Painful sex after birth

It’s completely normal to feel like sex is the last thing on your mind after having a baby, while others may crave that connection again early on. But whenever you do decide to try again, it can be an anxious time, especially if you’re worried about it feeling different or painful down there.

Whether you’ve had a vaginal delivery or C-section birth, the pelvic floor muscles have been under serious strain for at least the duration of your pregnancy. Many C-section mama’s will have still experienced active labour and periods of pushing before an emergency C-section birth.

During vaginal birth you may experience perineal tearing or have an episiotomy wound which can be very painful as it heals. Similarly a C-section scar can be painful, tight or numb for a long time after your baby has arrived. In all of these scenarios the nerve endings in the tissue surrounding the wound site are affected and can become hypersensitive. This means they respond differently when they are stimulated, and can cause pain - and this can continue even many years after the actual wound has healed.

The pelvic floor muscles can hold a lot of tension and feel ‘tight’ after birth, and this is particularly common if you’ve experienced a traumatic birth or hold some negative feelings about your pregnancy or birth experience. These muscles are often known as being ‘emotional muscles’ and can be a site where we store tension or ‘clench’ in a similar way to the jaw, buttocks or shoulders. In this scenario, the muscles can cause pain, both locally and referred pain - and can aggravated during intercourse.

A side-effect of hormonal changes, particularly while breastfeeding, can be feeling dry at the vagina. The vulval tissue can also become thin or more sensitive making intercourse less comfortable. Using a natural lubricant such as this one from Yes! Organics can be really helpful and protect the area.

If you are experiencing painful or uncomfortable sex, please seek the advice of a pelvic health physiotherapist. A physio can treat your scar, internal pelvic floor muscles and support you with exercises and breathing techniques which help you to reduce tension. Alongside physically supporting you, they can also point you in the right direction for seeking emotional support if needed.