Pregnancy, birth and the postnatal period is a wild ride of emotions. Some of these emotions you may not be able to control (thank you hormones) and that’s okay. When it comes to intimacy after having a baby, it can leave you feeling unsure. Unsure how it will be when you resume sexual intercourse, unsure how you will feel about it, unsure of what your partner is thinking, unsure if it might hurt, unsure if you will get the time to even be intimate. These feelings and thoughts are normal.

During pregnancy, our rising oestrogen levels cause softening of ligaments and other structures in the body. This is a rapid change that can happen as soon as you see a positive result on your pregnancy test. This shift in hormonal makeup can cause an increase in the production of vaginal discharge you have. This isn’t necessarily a bad thing when it comes to intimacy as you will typically feel well lubricated. The increased hormones that flood through your body can have a powerful and positive impact on your libido.

When you deliver your baby, you will have a sudden drop in these love hormones, this happens almost instantaneously when your baby is born (hence, baby blues). You will also have a sudden drop in oestrogen, making your vaginal tissues feel very dry.

So mumma, you have a bit on, please don’t be too hard on yourself. When you go for your 6-week check up and the doctor says you’re ‘good to go’, you don’t have to resume sex at this point. They are simply telling you that if you want to have penetrative sex again, your perineal stitches or caesarean stitches have healed (and are still healing) enough to allow penetrative sex to occur.

Consider these 6 steps when resuming intimacy:

1. See a Women’s Health Physio – It is really important for your pelvic floor to be assessed internally (we use a single finger and get you to squeeze, relax and bear down) so we can assess for any weakness, tightness or increased sensitivity.

(Please note this is an option and there are other ways we can assess your pelvic floor if you do not wish to have the internal assessment done).

We can tell very quickly if you may experience discomfort during sex if your muscles are not relaxing. We will teach you how to relax your pelvic floor and give you some tips for when you’re-commence intercourse.

2. Look at yourself down there – Looking at yourself with a hand held mirror is really important to stay connected to your body. It’s normal for your vagina to look different, especially if you have a vaginal birth. If you avoid looking or touching your vagina (or your caesaraen section scar), the area can become very sensitive and you can become almost disconnected from your body.

3. Lubrication – This is the #1 most important thing you can do when you resume intimacy.

You will feel dry, your vaginal tissues will have some muscle wasting (we call this ‘atrophy’) and will appear thin and less ‘plump’ as they were, this is all normal. This doesn’t change if you have had a caesarean, same rules apply. When choosing a lubricant I recommend something natural like Olive and Bee (my personal favourite, not sponsored), it’s made out of Olive Oil and BeesWax (Olive Oil has an antibacterial and antiinflammatory effect) which is great for sensitive tissues.

Note – you can’t use oil based lubricant if you’re using condoms as they’re not compatible. If you’re using condoms, choose a water based lubricant like the “YES Water Based’ brand.

4. Mind over matter- If you are not relaxed, then your pelvic floor also won’t be relaxed and you might feel like you can’t ‘let go’ of the muscles to allow penetration. This can occur if you’re a little worried about resuming penetration. Don’t put pressure on yourself, you will be ready when the time is right. But also – foreplay before penetration helps.

5. Fear – If you’re putting off sex because let’s be honest, you’re tired, you’re busy looking after your baby, the house is a mess, you haven’t had a second for yourself in months – then that’s fine. If you’re putting off sex out of fear, this is where pain or increased sensitivity can happen. Talk to your Women’s Health Physio about how to overcome this fear.

6. Pain – When you have sex for the first time postpartum, it can feel like it’s the first time having sex again. It might be a little uncomfortable as you may be guarding (tightening up) with your pelvic floor muscles. This discomfort should not continue each time you have sex. If it does, please book an appointment with your Women’s Health Physio.

So ladies remember, you have just run a marathon, things take time. The postpartum phase is hard but always remember that you are not alone. Book in to see your Women’s Health Physio at the 6 week postpartum mark for a full assessment.

If you would like more free information about everything and anything pelvic health, please head to my Instagram page @femalephysioco.

You got this mumma x

Sarah Anderson
Women’s Health Physiotherapist & Director – Female Physio Co.