As a former midwife and now a couples therapist, I often see that many women and their partners approach the first penetrative intercourse after birth with caution — sometimes even postponing it. People frequently search for tips on “sex after birth”; unfortunately, the universal term “sex” is still often equated solely with intercourse between a woman and a man. This guide focuses precisely on that: the first penetrative intercourse after birth — while also offering helpful suggestions for other sexual activities in this period.

This renewed “penetration” of the penis — the timing varies widely — can feel for many women like “a second first time”, almost like a repeat defloration. Both partners wonder how birth will affect sex: whether it will feel like before, whether there will be pain in the vagina or perineum, which contraception to choose — and much more.

A conversation with your postnatal midwife can help. I have often encouraged new parents to talk about the first sex after birth — because, especially in the postpartum period, there are inhibitions about addressing sexuality and intercourse in particular. A shared sexuality after the postpartum phase — regardless of the practice — supports the couple relationship and positively affects bonding within the whole family. Your body also benefits: sexual activity supports recovery and strengthens the pelvic floor.

Contents:

Changes due to pregnancy and birth

Pregnancy and birth are life-changing experiences — for women and their partners. The changes show up on several levels:

• Physical: possible injuries, pain, scars, lochia, pelvic floor, body shape. Your body feels different after birth — regardless of how your baby was born. Accepting this takes time and space to process what happened around the birth.
• Emotional: sensitivity, uncertainty, overwhelm, sleep deprivation. Hormones can add to the turbulence; breastfeeding mothers are especially sensitive and in need of care.
• Psychological/spiritual: disorientation — you’re finding yourself in a new role and re-aligning.
• Social: high expectations on parents and, at times, outside criticism.

Changes in your sexual experience

Your sexual experience (images, fantasies, needs) can also change after pregnancy and birth: new things may become important, while others move into the background. Take time and space to find a shared, truly fulfilling sexuality. Within the framework of professional sexual counselling, you can learn to talk about it openly. 

Your psyche in the postpartum period

During pregnancy, birth and the postpartum period, hormones are on a rollercoaster — with a major impact on your psyche:

During pregnancy oestrogen, hCG, hPL, progesterone and relaxin play key roles,

during birth especially oxytocin, adrenaline, noradrenaline and endorphins,

postpartum still oxytocin and the milk-producing prolactin.

Right after the placenta is delivered, pregnancy hormones drop rapidly while postpartum hormones rise quickly. This shift often triggers an emotional up-and-down:

Many new mothers feel highly sensitive, with tears or irritability. At the same time, these “birth hormones” carry you through the first weeks — despite sleep loss and discomforts (wound pain, tender nipples from breastfeeding, afterpains, etc.). My advice: allow your feelings. Suppressed emotions can inhibit milk flow, make breastfeeding harder and affect lochia.

Why there’s little desire for sex

In the postpartum period, many women are tired from interrupted nights and already physically “saturated” by the closeness with their baby. So sexual desire is often low. Instead there’s a strong need for “me-time”: time just for you, without caring for anyone else. These breaks are nature’s way to support recovery.

Further reasons for low sexual interest:

(Still) struggling to accept your changed body

You may feel unattractive: more weight than before pregnancy, softer contours, perhaps stretch marks. Your breasts can feel unfamiliar due to breastfeeding. The pelvic floor is weakened, birth injuries may still be noticeable — and the birth experience may not yet be fully processed. Contraception may also still be undecided…

The systemic shift from couple to family

It’s completely normal that sexuality takes a back seat in the first days and weeks — regardless of the type of birth — so the lived system “couple” can transform into “family/parents”. New routines need to grow; that takes time and mutual understanding. The focus is now less on the couple and more on the child.

Biologically, in terms of species survival, this process is ancient and natural; at the same time, becoming a mother or father is a magical, often spiritual experience.

