Painful Sex After Childbirth

Read the following caption in a cliche infomercial voice:

“If you or a loved one has had painful sex after childbirth, you should know that you are entitled to a better sex life. Painful intercourse is a common occurrence after child birth. Please don’t wait, read my blog today for free information! Are you having painful sex? Don’t wait, read now!” 

The last time I talked about sex after childbirth, regarding having a drier vagina, there was a huge response of women going “YEP!” Because, guess what, we all experience it and we all wonder about it and we all (mostly) stay quiet about it.

Painful sex after childbirth is a hugely important topic to address for your quality of life.

The First 6 Weeks After Giving Birth

Now, the standard rule after giving birth (vaginally or via cesarean) is to wait to have sexual intercourse (re: inserting anything into the vagina) for at least 6 weeks to allow time for healing of birth injuries and for your cervix to fully close. For some women, they are ready to go before then. For others, arguably the majority, it’s not enough time. Frankly, it can be very scary. I was definitely freaked out.

You will have one follow-up appointment, around six weeks postpartum, where your doctor will check in with you and determine if you are ready to “resume normal activities.” The majority of women are, unfortunately, given clearance at this time to resume exercising, sexual intercourse, and in general anything they were doing before giving birth. I have a post on Pelvic Floor Physical Therapy for Moms, check that out when you are finished here. My quick caveat here is that most women are NOT ready to resume normal activities, because their pelvic floor is NOT fully healed only 6 weeks postpartum.

You should most certainly, definitely, for sure get checked out by a pelvic floor physical therapist before resuming normal activities. How do you do that? You find one in your area that is within network for your insurance, and ask for a referral from your doctor!

Now, moving on to the juicy stuff, why do you have painful sex after giving birth?

There are a few different reasons why you may have pain with sex, here are a few of the common ones:

1. Vaginal dryness– You can read more about this topic on my other blog post Postpartum Sex. The hot tip here is to use lube with every sexual encounter. Your body has a harder time producing lubrication, because you have lower levels of estrogen, especially if you are nursing. Less estrogen = less lubrication = discomfort with sex
2. Scar tissue– If you had perineal tearing or an episiotomy, you likely will have some residual scar tissue that creates painful areas of tissue when you insert something into the vagina. Often times, scar tissue does not just go away, and certain sex positions may be more painful than others.
3. Overactive pelvic floor muscles– This happens when your pelvic floor muscles may be tightening when they are supposed to be relaxing.

What can you do about it?

Go see a pelvic floor physical therapist 🙂 … louder for the ones in the back: GO SEE A PELVIC FLOOR PHYSICAL THERAPIST.

Pelvic floor physical therapists are specially trained in pelvic health, which is all the things related to pregnancy, child birth, and postpartum recovery. They will complete a thorough evaluation of your medical history, ask about your birth experience and injuries, and ask about the symptoms you are experiencing. You may have other symptoms other than just painful sex. Hell, you may have other things going on that you didn’t even know about! They will create an individualized treatment plan to HEAL you safely and get you back to normal. Back to enjoying your sex life.

Why does it matter? Here are some facts for you.

• 85% of women report pain with sex the first time after giving birth
• 1 in 5 women will STILL HAVE PAIN WITH SEX 12 months after giving birth
• If you had internal or external injuries during child birth (like tearing or an episiotomy), you are at a higher risk of having pelvic floor dysfunction which may include pain with sex
• The internet will tell you to do Kegals. Please refrain from doing that until you have had an evaluation from a pelvic floor physical therapist. You may make your symptoms worse.
• Women who participate in pelvic floor rehabilitation experience less pain with sexual intercourse compared to women who do not receive therapy.
• If you gave birth via cesarean, you may likely still have pain with sex.
• Women who have pain with sex have increased risk of sexual dysfunction, anxiety, depression, relationship problems, and diminished quality of life.

All that to say ladies, you owe it to yourselves to ENJOY having sex with your partner again.

I’ve asked it before, and I’ll ask it again…

Can we all agree to take better care of our lady parts?

Related blog posts:

Postpartum Sex

Pelvic Floor Physical Therapy for Moms

And speaking of taking better care of your lady parts, don’t forget to read my post about The Fourth Trimester

Does this post resonate with anyone? Let me know in the comments below!