Posted on March 02 2021
Take it slow, be it after a natural or caesarean delivery, as a woman’s body requires time to heal.
So you’ve had a little bub, and you’re still feeling a little zonked out and are trying to get back to a regular ‘normal’ routine. Between trying to toggle the lack of sleep and baby’s 2-3 hour feeding schedule, you also need to give your hub some tender loving care and maintain a healthy sex life. Some might say that jumping back into the sack immediately after delivery is perfectly fine, while others advise against it. Some mums might be worried about sexual intimacy and extreme pain during intercourse. Others might also feel disheartened that their sexual desire is not the same as before. To ease your concerns, here are eight things you need to know about postpartum sex.
1. Take it slow; the 6-8 weeks timeline varies among individuals.
After a natural or caesarean delivery, a woman’s body requires time to heal before performing the intimate act. Most women are able to resume sex after six weeks as it usually takes four to six weeks for your body to recover post-delivery.
Lochia is the “bloody” discharge which begins right after delivery and during the first couple of days, bleeding can be quite heavy, but it will gradually decrease. The lochia colour changes from bright red to pink or brown and may become yellow before it disappears completely. Most mums find that bleeding stops within three to four weeks, although for some, it might persist till eight weeks. While the body is ready, ,you might not be emotionally, but that is very common, so don’t worry. It varies from one woman to another - so don’t rush and take it slow at the beginning!
2. Everyone’s physical, emotional, and mental readiness is different.
No two mums will feel the same after delivery, so don’t compare! Issues like fatigue, bleeding, pain, mood changes, and hormone levels may affect the return to normal pre-baby intimacy. What’s more, we all know about post-natal depression - a phase of temporarily feeling completely down and out soon after delivery. Some might feel anxious, lonely, overwhelmed, depressed, and even angry about motherhood's unending responsibilities.
Take time to see how you feel after delivery or post-c-sect as hormone levels will be all over the place. While you may be physically ready for intimate moments with your spouse, you might need more time emotionally and mentally.
You might even feel like you will never be passionate or as fervent about sex ever again. Fret not, as this is not true, granted that it is only a temporary state of mind. However, if all these feelings persist, hinder your ability to care for your baby, affect your relationship with your partner, seek help from family, friends, and consult a doctor.
3. Decreased sexual desire is normal.
The dreaded hormonal levels postpartum will take its toll on sexual desire and coupled with all the sleepless nights tending to baby, a decrease in its level is entirely normal. If you find that you are not in the mood for sexual intercourse yet, try to explore other ways of intimacy with your partner like, snuggling, kissing or caressing.
It’s all about taking things down-tempo post-baby, like taking your time to do things that make you feel good about your body. Think about what makes you relax - it could be the long-overdue manicure and pedicure, getting your hair done or going for a stroll in a nature park. Harnessing these positive vibes will help when it comes to increasing sexual desire and intimacy in bed. Find time to be alone with your spouse and enjoy the moment. Sometimes getting a family member or helper to look after your little one for just 30 minutes might do the trick and ignite that spark again in your relationship. Or about carving out time to go on a romantic date? You never know what it might lead to and how it can help with your libido.
4. Pain occurs for various reasons.
Experiencing a mild ache or "afterpains" or postpartum cramp felt in the lower abdomen in the first few days following delivery is expected. It is most intense within the early days after giving birth and may last from a few days to between four to six weeks after the delivery. This explains why you should take it slow and wait it out till after six weeks before jumping in the saddle once again.
After pregnancy, reduced hormone levels can make the vagina tissue dry and uncomfortable, thus causing pain for some during intercourse. To avoid this, use lubricating gel until your natural secretions return. Most importantly, do not worry!
Pain might also occur during certain sexual positions. Explore with your partner different positions that might give you more control over penetration and put less pressure on your episiotomy site or cesarean scar. For example, you can consider the side-to-side or woman-on-top positions. This might help alleviate pain, discomfort, and won’t throw you off-guard.
