Postpartum Recovery: Exploring Intimacy After Giving Birth

 After nine months of growing a life inside your belly, you’ve delivered your baby and now you have a set of physical and mental changes to come to terms with during your postpartum recovery – including to your sex life. While you will definitely enjoy sex again, before you leap back into bed, here are some important things to understand about postpartum intimacy and what you can expect from your first time.

What To Expect After You’ve Expected

So what’s actually happening to your body after you’ve had your baby? “In the first week postpartum, your oestrogen and progesterone levels drop significantly, which can contribute to ‘baby blues’. During the same time, there is a surge of prolactin and oxytocin. These wild changes in hormones can lead to crazy emotions (irritability, mood swings, anxiety and sadness), so it’s important to understand that postpartum recovery is not only a physical experience,” explains Carren Hughes, a pelvic-health physiotherapist based in Johannesburg.

“It took 40 weeks for you to grow and produce this baby and during this time your body had to adapt in a variety of ways (circulation changes, postural adaptations, cardiac and respiratory changes, as well as pelvic-floor and perineal stretching), so it’s only fair that it should take time for it to heal and recover from both the pregnancy and the birth,” says Carren.

Your Intimacy Timeline

It is recommended that you wait at least six weeks before having sex again. “Whether you’ve had a Caesarean or vaginal delivery, almost all medical doctors and midwives suggest a healing period of this length. This is because of the risk of infection, as well as the trauma done to the vagina during childbirth,” explains Carren.

“There will have been significant stretching, tearing and bruising in the pelvic and perineal region during a vaginal delivery and moms who labour and end up with an emergency C-section also experience pressure and internal strain – which those who have opted for an elective C-section don’t – so they need more pelvic-floor and perineal care. If there was tearing during a vaginal birth, an episiotomy wound or scar can become painful due to nerve irritation and inflammation from the scar tissue,” says Carren. A C-section scar can also be painful and women who’ve had Caesareans can still experience perineal or pelvic pain when having sex. “There is nothing wrong with you. It’s quite normal and this is why a mom might need me. Overcoming pain or discomfort during sex does not need to take months and months of struggling alone,” Carren insists. 

Losing Your Postpartum Virginity

Even once you feel like you’ve healed physically, still prepare for things to have changed. “Sex will be different. You’ll feel different in yourself (emotionally and psychologically) and often post-NVD moms feel like their vagina is ‘looser’. Women can also experience vaginal dryness and perineal pain the first few times they have sex again.”

At first, you may not orgasm, even if in the past you were highly orgasmic, and “you may have little or no desire due to the impact of postnatal hormones and the pressure of looking after a baby while dealing with postpartum fatigue,” says Carren. “But you will absolutely enjoy sex again and your libido, desire and orgasms will improve, as time goes on.” Of course, every body is different, so how long it will take you to get your groove back depends on your body – every woman’s experience will be different because we all heal at a different rate.

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It’s also vital to speak to your partner so that they understand that things will take time to get back to the way they were. “It’s absolutely important for a new mom’s partner to have a good understanding of what she is going through physically and emotionally. Managing expectations is vital to a healthy relationship and a partner needs to know what physical changes have occurred and how their partner feels about it too,” explains Carren. “A few ways to prepare for the first time is to purchase a good lubricant, organise a helper, go out for a date night, make time for each other and start things off with a massage.

I encourage patients to buy the best lube they can and I always tell them that the first few occasions they have sex are likely to be disappointing. However, I remind them that this won’t last and this could be a special time to explore each other’s bodies again by working on foreplay and external stimulation during your road to Postpartum recovery. It’s important not to focus on intercourse alone.” A helpful tool could be a clitoral stimulator or any sex toy that arouses you.

Help Is At Hand

Apart from the changes that come from simply carrying and birthing a baby, there are a few complications that can arise from giving birth and it is here where pelvic-health physiotherapists, like Carren, also play an invaluable role. “Breast engorgement and cracked nipples, prolapse and pelvic and perineal pain are the most common things I treat in my patients, but I’m also able to help with pelvic-girdle pain, incontinence and rectus diastasis,” explains Carren. With two kids of her own, and her own postpartum recovery journey, Carren is passionate about changing lives and providing the right care and treatment to help women regain their confidence and health.