The six-week checkup after having a baby is a standard yet important appointment to keep. The doctor will tell you when you can go back to work, whether your cesarean section (C-section) incision is healing, and – at the top of many women’s list – whether it’s OK to have sex again. But let’s set one thing straight: The six-week-visit not a set deadline at which your breasts, vagina, and sexual desire will magically return to normal. This checkup is associated with resuming intimacy only because it’s usually the first time you’ll see your Ob/Gyn after your baby is born. Some women are raring to go four weeks after delivery; others need as long as 12 weeks until they feel comfortable having sex again. Every woman is different, and so is every childbirth experience. However, many women feel like something is wrong with them if they aren’t in the mood much, or at all, during the postpartum period. Having a baby changes your body and your life in many ways. It only makes sense that your sexual desire will change, too. We’ve compiled five concerns our patients commonly raise about sex and pregnancy, as well as signs that it’s time to call the doctor.
“The six-week visit is not a set deadline at which your breasts, vagina, and sexual desire will magically return to normal. This checkup is associated with resuming intimacy only because it’s usually the first time you’ll see your Ob/Gyn after your baby is born.”
5 concerns about sex after pregnancy
1. “Sex sounds more painful than pleasurable right now.”
A 2019 study published in Culture, Health & Sexuality found that fatigue, vaginal dryness, and fear of painful sex were common in the first six weeks to six months after delivery. Pelvic or abdominal pain associated with vaginal tears from childbirth or from the C-section incision can cause new mothers to have zero interest in sex. Women who are breastfeeding often experience breast leakage or tenderness and vaginal dryness due to hormone changes. Helpful tip: Don’t rush into sex just because you feel like you should. Sex should be enjoyable, so give your body time to heal. After all, you just brought a human into the world, and that’s a lot of work!
2. “I don’t feel sexy. Like, at all.”
Pregnancy and childbirth change the body in sometimes unexpected ways. You might have leaking breasts or loose belly skin, which can cause decreased self-image and diminished sexual desire. Some women say their vagina feels like a gaping hole, and they worry that their partner will not enjoy intercourse (which is highly unlikely). Helpful tip: Focus on attributes that haven’t changed, such as your sparkling eyes, flowing hair, or sense of humor. Remember that “different” doesn’t mean “bad.” Weight can be lost, and your vagina will feel normal again soon. Also, partners: Remember that compliments can go a long way toward helping a woman regain her self-confidence.
3. “I’m way too tired to even think about sex.”
Fatigue is common for new moms, especially if you try to tackle too many responsibilities on your own. You will become exhausted if you take on all the housework and the needs of older children while caring for a newborn on a sporadic eating/sleeping schedule. Burning the candle at both ends can leave little energy or desire for sex. Helpful tip: Accept help when it’s offered; if it’s not offered, delegate! You need to rest for your own health and so you can care for the baby. If you allow yourself to rest, your sexual desire is more likely to return sooner.
4. “Sex isn’t a priority.”
You might feel like intimacy should take a back seat to motherhood rather than having both roles coexisting in your life. As such, the dynamics of your relationship with your partner can change, especially when one party does much more or much less housework. That shift can drive a wedge and reduce sexual desire. Helpful tip: Have a frank conversation with your doctor and your partner about your feelings. While your role as a mother is life-changing, it’s important to take time for the people and activities you enjoy. Your partner can help by taking on some of your household responsibilities and supporting you as you adjust to your new life together.
5. “I’m scared and down, and I just don’t feel up to sex.”
Traumatic pregnancy or birth experiences such as severe preeclampsia, a lengthy delivery, or an emergency C-section can cause fear of getting pregnant again. This can lead to avoiding sex. Also, having the “baby blues” (mild, acute) or postpartum depression (serious, longer-term) can reduce your interest in many favorite activities, from socializing with friends to intimacy with your partner. Helpful tip: Talk to your doctor about your concerns. We can help get to the root of the issue and connect you with effective treatment. Partners should keep an eye on new moms for symptoms of postpartum depression, which can include apathy, extreme fatigue, excessive tearfulness, or talk of/attempts at harming herself or the baby.
When to call the doctor
If you notice physical symptoms along with a lack of desire – such as vaginal bleeding, vaginal discharge, or pelvic or abdominal pain – visit your Ob/Gyn to find out what is going on. You might have an unhealed vaginal tear or an infection that we can treat. If your sexual desire or body image doesn’t begin to return by 12 weeks after delivery, talk to your doctor. The root of your issue might be a psychological concern that we can help you overcome with treatment. Don’t be embarrassed to talk to your Ob/Gyn about your sexual desire – or lack thereof. Enjoying sex is a normal, healthy part of womanhood, and we are here to help you feel like yourself again.
This article was previously published here
Shivani Patel is an Assistant Professor in the Department of Obstetrics and Gynecology at UT Southwestern Medical Center in Dallas. She specializes in maternal-fetal medicine.