Why does sex hurt after birth?

Whether you had a natural birth, a C-section or an assisted vaginal delivery, you may find that after having a baby sex is different or even hurts. We look at the reasons why. By Licia Selepe

Why does sex after birth hurt?

After childbirth, experiencing pain during sexual intercourse is common. In fact, nearly nine in 10 women experience pain the first time they have sexual intercourse after having a baby, according to a study published in an International Journal of Obstetrics and Gynaecology.

Is your body ready for sex?

Midwife Louette Maccullum says sex after birth can be daunting, and the question often asked is, “How long should I wait to resume sexual intercourse?” She explains, “The choice is yours. It does depend on a lot of factors though, like if you had an episiotomy, whether you had stitches after tearing or you had a C-section.”

“After a vaginal birth, if you have a tear, which is common, the stitches will take 10 to 14 days to heal, but with an episiotomy, where nerves and blood vessels are cut, the healing can take longer and can remain sensitive for up to three or four months after the birth. You may bleed for three weeks, with spotting that can continue for up to five or six weeks after a vaginal birth, while with a C-section, the bleeding usually continues for a shorter period. Some couples prefer not to have sex if there is any sign of bleeding,” Louette explains.

ALSO SEE: Your period after baby – what you need to know

After a C-section, it is recommended to wait for six weeks to have sex. “A C-section is a major abdominal surgery, and although the wounds heal within two to three weeks, the general pain and discomfort can continue for up to six weeks and sometimes even longer,” says Louette.  She advises women to see their healthcare advisors after six weeks to get a clean bill of health and the go-ahead to resume normal activities, including sex.

Aside from the physical factors, there are also many other issues which can affect how ready you are for sex after birth. These include exhaustion from sleep deprivation, breastfeeding, self-body image, fear of falling pregnant again and your baby sleeping in the room with you. Louette says it is important to discuss your readiness with your partner, and to communicate your needs and how you are feeling when having intercourse for the first time after giving birth.

ALSO SEE: 6 things you need to know about having sex after birth

Why does sex hurt after birth?

Midwife Heather Pieterse, manager of Midwives Exclusive, says most women will experience painful or uncomfortable sex the first few times after birth. “It’s interesting to note that studies have shown that women who have C-sections or vaginal births with the assistance of vacuum extractions (suction) are twice as likely to experience painful sex up to 18 months after birth than women who have had normal vaginal birth without intervention.”

Heather says there are many reasons why sex after birth hurts, such as:

  • After a vaginal birth there may be scar tissue that is still sensitive. Gently massaging the areas that are tender will help with circulation and healing.
  • The vagina is a little dryer after birth while breastfeeding, so lubrication can help with this sensitivity.
  • After a bad tearing or an episiotomy, some women may find it takes as long as four to six months to heal to the point that it is no longer sensitive. If painful intercourse continues, it is important to see your medical practitioner to establish the cause.

Heather shares some tips to help prevent painful sex after birth:

  • Empty your bladder before sex.
  • Use lubrication.
  • Don’t rush it, start slowly.
  • Have lots of foreplay.
  • Check with your medical practitioner if any stitches are fully healed.

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