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Taboo Talk: Sex for the First Time After Baby

By Dr. Esther Lim, PT, DPT

· Postpartum,Sexual health,Pelvic Health,Pelvic Floor Physiotherapy

When is it safe to have sex after childbirth?

Most doctors give the go-ahead to have sex 6-8 weeks after vaginal or C-section delivery.

Allowing your body to heal before resuming sexual activity

Perineal tears typically about 4-6 weeks to heal, while lower abdominal C-section wounds take longer, or approximately 6-8 weeks.

Around the same time, at 6-8 weeks, the uterus would have returned to its original size, and the cervix would have closed.

I'm never having sex again!

Sex is often the last thing on anybody's mind during the newborn phase. Caring for a newborn is an overwhelming and exhausting experience. Mothers usually feel "touched out" from constant latching, pumping, burping, and soothing the baby to sleep. Co-parents or husbands are equally drained from their efforts to support and help out.

In addition to the lack of sleep, a women's body has now physically changed to support the needs of the baby. For example, women have lower estrogen levels after having a child, and levels don't return for up to a year, particularly while breastfeeding (Diorella et al., 2022). These hormonal changes can result in decreased sexual desire and libido.

So listen up new moms, if you're feeling of sync, acknowledge that there are biological factors that are outside of your control.

In addition, some women find it difficult to embrace the fact that their breasts now has two functions - for breastfeeding and sexual pleasure. As a result, women may downplay their sexuality and primarily identify themselves as a breastfeeding mother (Hipp et al., 2012).

Decrease sexual desire also affects men during the postpartum period. Research shows that men don't desire sex as much due to factors relating to caring for a newborn rather than mothers being disinterested in sex (van Anders, 2013).

By acknowledging and validating how difficult this period is by both men and women, parents or couples can better support one another during this transformative time.


Couples who share chores have more and better sex

Don't pass off those dirty dishes in the sink. It's a ticket to getting it on! Point being is that heterosexual couples that share household chores have sex more often. Dividing household duties creates a greater sense of satisfaction and fairness in a couple's relationship, which is reflected in many ways, one of them being sex (Carlson et al., 2016). Aside from having sex more often, mothers feel a greater sense of sexual enjoyment when they have supportive partners that help with the baby and child-rearing tasks (Hipp et al., 2012). 

Easing yourself back into sex

Sex is more than the act itself. It isn't a competition where we're to prove each other, or try hit a home run each time we get it on. It's a journey, and there are multiple ways to achieve the sense of closeness and intimacy that we crave without the traditional way of sex or penis in vagina kind of a situation.

If you don't feel like having sex, but miss the closeness. You could try non-sexual touching like hugging, exchanging massages, or taking a bath or shower together. You don't need to have sex to feel connected with your partner.

Neither should you feel pressured to have sex or think about it as an end goal. Esther Perel, a psychotherapist and New York Times best-selling author, suggests shifting our focus away from performance-driven sex and recognizing that sex isn't solely about achieving an orgasm. She wants us to expand the definition of sex, one that includes intimacy, eroticism, and sensuality. Ultimately, fostering fulfilling connections through the quality of the sexual experience, not the frequency and performance.

Also, Esther Perel reminds us that "love is not a permanent state of enthusiasm." Her working definition of love is that it is like the moon. The postpartum period is an example of a time when the moon has vanished, but rest assured that with practice, it gradually returns.

6 Practical tips for pain-free sex for the first time after childbirth

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1. Go slow and gentle: The postpartum period is an incredibly vulnerable time for everyone, remember to prioritize communication, mutual consent and trust whilst getting back into this intimate experience. Please be reassured that it is normal for the sex itself to feel strange and different for the first time after the baby.

2. Use a lubrication: Postpartum vaginal dryness is common and normal, especially for mothers who are breastfeeding. Adding lubrication can alleviate vaginal dryness during penetrative intercourse which allows sex to be more pleasurable.

Water-based lubricants are highly recommended, as they are compatible with all toys and condoms. They are widely available, and inexpensive.

