Postpartum Sex
What do you know about postpartum sex??? When I ask that question, I often get an answer about “you should wait 6 weeks.” Unfortunately, there is NO medical reason to wait this arbitrary 6 weeks. Plus, it’s missing the point!!!! Some people are raring to go right away, & others choose to wait 6 months or a year to return to vaginal penetration after giving birth. All of those things are NORMAL & there are so.many.factors that affect your decision to return to sexual activity.
Factors can be generally lumped into three categories, although often they overlap. Physical factors such as the type of delivery, if there’s pain with penetration, how exhausted you are/quality of sleep, & whether you are breastfeeding all affect postpartum sex. Psychological factors such as depressive symptoms (even in your partner), the transition to motherhood, your birth experience, & body image / body changes affect postpartum sex. Then there are external factors such as what situation you are in (how much familial and/or partner support you have, your age, expectations to return to work) as well as cultural beliefs around returning to sex.
None of these factors alone should drive your decision as to if/when you are ready to resume sexual activity. But knowing some things may help you give yourself some grace if you are NOT ready. Or give you the freedom to say “YES” if you are! See the point…. it’s ALL NORMAL.
Let me give you a few nuggets from the research in the past 5 years….
painful sex happens in 30-45% of postpartum mothers, is worst before 3 months & decreases over time (affected by episiotomy/repair, grades 3 & 4 perineal tears, & injuries to the anal sphincter)
while people report a FEAR of change in sexual function after vaginal delivery, a non traumatic, spontaneous vaginal birth results in the lowest rates of sexual dysfunction
C-section mamas have less chance for postpartum pain with sex, but higher chance for sexual dysfunction (change in desire, arousal, or orgasm)
exclusively breastfeeding MAY negatively affect sex for 4 months postpartum, but this is being debated
better partner support (actual AND perceived) help sexual function, but partners also are at risk of depressive symptoms in the 1st 3 months postpartum
Because postpartum visits to a healthcare provider in the US come between 2 and 8 weeks, and because less than 50% of mothers even attend these visits, only the very top concerns of the mothers are addressed. Some people do not even get a pelvic exam during this visit (gasp!), & most often the mother is not getting asked about sexual function &/or concerns.
My goal as a healthcare provider is to do better!!!! Feeling in control, actively giving consent for exams/treatment, & social support can all help. Giving accurate, clear information & addressing ALL of your concerns (big & small) is valid, important, and life-giving. Schedule with your pelvic