Why does sex hurt after having a baby? 5 reasons to consider

Reviewed by Natalia Viarenich, MD, Obstetrician-Gynecologist, Lithuania

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When can I have sex after giving birth?

Pregnancy and delivery ask a lot from your body. Some people are eager to get back to sex after healing from birth, while others are content to wait.

Of course, if you’re recovering from stitches, your health care provider might advise you to wait. Usually, your doctor or midwife will advise abstaining from having sex during the first six weeks after delivery. 

Each person’s body heals at a different pace, so it’s important to monitor how you’re feeling physically and mentally. When possible, keep your partner informed so they can support you. 

There are different reasons why postpartum sex hurts. Let’s take a closer look at the most common ones.

5 causes of painful intercourse after giving birth

Here are the five most common reasons why postpartum sex is painful. 

Tears and stitches

People who deliver vaginally may experience tears and cuts, some of which may need stitches. A perineum stitch takes about four to six weeks to heal, and any discomfort around the perineum will usually fade by 12 weeks. In this case, your health care provider will advise you to wait to resume penetrative sex until the stitches have healed.

Resuming sex after episiotomy stitches (a minor incision) can also cause significant pain if done too early. It’s important to allow the stitches to heal before penetration.

Once your health care provider clears you to resume sexual activity, you can take certain steps to promote comfort, such as emptying your bladder beforehand and taking a warm bath or shower to relax. If you experience pain after sex, apply ice wrapped in a small towel to the area.

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Vaginal dryness

After having a baby, a person’s oxytocin level rises, causing their estrogen level to fall. This drives the bonding between a parent and their newborn. For many parents, their sex life after having a baby might look different for a few weeks or months due to this new responsibility. 

This drop in estrogen can lead to vaginal dryness, causing intercourse to be painful. As a result, you and your partner may need to wait on penetrative sex. Low estrogen can also decrease a person’s libido. This helps explain why an estimated 17–36 percent of women report dyspareunia (painful intercourse) at six months postpartum.

If you feel ready to resume penetrative sex, using water-based lubricants and vaginal moisturizers can help make the process more comfortable. Low-dose vaginal estrogen can address vaginal atrophy, with only minimal systemic absorption. Check with your health care provider before using vaginal estrogen, especially if you are breastfeeding.

Cervical dilation

Having sexual intercourse with a dilated cervix can increase the risk of infection and pain. To minimize painful postpartum sex, give yourself time to rest and heal, which may take around four weeks. 

Pelvic bone problems

Pregnancy and childbirth stress the pubic bone. In some cases, it can become weakened or injured, leading to pain during intercourse.

C-section delivery

After a C-section delivery, you will have healing incisions covered by stitches on your uterus and lower abdomen. 

A C-section can lead to persisting pain during or after sexual intercourse. Just like in vaginal deliveries, bleeding also occurs in cesarean deliveries. Health care providers mostly advise their C-section patients to let their stitches dissolve completely before they resume sexual activities.

Minimizing painful sex after delivery

Some people wait on sex because of exhaustion, new responsibilities, or prolonged healing. But what about couples dealing with sexual pain? Here are some tips to minimize discomfort in this season.

• Get creative. Find other sex positions that offer pleasure without pressure. Massages or oral sex after pregnancy are also great ways to build intimacy.
• Practice Kegels. Kegels help to strengthen and lift the pelvic floor muscles. Doing them regularly can help your healing process.
• Use lubrication. Take your time to relax. If you plan to try penetrative sex, use a lubricant. If you still experience dryness or discomfort, talk to a health care provider.
• Be honest. Openly discuss your feelings with your partner. 

Great sex builds on great communication. Sharing your emotions and feelings openly with your partner can help improve your sexual experience. If you have any concerns about postpartum healing or sex, ask a health care provider. 

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History of updates

Current version (15 March 2021)

Reviewed by Natalia Viarenich, MD, Obstetrician-Gynecologist, Lithuania

Published (12 November 2018)