Silicone-based lubricants are also highly recommended. They are long-lasting and best for for having sex in the shower or in the bath. Be careful about application, as they can feel "oily" and can stain sheets/clothes. They need to be washed off the skin with soap and water and might be slippery if they get on the floor.

Oil-based lubricants are not generally recommended, as they may disrupt the local vaginal flora.

Petroleum-based lubricants are not generally recommended, as they may irritate the vulva and increase the risk of a yeast infection or bacterial vaginosis.

3. Switch positions: It can be beneficial to explore different sexual positions where the woman or person with a vulva is in control of the rhythm and depth of penetration. For example, the person with a vulva can try being on top with their partner lying flat or straddling their partner who is sitting on a chair.

If deep penetration is challenging or uncomfortable, you can consider using an "oh-nut" which is a stackable silicone donut ring that you can place around the base of the penis. The donut ring will limit the depth of penetration during intercourse providing a more comfortable experience. It is a useful tool for couples looking to adjust the depth and intensity of penetration to ensure a more enjoyable and comfortable sexual experience.

4. Explore non-penetrative or external pleasure: Recognize that the majority of women and persons with vulvas require clitoral stimulation to achieve orgasm, as penetration alone may not be sufficient. Therefore, exploring non-penetrative or external pleasure can be beneficial.

Aside from external stimulation of the clitoris, the perineum is also an erogenous zone that contains many nerve endings that help with sexual arousal. You can get your partner to massage the area slowly or use external toys for stimulation

Remember, every individual is unique, so it's important to find what works best for you and your partner through open communication and experimentation.

5. Schedule in sex: While scheduled sex may sound boring, spontaneous sex in the early days of having a baby is nearly impossible due to childcare constraints. Seek help from a trusted caregiver, nanny, helper or grandparent(s) to take the baby outside of the house. Doing this can provide much-needed restorative baby-free couples time.

Scheduling in sex can also build anticipation and excitement. Couples can even take turns to set the mood. If the idea of having sex feels too intense, use the time to cuddle, watch movie, take a bath or shower together, or get some sleep—whatever suits YOU.

6. Gently massage or stretch the perineum
Perineal stretching is an exceptionally useful technique to ease into the activity itself. Think about it as a warm-up jog prior to a full run. Starting with a little foreplay, sexual arousal relaxes muscles around the vaginal opening. Afterward, you and your partner can consider this gentle manual technique:

6 Steps to warm-up the perineum:

1. Women: Lie propped up in bed with your sacrum flat against the bed. Partners: Gently part the labia with the non-dominant hand and find the posterior fourchette or V-shaped part at the bottom entrance of the vagina.

2. Take the clean, lubricated index finger of your dominant hand and lean into the fourchette or bottom tear-drop edge of the vagina. You should not feel any resistance. Ladies or vulva-owners, if needed, don't be shy, take your partner's hand and guide them through the process.

3. Insert the index finger to the depth of the first or second knuckle.

4. Apply downward pressure at the 6 o'clock position to lengthen the pelvic floor muscles. The amount of pressure to apply is as if checking the ripeness of a tomato.

5. Repeat the same technique at the 7 and 5 o'clock positions to gently relax all of the pelvic floor muscles.

*Do not swipe when moving from one position to the other. Swiping the finger is an aggressive soft tissue manual technique that pelvic health physiotherapist use. Instead, whilst moving to different clock positions, lift your finger away from the spot, rotate your finger by rotating your wrist as if turning a key, then apply pressure to the new location.

6. See the next section if you decide to try penetrative sex.

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This not the time to play "Pin the Tail on the Donkey"

Add a little finesse to your bedroom repetoire. The following is specific instructions on how to insert the penis in vagina with skillful precision to eliminate unwated discomfort for all vulva owners.

