Returning To Intimacy After Birth
Women's Healtth Physiotherapy Advice
Remember
- This is the "fourth trimester!"
- Pregnancy and childbirth takes an enormous toll on your body.
- Consider the postnatal period a rehabilitation process from the inside out. You need to lay good foundations to achieve your long term goals
Purpose
To know what is 'normal' to you, and being aware of any changes you notice that can be discussed with me at your 4 - week review
Considering Contraception?
It is a myth that you can't get pregnant while breastfeeding! Speak to your doctor about your options for contraception.
Returning to intimacy is a personal decision and different for each couple. Due to physical and emotional exhaustion, a women’s desire to be intimate can be varied and quite different to pre-birth.
At a very minimum, you need to wait until your 6 week check up with your doctor to return to sexual intercourse.
Postnatal Depression
1/4 women, and 1/10 men can experience PND. Be alert for signs and symptoms of postpartum depression — such as severe mood swings, loss of appetite, overwhelming fatigue and lack of joy in life. If you think you might have postpartum depression, contact your health care provider. Prompt treatment can speed recovery.
Further Info
Read the following handouts in your link:
- DRAM Recovery
- Back & Pelvic Care After Birth
- Pelvic Floor Exercises
- Healthy Bladder & Bowel Habits
- Returning to Exercise After Birth
92% of women will experience discomfort, or even pain the first time they have intercourse after having a baby. Fatigue, vaginal dryness, breastfeeding, low sexual desire and tissues that are still healing can all be the cause.
What Happens During Arousal And Intercourse
Understanding how the vagina, clitoris, state of arousal and how your body produces its own lubrication will make a huge difference in returning to intimacy:
At rest, the length of the vagina is 4-6cm.
When you are aroused, the vagina lengthens up to 10cm, making it more comfortable for a penis to enter
The top of the vagina widens up to 6cm, while the muscles surrounding the lower 1/3rd of the vagina contract multiple times, building to an orgasm
The vaginal walls attract more blood flow which thicken them - in turn secreting the body's natural lubrication
After intercourse stops, or you have an orgasm, the width and length of the vaginal walls shrink back to normal
What to consider when returning to intercourse
The scene - intimacy doesn't have to start as soon as you hit the bedroom! Think about what usually gets you in the mood and share this with your partner - i.e. date night - a nice dinner, movie (not a scary one!), music, dim lights, touch, cuddling, etc. This will allow your body to relax and start the arousal process.
Lubrication - lubricants are highly recommended while you are not menstruating as your oestrogen levels will be very low causing vaginal dryness.
Water based lubricants, i.e. KY Jelly are not recommended if the vagina is dry, as it will reabsorb the water.
Oil - based lubricants are not recommended with condoms as they can break them! Silicone - based lubricants should not be used with silicone toys, as they can break down the outer layer of the toy. We recommend the brands Purj, Uber Lube, Yes and Wet Stuff.
Foreplay - nearly 60% of women cannot orgasm with vaginal intercourse or internal stimulation. Foreplay is essential for the vagina to prepare for intercourse. Clitoral stimulation is great foreplay to prepare for intercourse - it will bring more bloodflow to the vaginal walls, leading to more lubrication. It can take up to 30 - 45 minutes of foreplay for a woman to be fully aroused.
Common reasons to delay intimacy & sex post birth
Fatigue - it is normal to be very tired when caring for a newborn. Allow yourself a full recovery, as intimacy should be voluntary, enjoyable and pain - free. It can help to set time aside when you won't feel as tired or anxious.
Low sexual desire - There's more to intimacy than sex, especially when you're adjusting to life with a new baby. Until you're ready to have sex, maintain intimacy in other ways. Spend time together without the baby, even if it's just a few minutes in the morning.
Vaginal dryness - due to very low levels of oestrogen in the postnatal period (until you begin to menstruate), your vaginal tissue is thin and fragile and your natural lubrication is very low. This may cause the sensation of your vulva and the intensity of your orgasm to be reduced.
Pain - low oestrogen levels, an episiotomy scar, or even the positions you are having intercourse in can all be managed - speak to your Women's Health Physiotherapist to return to pain - free sex.
Remember your 4 - 6 week review with your physiotherapist to asses & monitor your
- Pelvic floor recovery
- C – section incision
- Exercises to close the abdominal separation
- Returning to exercise after birth
Disclaimer
Women are encouraged to discuss their health needs with a health practitioner. If you have concerns about your health, you should seek advice from your health care provider or if you require urgent care you should go to the nearest hospital Emergency Department.
Contact us
Performance Plus Womens Physiotherapy, 40 Lemana Crescent, Mount Waverley
03 9815 2555 (Main rooms)
