Introduction to sexuality after childbirth

Most women experience considerable sexual changes following childbirth. This is completely normal. In this period, hormone levels change and women experience new emotions, demands and responsibilities as a result of being a mother. This can influence how much women feel like having sex, how often they have it, and how much they enjoy it. Men experience lifestyle changes which can influence their sex drive after their partner gives birth.

Changes in sexuality after childbirth are common, but few women discuss them and many have questions about when they should have sex, why they do or do not feel like having sex, and why they experience sex differently after childbirth.


When is intercourse safe?

Sexuality after childbirthTraditionally, it was recommended that a woman shouldn’t engage in penetrative sex for six weeks after childbirth. Current recommendations are that women need only wait two weeks to resume sexual activity. The increased risk of infection, bleeding and pain associated with childbirth diminishes after two weeks. However, women who experienced tearing or underwent episiotomy may still be healing at this point and should wait some more.

Check with a health professional if you’re uncertain whether it is safe to resume sexual activity.


Pregnancy and contraception

While sex is generally safe after two weeks, you can fall pregnant (even if you’re breastfeeding) and contract sexually transmitted infections. Even if you want another child, it is recommended that you wait at least a year before falling pregnant again. To prevent pregnancy, many women choose to use condoms, which also protect against sexually transmitted infections. There are also hormonal contraceptives which are safe to take immediately after childbirth, even if you’re breast feeding.

Talk to a health professional for further advice.


Changes in libido

For about a year after childbirth, women experience lower libido compared to before their pregnancy, especially in the initial 4-6 weeks. One Australian study found that less than 20% of women were sexually active four weeks after childbirth. There is no “normal” or “right” time to return to sexual activity – it depends entirely on how you and your partner feel.

During the initial 4-6 weeks, most women are tired, emotional and in pain. Levels of the hormones oestrogen and progesterone drop considerably, and the vagina produces less natural lubrication as a result. Because of this, many women feel less sexual desire and experience pain during intercourse. On average, women also report being less satisfied with sex.

Breastfeeding women’s hormones are affected for the period they are feeding. In non-breastfeeding women, hormone levels stabilise 4-6 weeks after childbirth.

Even after hormone levels have returned to normal, most women still report their sex drive is lower than before pregnancy because of emotional issues. For example, first time mothers in Melbourne reported that, on average, their sex drive was lower and they engaged in sexual intercourse less frequently in the six months after child birth than they did before falling pregnant. Many women feel tired, take time to adjust to the mother role, experience dissatisfaction with their relationship, are selfconscious about the changes in their body and/or suffer from postnatal depression. These emotions generally reduce women’s libido.

Men’s libido may also change after their partner has given birth. In some men libido increases, perhaps because they are attracted by the physical changes in their partners body or because they are happy about the birth of the child. However, men also experience decreases in libido, perhaps because, for example, they are worried about causing their partner pain or are uncomfortable having sex with the new baby around.


Importance of communication

Whatever you and your partner are feeling, it is important that you talk about it. Talk to your partner about physical changes, how it feels to have sex or be intimate now, and any concerns you may have about resuming sexual activity. This may be uncomfortable at first, but if you haven’t discussed these things, your partner probably wants to talk about them just as much as you do! If you feel comfortable, talk to friends or family members who have children (whether they’re men or women, it’s likely that their sexuality changed after childbirth) and be sure to speak to a doctor or other professional if you have concerns.


Tips for returning to sexual activity

Talking is the most important thing you can do to return your sex life to normal, but you should also remember:

  • Don’t force yourself to have sex too soon. If either you or your partner don’t feel like it, you should wait.
  • Be intimate. Spend time kissing and cuddling, or just being close to each other, and you’re much more likely to become aroused.
  • Spend time together with your baby, but also make sure you and your partner have time alone without the baby.
  • When you’re ready to, have sex! But remember that you can get pregnant (even if you’re breastfeeding) and contract sexually transmitted infections, so take care.
  • Make sure you have water-based lubricant handy.
  • Make sure you have time and privacy to focus on sex. You are unlikely to feel like sex if your baby is screaming in the background.
  • Experiment with a range of different sexual positions. A woman may prefer to start on top, so that she can control the intensity of penetration. Whatever you choose, make sure it is comfortable and remember you can stop.
  • If at first you don’t succeed, try again! Don’t forget to talk to your partner about how you felt having sex.

 

References

  1. Rowland M, Foxcraft L, Hopman WL, Patel R. Breastfeeding and sexuality immediately post partum. Can Fam Physician. 2005; 51(10): 1367.
  2. De Judicibus MA, McCabe MP. Psychological factors and the sexuality of pregnant and postpartum women. J Sex Res. 2004; 39(2): 94-103.
  3. Pavone ME, Purinton SC, Peterson SM. Chapter 20: Post partum care and breastfeeding. In: Fortner KB, et al [eds]. The Johns Hopkins Manual of Gynecology and Obstetrics. Lippincott Williams & Wilkins: 2007. pp. 245-53.
  4. LaMarre AK, Paterson LQ, Gorzalka BB. Breastfeeding and postpartum maternal sexual functioning: A review. Can J Hum Sex. 2003; 13(3): 151-68.
  5. Connolly AM, Thorpe J, Pahel L. The effects of pregnancy and childbirth on postpartum sexual function. Int Urogynecol J. 2005; 16(4): 263-7.
  6. Hollander D. Postpartum sexual problems are similar for depressed and nondepressed women, but prevalence differs. Perspect Sex Reprod Health. 2004; 36(3): 135.
  7. Hyde JS, DeLamater JD, Plant EA, Byrd JM. Sexuality during pregnancy and the year postpartum. J Sex Res. 1996; 33(2): 143-51.

All content and media on the HealthEngine Blog is created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition. Never disregard the advice of a medical professional, or delay in seeking it because of something you have read on this Website. If you think you may have a medical emergency, call your doctor, go to the nearest hospital emergency department, or call the emergency services immediately.