Let's get intimate...talking sex after baby

As a pelvic floor PT, I find my clients feel really unprepared for returning to intercourse after birth. Many women go to their 6 week postpartum visit, are told they can have sex, and feel COMPLETELY overwhelmed by this prospect. “You think I can do what?? Already?!” Though you’re often given the go ahead at 6 weeks, you may receive little advice about how to return to sex and it may feel taboo to ask your doctor about it. So let’s get into it! There’s basically nothing I won’t talk about...

1. It’s ok if you don’t feel ready. You and your body have been through A LOT. It is absolutely fine to wait longer. If your partner is mad about it, you can tell them I said so :). I’ll take the blame. Maybe you experienced a tear, have pain or prolapse, or you’re just EXHAUSTED. Wait until you’re ready. Please. Pushing through sex because you think you should can cause more pain.  
2. Start with something less...invasive. Your body is different and the way you feel about it is different too. Start with lower pressure sexuality and intimacy. Have an orgasm! Get creative with your partner, get to know your body again, and have a good, intimate experience externally first. Sexuality is not just about vaginal intercourse.
3. USE LUBRICANT. I cannot stress this enough. Postpartum, your estrogen level drops significantly. Especially if you’re breastfeeding, but even if you’re not. This drop in estrogen leads to more vaginal dryness, so lubricate! Lubricants are not created equal, so try a few options to find your favorite. Check reviews online or visit the very knowledgeable folks at Good Vibrations to get some advice. Many people love a good water based lubricant, like Slippery Stuff, which I use for exams. If a water based lube doesn’t last long enough for you and you have to keep reapplying, you may prefer a hybrid or silicone lubricant. Sliquid is a good quality brand with water based, hybrid, and silicone options.
4. Scar tissue massage is your friend! I know touching your scar, or even looking at it, may feel scary but getting it moving better can make a world of difference to comfort with intercourse. This goes for perineal OR c-section scars! Try working on your scar in the shower! It’s a great time to do it because your hands are already clean and your body is warm with good blood flow to your skin. If it’s your perineal scar you’re working on, put one foot up on the side of the tub to reach better. Put your fingers on either side of your scar and wiggle it gently, sliding it side to side, up/down, in circles etc. The point is not to push into heavy pain, you want gentle stretching only. No more than 4/10 on a discomfort scale. If it hurts too much, you won’t be able to relax, which defeats the purpose. Don’t forget to breathe!
5. Breastfeeding is not birth control!! There is a misconception (pun intended) out there that you can’t get pregnant if you’re breastfeeding. Some women don’t get their periods the entire time they’re breastfeeding, but others will. Because you ovulate before you get your period, and periods during this time can be irregular, you need to use a form of birth control! Unless your dream was always to have kids one year apart…
6. Don’t be surprised if you lactate during sex. I know...that’s something you didn’t expect. Arousal can lead to lactation, so you may get some leakage of milk during intercourse. Some women choose to wear a bra and nursing pads during sex if this bothers them.
7. See a pelvic floor PT! (That’s always my answer, right?) You might not have known we can help with this, but a pelvic floor exam can give you a better picture of what’s causing the problem with intercourse. Is it tight or sore muscles? Prolapse? Scar tissue? Let’s find out and give you recommendations tailored specifically for you!