Article courtesy of Mendwell Pelvic Health

With all of the flowers, cards and candies around, it’s easy to get swept up in the romanticizing of Valentine’s Day. That is until your mind wanders to things like lingerie, which may be the last thing you want to put on after giving birth. Between the sleepless nights, feeding sessions, household chores and recovery, the thought of even wearing “real clothes” and going to store to buy a Valentine’s Day card can seem like a long shot. 

Commercial expectations may add pressure to being intimate. Having a healthy physical relationship with your partner and self is a crucial part of maintaining physical and mental health, but it can be hard to focus on being intimate when navigating the postpartum. With hormones changing, feeling “touched out,” and overall exhaustion, it can be challenging to find the time and space to be intimate. And to add to it all, sex after birth can be painful! Pain with intercourse (dyspareunia) is a very common challenge most birthing people experience postpartum, but that doesn’t mean it has to be a part of your “new normal.” 

Why Is Postpartum Sex Painful For Some People?

There are a number of reasons why many people begin experiencing dyspareunia after giving birth. A few of the most common include:

Increased Pelvic Floor Tension 

During pregnancy, your pelvic floor is experiencing an increased amount of pressure for extended period of time. Makes sense given you just grew a baby inside your belly for 9 months! Often times, your pelvic floor creates tension as it holds patterns to adjust for the increased weight of the baby. With increased tension, it can make insertion difficult and even painful. The muscles in your pelvic floor need retraining and time to get them back to a normal resting tone after the baby is born.

Hormonal Dryness

Your body reacts to systemic changes resulting from pregnancy, including hormones. Remember how pregnancy hormones felt? Postpartum, hormones shift again which can lead to vaginal dryness. In the bedroom that can translate to more friction and even pain. 

Tearing & Scarring 

Depending on the type of birth you experienced, pain may look different. If you experienced a vaginal birth, the body has undergone a major exercise, and potentially trauma, especially if any tearing occurred during the birth. In a cesarean birth, you’ve undergone a major surgery and your tissue needs time to heal, otherwise the scar tissue can develop increased sensitivity. In both cases, the best advice we give birthing people is to slow down. Give your body time to heal! A six-week postpartum clearance usually doesn’t take into account the tissue and muscle strength, weakness and healing process. And it certainly is not a green light that your body is healed and ready for sex – only you can decide that. Often times, waiting until at least around eight weeks postpartum is more realistic for some, whereas for others it could even be months. Remember, it should be on your timeline when you’re ready - do not rush intimacy or sex. Take it at a pace your mind and body are comfortable with. 

I’m Mentally Ready to be Intimate again... Now What?

If you feel mentally ready, there are ways that you can physically prepare your body to be intimate to reduce pain:

See a Pelvic Physical Therapist 

After you’re cleared by OB/midwife around six weeks, see a pelvic floor physical therapist to assess your pelvic floor and core and make sure everything is healing correctly. OBs/midwives are wonderful at checking to make sure your organs are healing; pelvic floor physical therapists are the musculoskeletal experts that assess your muscles, tissues and nerves to make sure you are not leaking, experiencing prolapse or pain (at all) after having a baby.

Use Open Communication and Level-set Expectations

With yourself and partner. Ensure that both you and your partner are on the same page in regards to what is comfortable and what is not with intimacy. Setting clear expectations up front (or acknowledging that there are no expectations!) will help ease you back into intimacy with your partner.

Lubrication 

Use lube as needed to help reduce friction with vaginal dryness. Lube can be water-based, oil-based, silicone-based and more, so have fun exploring what feels best for your body! As a side-note we always recommend staying away from the sparkles and scents when choosing a lube.

Dilators

Dilators are a tool that in some cases can be used postpartum to work muscles. They are not necessary for everyone, but can be a tool to consult with your pelvic health physical therapist to determine whether they’re right for you based on your pelvic floor muscles and needs.

Scar Work 

If you had a cesarean birth, once your incision has healed (no more scabs and clearly no sign of infection) begin to gently start touching and moving your scar. It’s important to progress to gently picking it up, rolling it and getting the scar to move in all directions to improve tissue mobility, reduce sensitivity, and improve overall function of the tissues. This will decrease pain when having sex by allowing your core muscles to function properly and helping reduce sensitivity with friction. 

All of that being said, intimacy comes in different forms. Don’t worry if you’re not yet ready for vaginal intercourse in your postpartum journey. This is your journey to take at your own pace. Just know that there are tools and resources to help you. You are not alone. 

At Mendwell Pelvic Health, our specialized physical therapists would love to be a part of your postpartum journey and get you back to being intimate and being able to feel your best in all aspects of life. For a free consultation to see if pelvic floor physical therapy could be right for you, feel free to visit our website, email or give us a call to schedule: 503.794.9360. To learn more, follow us on Instagram.

As a partner of Bridgetown Baby, we provide $50 off an evaluation for patients who reference Bridgetown Baby when speaking to our therapists.