Embracing Sex and Intimacy Postpartum
By Sherraine Miller, MA, ATR-P
The arrival of a new baby brings immense joy, awe, and—let's be for real—a fair share of craziness. You may have this weird foreign feeling of familiarity with your body. The idea of sex and intimacy could also be feeling like unchartered territory. You're likely trying to remember all the things at once, such as "When can I have sex?" and "Is it safe?" Those questions are likely compacted onto other questions about your body, baby, and more. However, as a mom, you should try to focus on this beautiful new time, which should focus on what you think and what feels right and comfortable for you.
Rediscovering Your Body: Permission to Feel and Heal
First and foremost, and if you haven't already, take time to acknowledge that your body has just accomplished something incredible. It has been a vessel of life and is now entering into nurture mode. Your body goes through a range of physical changes post-birth. Hormonal shifts, healing tissues, and the demands of caring for a newborn can all play a role. That tender, tired, and unrecognizable feeling is normal. And yeah, sex and intimacy can be affected. During those first several weeks, you may experience vaginal dryness, pelvic floor weakness, and being physically sensitive. Permit yourself to ask, "What do I need to feel comfortable in my body again?" Maybe that's rest, gentle stretching, a warm bath, or simply sitting with the sensations as they are without rushing to change them. Embrace each feeling as part of a compassionate dialogue with yourself.
Tailoring Postpartum Intimacy to Your Delivery
The type of delivery you had—whether vaginal or cesarean—can significantly shape your postpartum experience with intimacy. After a vaginal birth, perineal tears, episiotomy scars, and stretched pelvic floor muscles often make early postpartum sex uncomfortable. Many women feel tenderness, dryness (especially if breastfeeding), and tightness, all of which require gentle re-adjustment to sexual activity. Vaginal deliveries can sometimes lead to issues like pelvic organ prolapse, where organs such as the bladder or uterus drop slightly due to weakened pelvic floor muscles, causing discomfort or even pain during sex.
Meanwhile, cesarean deliveries leave abdominal incisions that need time to heal, making positions that put pressure on the stomach challenging at first. Although C-sections typically involve less vaginal trauma, the core muscles are affected, meaning regaining strength and comfort may take some time.
An increased risk of tearing or an episiotomy can occur if forceps or a vacuum are used during delivery. A tear or episiotomy adds to discomfort or prolonged healing in the perineal area. These interventions can cause bruising and swelling in the vaginal area, which may take longer to subside. This can make resuming sex challenging and potentially painful in the first few months.
Strengthening exercises, like Kegels, can help improve muscle tone and reduce discomfort. Core muscles take time to regain strength after a C-section, due to being impacted during surgery. This can affect your ability to hold certain positions comfortably. Gradually rebuilding core strength with gentle exercises, such as diaphragmatic breathing, as approved by your doctor, can be helpful.
Bleeding, known as lochia, is common after both vaginal and C-section deliveries. It can last for several weeks as the body heals, and for some individuals, it is essential to wait until the bleeding has stopped before resuming sexual activity. Waiting for it to stop allows time for tissues to heal fully and reduces the risk of infection. If bleeding resumes after starting sexual activity, it could be a signal to slow down and give your body more time. Always consult with your healthcare provider for guidance specific to your recovery.
When Will You Be Ready for Postpartum Sex
Healing after childbirth isn't just physical; it's deeply emotional. Your emotional readiness will be just as important. Often, doctors encourage waiting 6 weeks postpartum to promote initial healing, but everyone's timeline is unique to them.
Listen to your body: Feeling physically ready before emotionally ready is common (and vice versa), so take things at your own pace. Physical and emotional factors each play a role in readiness.
Open communication: Be willing to share and open up about how you feel with your partner. Share your concerns, anxieties, or desires. Create an environment that promotes understanding and patience.
Your body is still your own, even with the changes happening. You may have to consider fatigue, body image, and mental health in your readiness, too, so remember to take all the time you need to feel at ease in it again. Questions to consider asking yourself:
What parts of your body feel good to touch?
Which areas need more time and care?
By exploring these questions, you can gently reignite your connection to yourself and, over time, to intimacy with your partner.
Communicating Intimately: Little Conversations, Big Connections
Whether a first-time mom or seasoned, a new life means new and different responsibilities like late-night feedings mixed with a touch of sleep deprivation. Sexual desire often fluctuates as you battle the new responsibilities, in the same manner they may have fluctuated during pregnancy. Small gestures and gentle communication go a long way during this period. Intimacy is more than sex —it's closeness. Think about small acts of love and care you can do or share with your partner to expand non-sexual intimacy between you.
Mismatched libidos should not be a cause for concern, especially in the postpartum period. Whether it's a shared moment of laughter, a lingering kiss, a hug, holding hands, or a meaningful gaze, these acts of intimacy can renew closeness when time and energy for more may feel sparse.
