should be mindful as well that breastfeeding can make a woman’s breasts super sensitive and contribute to vaginal dryness. Applying nipple cream or lubrication could be one way to sexually connect, though, Hall suggests.

READ MORE: ‘It felt like we were going rogue’ says mom who let friend breastfeed her baby

Gynecologist Jennifer Gunter writes that sex can sometimes be more painful for breastfeeding women due to:

  • Low estrogen (which can be remedied through a small amount of vaginal estrogen if lube doesn’t work).
  • Problems with the scar (which should be evaluated if it hasn’t healed by eight weeks).
  • Muscle spasm associated with pelvic floor muscles.

Those can be tightened and toned through Kegels. They can also help with post-pregnancy incontinence — something even Chrissy Tiegen confessed she struggled with.

READ MORE: Vagina Pilates? What you need to know about pelvic floor physiotherapy

Can sex ever be better after childbirth?

O’Reilly says almost every couple she meets finds that sex declines — in both quantity and quality — once kids are born, especially in the early years.

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But that’s definitely not always the case. Some women have told her “they’re more sensitive and aware of their pelvic region post-childbirth.”

One British parenting site found nearly 60 per cent of 1,000 parents surveyed believed sex improved after childbirth.

While it may seem like an urban legend (that experts can’t really explain), there are plenty of online testimonials to back up the phenomenon.

“I rarely reached [orgasm] before and it was a lot of work … and never from intercourse,” Jamie B. wrote on the Mothering forum. “Now it happens from intercourse every time, without a lot of effort.”

She added her sex drive “is through the roof,” as a result.

Other women echoed her experience, saying their G-spot was more easily stimulated after childbirth.

“I also feel sexier, even though I have some stretch marks, I feel more self-confident after having a child,” one woman added.

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“Everything utterly totally wonderful despite what media tells us about needing to be tight and neat,” another user wrote.

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“Things are not like they were before giving birth at all but in the most wonderful way.”

SOUND OFF: Did your sex life improve after you had a baby? Share your story with us through the contact form below.

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