Medically reviewed in January 2022
Updated on July 7, 2022
When you have a brand-new baby in the house, your sense of time may become warped as the line between night and day is blurred by a steady rhythm of feedings and diaper changes. For your partner, though, there is likely one date circled in red on the calendar: your postpartum checkup. That’s when, if all goes well, your healthcare provider (HCP) will give you the green light to have sex again.
Wait, hold on, sex?
“There are many reasons—both physical and emotional—why a new mom may have very little interest in sex,” says Kimberly Larson-Ohlsen, MD, an OBGYN at The Medical Center of Aurora in Colorado. Six weeks is definitely not a magic moment when all systems are go again for all women, she adds. After delivery, new mothers should take their time, get plenty of self-care, and communicate with their partner.
That said, consider these common post-baby intimacy barriers, plus the healthy strategies that could help you manage them.
Allow your body to recover
If you required an episiotomy or had any tears in your perineum during childbirth, it can take from six weeks to several months to heal. But even after your HCP has examined your lacerations and declared you good as new, you may feel anxious about using that part of your body again.
“It’s very important to have adequate foreplay,” says Dr. Larson-Ohlsen, who recommends easing the way with plenty of lubricant and going very slowly. Taking a warm bath, emptying your bladder, and taking over-the-counter pain relievers before you get started can also help.
Pregnancy and childbirth can also stretch and weaken your pelvic floor muscles, making sex uncomfortable and increasing the likelihood that you will leak urine, which can dampen the romantic mood. To get those pelvic muscles back into shape, practice Kegels:
- Squeeze the muscles of your pelvic floor by pretending you’re holding in urine.
- Hold for three seconds, then release for three seconds.
- Repeat this exercise three times daily, gradually increasing how long you hold the contraction.
“The first time having sex may not be as comfortable or as wonderful as you remember, but it will definitely get better over time,” Larson-Ohlsen points out. This is also a great time for you and your partner to explore other types of intimacy, such as massages, oral sex—even making out like teenagers.
Ride out the hormonal rollercoaster
During pregnancy, your body produces much more estrogen and progesterone. Levels of these hormones drop very quickly after delivery, within the first 24 hours.
This dramatic hormonal shift can trigger mood swings. Combined with the sleep deprivation, physical discomfort, and emotional strain that many new moms face, it could not only leave you feeling uninterested in sex but also contribute to postpartum depression (PPD).
Up to 75 percent of women experience a temporary case of the “baby blues,” and 15 percent will go through a more severe case of PPD.
Unlike the worry, fatigue, and unhappiness of the baby blues that most new mothers experience, PPD symptoms are more severe and can linger and affect a woman’s ability to take care of herself and her baby. These serious symptoms include:
- Crying more frequently or for unexplained reasons
- Feeling very sad, hopeless, or empty
- Feeling overly worried, irritable, or anxious
- Having trouble concentrating or making decisions
- Feeling enraged, angry, or inadequate
- Avoiding friends or family members and losing interest in once enjoyable activities
- Sleeping too much or not enough, even when the baby is asleep
- Having thoughts of self-harm or hurting baby
If you’re experiencing any of these warning signs, talk to your HCP right away.
Aside from your mood, the drop in hormone levels after delivery can also lead to some physical changes, which could affect your desire to be intimate, Larson-Ohlsen points out.
There is less moisture in your vagina, and the vaginal walls become thinner, often making it more painful to have intercourse, she explains. In this case, consider using water-based lubricants, available without prescription in most drugstores.
If those aren’t sufficient, ask your HCP about using a topical estrogen cream or vaginal moisturizer. These treatments can pump up the moisture in the vagina, decreasing friction and making everything slide in more smoothly, according to Larson-Ohlsen. But remember these physical issues should resolve once your hormones stabilize and return to normal levels, she adds.
Consider your birth control options
Taking care of one small, helpless human being can be challenging enough—and the thought of having another one right away can be enough to make you take a temporary vow of celibacy. But discussing birth control options could help you relax and feel more comfortable with the idea of resuming your sex life.
“We can put in an IUD or birth control implant while you’re still in the hospital postpartum,” says Larson-Ohlsen.
The American College of Obstetricians and Gynecologists recommends that when possible, IUDs be placed while new mothers are still in the delivery room. Although this increases the risk for expulsion, or the IUD falling out of place in the uterus, it’s still the most effective way to prevent unintended pregnancies, especially among women who may not go to their postpartum follow up visit.
Other new-mom options include progestin-only birth-control pills, the shot (Depo-Provera), the implant (Nexplanon), and condoms. And remember: Though breast-feeding exclusively (meaning at least every four hours during the day and every six hours at night, without supplementing with formula) is up to 98 percent effective as a form of birth control for up to six months if you haven’t started menstruating again, it is not foolproof.
Reach out for help so you can rest
When you finally fall into bed at night, and the most wonderful thing you can imagine is a few sweet hours of uninterrupted sleep, trying to stay awake for some nighttime nookie may not be at the top of your to-do list. “You’re so fatigued as a new mom, that could really lower your desire,” Larson-Ohlsen says.
Talk to your partner and your family about getting the support you need. “It can take a village to make this happen,” she notes. “Can your partner help feed the baby in the middle of the night? Is there someone who can watch the baby for a few hours during the day so you can have some me time, where you just don’t have any responsibilities and can just relax?”
Find time for self-care
In addition to exhaustion, there are many reasons you may not feel like your pre-baby sexy self. You spend half the day covered in spit-up, you’re still carrying around extra weight, and you barely have time to comb your hair, much less put on makeup or find a pair of jeans that fit. And as much as you love your partner, it can be a challenge to feel romantic right now.
“You may be super-stressed because you’re responsible for this new baby, and if your social, physical, and emotional needs aren’t being met, it’s really hard to feel that desire to be intimate,” Larson-Ohlsen says.
If you can set aside some time to walk or be physically active and de-stress, it may have a positive effect on your libido. Regular exercise and strength training could help improve your mood and your post-baby body image.
“No matter how you think you look, your partner probably thinks you look beautiful,” Larson-Ohlsen says. “After all, you just gave birth to your baby. If you can get into a mindset of taking care of yourself and having someone take care of the baby so you can dress up and go out, that can really help.”
And keep in mind that it does get better. After all, how do you think all those younger siblings arrived?