1. Try the woman-in-control position as mentioned above and use sufficient lubrication for added comfort.

2. One common mistake is blindly attempting penetration without being precise. Instead, gently part the labial folds and aim for the space slightly above the posterior fourchette or V-shaped part at bottom entrance of the vagina and lean into shiny, lubricated mucosal skin within the vagina. Why bother you might say? It matters because when blindly take stab at things, you might pull on the outer and inner labia that is keratinzed and "dry", the perineal scar may be dragged in for the ride, causing pain. Additionally, be mindful not to go too far upwards towards the pubic bone as it can lead to friction and chaffing at the urethra. The urethra is within the labial folds and immediately above the vagina. Too much friction around the area can push bacteria into the urinary tract, causing a bladder infection.

4.Take a slow and gradual approach, maintaining open communication with your partner throughout the experience. Listen to each other's needs, desires, and comfort levels for a mutally enjoyable experience.

Troubleshooting perineal pain and discomfort after sex

1. Wrap a thin towel around the icepack and place it over the groin area for 5-10 minutes to soothe vulvo-vaginal soressness after sex. You can ice the area through groin.

2. Apply an intimate balm to the inner labial folds of the vulva and the opening of the vagina to alleviate the burning and achy feeling. Please note that the balm is strictly for external use. The Medicine Mama's V-magic Vulvar Balm a natural and hormone-free solution, is no longer available on iHerb. However, you may find it on For hygiene reason, I highly recommend the pump bottle over the jar because you'll never double-dip. Once applied, this versatile balm works wonders and can also be used for vaginal dryness. If you know of alternative balms that are easily available locally, drop me a comment!

3. Using the shower head, run cool water from front to back to calm the external genital area. In addition, rinsing the area after sex cleanses the vulva/vaginal area to prevent a urinary tract infection.


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Debunking the myth of vaginal laxity after childbirth and sexual satisfaction

Women often express genuine concerns about vaginal laxity after childbirth, believing it to be the cause of low libido and sexual dissatisfaction. However, sexual satisfaction encompasses more than just penetrative sex. It's important to note that thinking the vagina is irreversibly stretched or damaged after giving birth is false. The truth is that the vagina is capable of recovery and designed to be dynamic. For example, the muscles of the pelvic floor actually stretch and relax during arousal and act like postural muscle, firing-first before we even get-up and move.

Patients and clients mistakenly think that a "tight" vagina is preferred. Unfortunately in most cases a hypertonic or tense pelvic floor can make achieving orgasm more challenging. It's essential to be cautious of vaginal tightening procedures, quick-fix 'Kegel' chairs, or trendy yoni eggs that promise a better sexual experience.

Final thoughts

Society places unrealistic beauty standards on mothers to 'bounce back' at 6 weeks or sooner after having a baby. Be kind to yourself and your partner. Speak and communicate with each other about your concerns. Only you and your partner will know when you're ready to have sex again, even if it's not for a long time.

Understand that having postpartum sex for the first time can be painful, strange, and even scary. However, with the techniques discussed above, you can ease discomfort and eventually enjoy pain-free sex. If you are experiencing persistent discomfort, it's highly recommended that you reach out to a specialist earlier rather than later to address these issues or receive reassurance that you're on the right track.

Your gynecologist or pelvic health physiotherapist can recommend solutions tailored to your specific needs. Remember, you are not alone, and seeking professional help is a proactive step towards reclaiming your sexual well-being


Carlson, D. L., Miller, A. J., Sassler, S., & Hanson, S. (2016). The Gendered Division of housework and couples’ sexual relationships: A reexamination. Journal of Marriage and Family, 78(4), 975–995.

Gettler, L. T., McDade, T. W., Feranil, A. B., & Kuzawa, C. W. (2011). Longitudinal evidence that fatherhood decreases testosterone in human males. Proceedings of the National Academy of Sciences of the United States of America, 108(39), 16194–16199.

Lopez-Gonzalez DM, Kopparapu AK. Postpartum Care of the New Mother. [Updated 2022 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:

Schwartz, A. (2018, December 9). Love is not a permanent state of enthusiasm: An interview with Esther Perel. The New Yorker.

van Anders, S. M., Hipp, L. E., & Kane Low, L. (2013). Exploring co-parent experiences of sexuality in the first 3 months after birth. The journal of sexual medicine, 10(8), 1988–1999.

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