Sex During Pregnancy and Postpartum

By Jessie Mundell

Oh, yes. We’re going there!

This is such an important conversation to have about what’s normal and what’s not regarding consensual sexual intercourse in pregnancy and postpartum.

Note: While we recognize that there are many ways to experience sexual pleasure, this article specifically addresses sexual intercourse involving vaginal penetration.

Sex during and after pregnancy is still a hush hush conversation in many circles. For example, if people are feeling any discomfort, pain, touched out, or experiencing low libido, these are not topics many people feel comfortable talking about.

You might feel frustrated, confused, or embarrassed by these things. Or, you might not know that so much help is available to increase the joy factor of sex.

Sex during pregnancy typically falls in one of two categories (or both):

sex-duringpregnancy-postpartum-pregnantcouple-in-bed-401x3501. FINALLY! Sex that isn’t on a timeline.

You’re not stressed about birth control. You’re not charting your temperature or wondering whether you’re fertile, ovulating, or whether this is going to be the cycle.

If it’s been a long road to conception, this can feel like total freedom. You’re feeling super comfortable in your body and more in your skin than ever before!

2. It all feels a little weird.

You’re growing a baby. Your body is changing. You and/or your partner feel a bit uncomfortable having sex while there’s a baby in your body.

The baby is kicking, and you don’t quite know how to maneuver your 3rd trimester body into a position that will let you relax enough to enjoy the moment. 

While increased libido is common in pregnancy, many women actually experience a decrease.

Spotting after sex—Is it normal?

It is fairly common to experience some light spotting or bleeding in early pregnancy after intercourse. Normally this occurs because there are tiny blood vessels in plentiful supply around the cervix during pregnancy, and sex could cause some to rupture.

Although this can be completely normal, you should still mention it to your healthcare provider if it happens.

Common medical reasons why you would not have sex during pregnancy include:

  • Placenta previa
  • Unexplained vaginal bleeding
  • History of miscarriage and your doctor recommends abstaining for the first trimester, etc.
  • “Incompetent” cervix (cervix effacing and dilating too early in pregnancy)
  • Your water has broken

Is sex painful during pregnancy?

sex-duringpregnancy-postpartum-pregnantcouple-in-bed-450x297Whether you’re pregnant or not, pain during sex isn’t normal, and you don’t have to suffer through it.

If sex is painful, causes a burning sensation during or after intercourse, or just doesn’t feel quite right in your body during pregnancy, book an appointment with a pelvic floor physiotherapist. For example, a pelvic floor physio can help you learn how to relax tension in your pelvic floor that might be contributing to painful sex.

There are certain positions that can help to increase the comfort level of sex during pregnancy as the belly grows:

  1. sex-duringpregnancy-postpartum-couple-in-bed-373x340You on top: no pressure on the belly and you have more control over the angle of penetration.
  2. Spooning: you both are side lying, which gives support to your belly and can help penetration feel more comfortable.
  3. Forward leaning: you are in a forward lean position, with your hands on the bed or a couch and your partner behind you.
  4. Edge of the bed: you lie on your back, at the edge of the bed, with your partner standing at the edge of the bed.
  5. Reverse Cowgirl: you on top but facing towards your partner’s feet, allowing you to control the depth and pace of penetration.

What about postpartum sex?

The “six-week check-up” is not a one-size-fits-all guideline for resuming intercourse

. You simply may not be physically, mentally, or emotionally ready even if your healthcare provider gives you the go-ahead to start having sex again.

sex-duringpregnancy-postpartum-couple-in-bed-450x300If you’re barely sleeping, exhausted, needing some time alone, feeling stressed, touched out, or healing tears in your perineum, it’s no surprise that sex is dead last on your list of things you want to do (if it’s on that list at all). Then again, you might be ready for sex even earlier than six weeks, and that can be completely safe, too!

If you’re not experiencing pain in the pelvic floor, any stitches are healed, the postpartum bleeding has stopped, your C-section incision isn’t painful, and sex boosts your mental and emotional well-being, you should absolutely give it a go.

Is it safe to have sex if there’s pelvic organ prolapse?

You can have sex if you’re experiencing pelvic organ prolapse. You might have to experiment and find a position that works best for your body, but you don’t have to be afraid of worsening your prolapse with intercourse. You might even find that your symptoms decrease after sex.

Why am I having pain during postpartum sex?

Pain during sex is called “dyspareunia” (pronounced: dis-pa-roo-knee-a). Painful postpartum sex could occur:

  • If you had tearing or trauma to your pelvic floor during birth
  • If you had an episiotomy, forceps, or vacuum used during baby’s birth
  • If you’re breastfeeding and the hormonal changes are causing vaginal dryness
  • If you’ve had a C-section and there are adhesions of the tissues in the pelvis and lower belly caused from the incision
  • When there’s stress (“Was that the baby?”)
  • When not enough is spent time in foreplay to warm your body and mind up before intercourse

Pain during sex postpartum is extremely common. That being said, it’s not a normal experience for the body, and you do not have to live with this.

Please know that if you do bring this topic up with your doctor (good for you!), and they dismiss your concerns or they tell you, “It’s normal after having a baby,” or “It’ll get better the more sex you have,” that is not good enough. You deserve better care.

5 Tips for More Enjoyable Postpartum Sex

  1. sex-duringpregnancy-postpartum-couple-in-bed-350x233Book an appointment with a pelvic floor physical therapist! Some internal release for tight pelvic floor muscles or massage where perineal tears occurred can make a world of difference. Painful sex isn’t something you need to live with and postpartum sex doesn’t have to be something you dread for months and years because of it.
  2. Use plentiful and good lubrication. A couple examples of more natural and body-friendly ideas are plain coconut oil, or Sylk.
  3. Keep practicing getting comfy with your own body and your new (amazing!) body shape.
  4. Even when time is tight, spend some effort on foreplay, getting in the mood, and relaxing into things.
  5. Test out different positions to find the ones that keep you in control of entry, speed, and depth of penetration.

Sex after pregnancy will likely be different for many reasons, especially in the early months after birth. But it really does get back to normal if you give your pelvic floor a little TLC, and you find comfort and pride in your postpartum body.

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About the author:  Jessie Mundell

Jessie Mundell is a certified kinesiologist and a Precision Nutrition Level 1 coach, as well as an author and mother. She specializes in pre- and postnatal exercise and corrective exercise. Learn more about Jessie on her website and connect with her on Twitter.

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