let’s talk about sex, Baby!

RETURNING TO SEX POSTPARTUM

Picture this: You schedule your 6 week postpartum follow up visit with your OB/GYN. Your doctor assesses you, says you are fully healed, and that you can return to sex and your pre-pregnancy exercise routine. You go home, excited to be intimate with your partner again, and BUMMER…. sex doesn’t feel the same. And it’s painful. You don’t know if this is normal, if you should try to tough it out, or where to find help with this problem.

Pain with sex is NEVER normal and there is healing from it. Before we chat about how pelvic physical therapy can help, it’s important to understand the anatomical and physiological changes that your body goes through during pregnancy, labor and delivery, and postpartum. Without an understanding of the process, it’s difficult to understand why your body might be responding like this.

First, we don’t give our bodies enough credit. Physiologically, there are so many processes that must be orchestrated and come together perfectly to allow a baby to grow and flourish. Growing a child is literally a miracle and pregnant women are not given enough grace and respect for the beautiful sacrifice they make to grow and nourish a child.

Every system in your body is affected during pregnancy. Growing another person requires a large amount of resources for making extra blood, growing a placenta, and producing more hormones. Not to mention the physical and neurological changes that your body is undergoing. Your brain changes, your organs get pushed upward, your joints become lax, your kidneys are working overtime, your uterus expands, and your muscles are stretched (Maren, 2020). Sounds like a lot, right? It is! It’s a lot of changes for the perfectly healthy mama.

You must understand that if you were not supporting your body appropriately during pre-conception and pregnancy, your body will favor the growth of the baby over your own health. Our bodies are set up to nourish the baby over our own bodies when we are pregnant. That means that the baby could literally suck the life out of you, if you are not properly supporting yourself. This can set you up for a difficult postpartum experience.

Birth and delivery also require extensive resources and are extremely taxing on the female body. Delivering a baby is a trauma to your physical body, no matter if you delivered vaginally or by C-section.

Give yourself grace, give yourself time to heal during postpartum. You sacrificed every part of yourself to grow this human being and you need to give yourself support to physically and emotionally recover from this experience.

As discussed previously, most providers have their postpartum patients come in for an appointment at 6 weeks postpartum and give the mother approval to return to exercise and sex. Mothers have no idea how to get back to their pre-pregnancy selves and they are currently given little medical advice or guidance on how to get there.

Pain with sex, or dyspareunia, is a common diagnosis seen during pelvic floor physical therapy. Pain with sex is treatable, and a pelvic physical therapist can assess your body to find the root cause. Your pelvic physical therapist should assist you in making a highly individualized plan and recommendations on returning to physical activities, exercise, and sex based on their assessment and intake. Here are a few tips for returning to sex postpartum and if you’re struggling with painful sex.

Returning to Sex Tips:

-Have an open and honest conversation with your partner about returning to intimacy at a comfortable pace. Just because you are cleared at 6 weeks, doesn’t necessarily mean you will be ready to return to sex at that point - physically, mentally, or emotionally.

-You will likely require more lubrication than you did pre-baby. Choose organic olive oil for lubrication to facilitate a healthy vaginal microbiome. Other good lubrication brands include coconu and good clean love.

-Foreplay is a very important part of postpartum sex for arousal and lubrication purposes. Don’t skip on it!

-It will likely take you longer to become aroused the first few times you have sex due to the fact that your tissues are still healing and breastfeeding (if you are) is affecting your hormones.

-Woman on top or side-lying are the best positions to start with to allow mom complete control of penetration.

-Practice meditation and breath work. Ideally, on the the inhale, your abdomen should be relaxing and you should be expanding your breath into your side body and upper back. The pelvic floor should descend as you inhale, which allows pelvic floor relaxation.

-Several exercises that you can use to assist with returning to sex and pelvic floor relaxation include child's pose and happy baby with breath work.

If sex is painful or you are experiencing any other pelvic floor symptoms, such as pelvic pain, low back pain, abdominal pain, incontinence, urinary urgency, frequent urination, or pelvic heaviness... please see a pelvic physical therapist!