Your partner’s state of mind

Alongside everything that concerns you, your (male) partner is also navigating a demanding phase — expected to show understanding and consideration. You’re often tired and constantly there for the baby. At the same time, you may feel deeply fulfilled: being needed, soothing your child with your milk, and sharing a lot of physical closeness. The relationship between mother and baby is very symbiotic now — a primal importance the father doesn’t experience in the same way, at least not for the baby.

At the same time, your bodily presence is constant. He may often see you partly or fully naked — your décolleté or full, firm breasts. That can arouse him, yet sex doesn’t happen — a tricky mix to handle.

The end of abstinence

As everyday life gradually returns, desire and sexuality move back into view. Talk openly about thoughts, wishes and any fears. Empathy and understanding are essential. Being seen and accepted opens the path to closeness and intimacy.

For some couples it matters to become sexually active again. You’re parents now — and you can approach the “first time after birth” deliberately, rather than avoiding or postponing it.

Some couples remain abstinent for (too) long…

After birth, the question is: How do we deal with the new constellation, new needs and unfamiliar roles? Can we find solutions together? Even a single hour of couples coaching can help a lot.

The first time — when after birth?

There’s no fixed date — every couple finds its way. Penetration isn’t the only route back to sexuality; your pelvic floor plays a role too. If penetration is your focus, medical advice often suggests around six weeks. Earlier is possible — then I recommend using a condom as infection protection while lochia is still present. What matters most is desire: some are curious even early in the postpartum period and want to experience themselves beyond the parent role. Others have no desire — your individual needs should set the pace.

Very important: agree on contraception

You can be fertile again just a few weeks after birth. Worrying about becoming pregnant again — due to missing or unsuitable contraception — is a real desire killer. Contraception is therefore a central topic. I can also advise you on this.

How to avoid frustration and conflict

To prevent (sexual) frustration and arguments, I recommend the following as a couples therapist:

Patience and calm for “the second first time”

are essential — and keep a sense of humour if it doesn’t work straight away. The pelvic floor is still weakened; penetration can initially feel unusual or uncomfortable, sometimes due to fear of pain. If you, as the man, feel highly aroused, a prior masturbation can help you be more patient. Then try penetration gently — and do use a good lubricant, because hormones affect vaginal moisture.

The “lost penis” syndrome

This can happen too: the penis feels “lost” in the vagina; the sensation during intercourse is weaker than usual or barely there — for both. The so-called “lost penis syndrome” — too little contact between a (smaller) penis and a very receptive vagina — can be addressed with a suitably sized Viball®.

When sexual needs change

If your needs and preferences have changed, make sure you talk about them!

“What are your secret fantasies? What images come up? What role do you — do I — take?” Such topics aren’t always easy, even for long-term couples. Sometimes it helps to avoid eye contact — for instance, playfully as an “interrogation game” with eyes covered, in the dark, back-to-back or in a tender embrace.

A few tips for a constructive conversation:

Name your real needs

Be honest about what you truly need — don’t water it down (out of shame or consideration), and don’t put forward other reasons to vent frustration.

Show empathy

Open up and bring understanding to your partner’s needs — instead of rejecting them or judging your partner.

Give sexuality a fixed space

Within a family system, sexuality and couple time need new habits — and that’s a good thing. Schedule regular, undisturbed time together for fulfilling sex. Take your child to grandparents or friends — and crucially: be alone in your “space”!

Yes, you can plan sex — instead of relying solely on spontaneity (which rarely fits everyday life). Spontaneous sex can still be a lovely extra!

Sex matters for your relationship — even as “mum and dad”. Don’t leave it to chance; give it priority within agreed-upon times.

Sexuality as un-folding

Keep exploring your desire — with creativity, time and humour. Penetrative intercourse isn’t the pinnacle of sexuality; it’s an option, not a must. Roles aren’t fixed (also) in sex: penetration isn’t reserved for men, nor being penetrated only for women. Experiencing “the other side” opens up new perspectives — far beyond sexual pleasure — and enriches the whole personality.