Comfort during this time may look and feel different than it did 10 months prior; therefore, checking in with yourself about comfort levels will be necessary. Remember that your partner may also have feelings about this new chapter, so conversations related to desires and comfort levels can bridge any gaps in intimacy and help you each navigate the journey together.
Finding the Right Positions Postpartum
When you're ready to resume sex, certain positions may feel more comfortable than others. Positions like side-lying in the spooning position can be more relaxed because there is less pressure on the abdomen and pelvis. Side-lying is relaxing and gentle and allows for closeness between partners without intense physical movement. With some unique adjustments, using pillows for body support may feel good. Face-to-face side-lying is also a slower, more intimate position that avoids putting pressure on your stomach or pelvis. A pillow between the knees can offer support in this position, too.
Try an edge of the bed position (missionary variation) by lying on your back close to the edge while your partner kneels or stands in front of you, allowing for control of depth and movement. This position reduces pelvic pressure, making it easy to change pace or stop as needed. A pillow beneath your lower back can provide additional support here as well. Another modified missionary position to try is having your legs resting on the bed around your partner's hips (as opposed to lifted) to help reduce strain. No intense physical movement or stretching is required with this modification, and it also allows for closeness.
If things are feeling good sexually and you want to try being on top, a cowgirl variation could be a position to bring back to the bedroom. Like traditional cowgirl, you're on top, but leaning forward slightly, keeping movements slow and shallow. This variation gives you the control, which can help you avoid discomfort. Only go as deep as what feels good. A reclined position where your partner sits up just slightly can provide additional support.
There are many ways to modify positions to suit your needs. Ultimately, you'll want to emphasize tactics that either reduce pelvic pressure, allow you more control, or both. Partners being in seated or chair positions, or reverse spooning are additional examples to try and modify for comfort. As mentioned earlier, postpartum hormonal changes and breastfeeding cause dryness, so extra lubrication may be needed. Being gentle and moving slowly is key. Figuring out what works best may require some trial and error while healing, but the results will be worth it.
Be curious about what brings you warmth and pleasure now, and let go of any expectations about "how it should be." You might ask yourself, "What am I open to experiencing today?" and embrace even the smallest sparks. Intimacy can start with a simple touch or massage—there's no rush. Small steps that feel right for you can help create a new foundation for intimacy without pressure.
If penetrative sex feels intimidating, take it off the table for now and instead enjoy gentle, non-penetrative touch or sensual moments together. Being patient with yourself gives your body and emotions space to realign, helping you naturally find what feels good over time.
Mental Health and Sexuality Postpartum
Postpartum depression, anxiety, or other mental health issues can add to the complexity of the postpartum period. Challenges such as these are impactful to your sexual desires and overall sense of intimacy. Much like pregnancy, our confidence in our bodies may fluctuate, and physical changes can impact how you feel about yourself. Getting back to a level of confidence with your body can take time, and it's okay to be honest with your partner about any insecurities. Seek support if mental health challenges become overwhelming. Postpartum depression and anxiety are treatable, and support can make a difference in your relationship as well as your overall well-being.
Building a New Rhythm Together
With motherhood comes new emotional bonds, especially through caregiving and breastfeeding. Our emotional priorities can shift, particularly towards baby, resulting in less urgency to be intimate with your partner. Embracing postpartum intimacy can be about creating a rhythm that honors your and your partner's needs. It's okay if sexual intimacy isn't a top priority immediately postpartum. Allow yourself the grace to grow into this new role without pressuring yourself. Additionally, talking to your partner and addressing the adjustments you are navigating can feel supportive.
Grace, self-awareness, tenderness, and communication are your guides in this new and evolving chapter. Embrace ideas that encourage soft, subtle styles of intimacy. Ask your partner, "How can we make this journey our own?" The answers may surprise you and bring you closer in ways beyond the physical.
Caring for Your Pelvic Floor
During postpartum sex, pelvic floor health is essential. For many, strengthening the pelvic floor muscles through gentle exercises or therapy can significantly improve physical comfort and sensation. Try exploring pelvic floor therapy, where you can work with a physical therapist trained in postpartum recovery. Your therapist can provide you with tailored exercises that support healing and improve comfort during sex. Pain during sex is common and addressable. Discuss your discomforts with your healthcare providers to help you identify solutions and increase overall sexual well-being.
Contraception and Birth Control After Pregnancy
Fertility returns soon after birth, even if you're breastfeeding, so remember to consider any contraceptive options if you're not ready for another pregnancy. Chat about options with your healthcare provider so you can make informed decisions and choose a method in alignment with your health and readiness for sex.
The most important takeaway is for you to make the right decisions, give yourself grace, and communicate your needs effectively. Motherhood is a season that starts with so many unknowns and will always require growth and rediscovery. Honor yourself and your well-being as a whole person —someone who is both a parent and a partner, a giver and a receiver, a friend to yourself, and a lover of life in its fullness. Here's to a journey that's as unique, beautiful, and evolving as you are.