5. Breastfeeding might affect postpartum sex.
Did you know that breastfeeding might affect postpartum sex? How? One way is through the release of oxytocin, the hormone that triggers the milk ejection reflex and is also called “the love hormone” because it’s released in men and women at the time of orgasm. This means that you could leak milk during intercourse!
Breastmilk is best for baby, but the hormones that are released during breastfeeding affects a mum’s overall sexual desire.
The release of prolactin helps with milk production and causes breasts to develop for breastfeeding. However, it can also dampen the lovemaking process as it counteracts dopamine, a type of neurotransmitter in our body which assists in sexual arousal and the feeling of pleasure. Therefore, prolactin can actually lower your sexual desire!
Testosterone, known more as a male hormone, also affects sexual desire and is naturally occurring in both men and women. Testosterone levels drop during breastfeeding, which means that it decreases sexual desire.
6. Don’t Forget About Birth Control.
Didn’t think you’d need contraception so soon after delivery? Your fertility can return within weeks after giving birth. Although your body may have barely recovered from childbirth, you may get pregnant when you have sex. If you’re fully breastfeeding and your menstruation has not resumed, you are protected from pregnancy, albeit with a 1 to 2% risk failure rate. This is known as lactational amenorrhoea method (LAM). If you do not want an unplanned pregnancy, take out those birth control pills or other contraception methods once again. Do check those which are suitable for breastfeeding.
7. Communication with your partner is key.
Talk, talk, talk - yes, find time to talk to your partner about how postpartum sex will feel different at first and if you’ve read up the literature on the topic enough, share with him on your worries and even fears. Let your partner in on your postpartum joinery so that he’ll be more equipped to know how to support you. While intimacy might not always be the easiest topic to bring up, communicating about it together is crucial towards getting your sexual intimacy back on track. Start slow and talk about how it feels along the way.
It is important to find time to talk and share with your spouse on how you feel about sex after delivery. Help him to understand that it takes time for your body to heal and hormones to regulate.
8. Do not be afraid to seek professional help.
In our Asian society, asking for help is not the norm, and it may be tagged to your incompetency in carrying out your responsibilities. But it is perfectly OK to ask for help with postpartum struggles! For some mums, it can take up to 6 months or more to get into the motherhood groove and feel ‘normal’ again when it comes to sexual drive and physical comfort. Whether it’s two months or six months, seeking help from a healthcare provider should be seen as an option and not a taboo. KK Women’s and Children’s Hospital offers a Women's Mental Wellness Service on a range of conditions, including postpartum care. Gleneagles Hospital can also assist in finding you a specialist in the field of sexual health to advise you on any postpartum concerns.
Getting back to a regular routine requires good hydration, adequate rest, a healthy diet and regular exercise. With patience and proper planning, sexual intercourse after pregnancy can be a pleasurable experience again. If you have any concerns, consult your gynaecologist and obstetrician to understand more.
Dr Tan Thiam Chye, Dr Tan Kim Teng, Dr Tan Heng Hao, Dr Tee Chee Seng John, The New Art and Science of Pregnancy and Childbirth, World Scientific 2008.
KK Women’s and Children’s Hospital - Women’s Mental Wellness Service - https://www.kkh.com.sg/patient-care/areas-of-care/womens-services/Pages/womens-mental-wellness-service.aspx
Gleneagles Hospital - Post-Delivery Care - https://www.gleneagles.com.sg/facilities-services/centre-excellence/women-health-gynaecology/sexual-reproductive-health/post-pregnancy
Lights, V. & Cirino, E. 2019. What You Should Know About Abdominal Tenderness. https://www.healthline.com/health/point-tenderness-abdomen
Waltman, A. B.& Stevens, L. R. n.d. What to Expect at Your 6-Week Postpartum Exam. Retrieved from: https://www.parents.com/pregnancy/my-body/postpartum/what-to-expect-at-your-6-week-postpartum-exam/