As a midwife and couples therapist, I am very aware that many women and their partners have respect for the first sexual intercourse with penetration after childbirth and often even delay it. People often google for tips on "sex after childbirth", because unfortunately it is still very common to reduce the universal term "sex" to sexual intercourse between a woman and a man. However, this guide is about exactly that: Namely, about the first sexual intercourse with penetration after childbirth - although I would also like to give tips on other sexual activities after childbirth in this context.
This renewed "penetration" of the penis, usually a few weeks after giving birth, is often like "the second first time" or a repeat of defloration for a woman. Both partners are unsure how the birth will affect sex: whether there will be pain in the vagina, what the woman or man feels, whether contraception is necessary, if so, what kind, and much more.
Talking to your postnatal midwife can help. I myself have often encouraged young parents to talk about their first sex after the birth, because women in the postpartum period, and especially their husbands, are often inhibited about discussing sexuality, especially sexual intercourse. However, healthy sexuality after the postpartum period is really important for a healthy relationship between partner and partner, regardless of sexual practices, because it also has an impact on the child and the whole family. And it is also very important for the pelvic floor, because sexual activity - regardless of the practices - ensures involution and therefore a healthy pelvic floor.
Changes due to pregnancy and birth
Pregnancy and childbirth are drastic experiences for women - but not to forget for their husbands too. The changes take place on different levels:
Physically (possible injuries, pain, lochia, pelvic floor, figure) Women experience a changed body through pregnancy and birth, regardless of how the baby was born. Feeling the changes in and on your own body requires time and processing afterwards.
Emotionally (thin-skinnedness, insecurity due to hormones) There is also a feeling of hormonal confusion, which is why the breastfeeding mother is often very emotionally sensitive and thin-skinned.
Mental (new, spiritual needs)
In society (demands on parents)
Changes in sexual experience
Women's sexual experiences (images, fantasies) can also change after pregnancy and childbirth: New sexual preferences may develop, others may fade into the background. Partners should take the time and space to talk openly about this. In a sexual counseling session, I can help you to find a common, truly fulfilling sexuality
The psyche in the postpartum period
During pregnancy, birth and the postpartum period, the hormones in a woman's body go on a merry-go-round, which naturally has an enormous influence on her psyche:
During pregnancy, the hormones oestrogen, hCG, hPL, progesterone and relaxin initially have an effect on a woman's body
Then oxytocin, adrenaline, noradrenaline and endorphins during childbirth
Oxytocin and the milk-forming prolactin continue in the puerperium.
Immediately after the birth of the placenta, the pregnancy hormones drop rapidly, while the postpartum hormones increase rapidly. This rapid change often causes emotional ups and downs:
A young mother feels a sensitivity and thinness of skin that often causes tears or irritability. However, these birth hormones also carry her through the weeks after the birth, the frequent lack of sleep and the pain that still exists (soreness, sensitive nipples from breastfeeding, afterpains, etc.). At this point, as a midwife, I recommend that you allow your feelings to be felt, as suppressed emotions often lead to stagnation in the milk flow, which hinders breastfeeding and impairs the postpartum flow.
Why hardly any desire for sex?
Women in the postpartum period are usually tired due to interrupted nights and physically more than satiated because they are very close to their baby. Accordingly, they have little desire for sexual activities, but are very much in need of "me-time", i.e. free time for themselves alone, in which they don't take care of anyone else but themselves. These breaks, in which they don't have to be there for others and don't have to "satisfy" the needs of a baby or other people, are intended by nature for important regeneration.
Other reasons for a lack of sexual interest:
Woman has not yet accepted her altered body
She feels unattractive because her body is probably heavier than before pregnancy (despite exercising), is softer and may have stretch marks. Breastfeeding can make her breasts feel unfamiliar. The pelvic floor is weak, there may be vaginal injuries from the birth and the birth as a whole has not yet been fully processed, and the issue of contraception is also still on the table...
The systemic transformation from couple to family
As a midwife, I find it very normal and understandable that sexuality, which is otherwise so important, takes a back seat for a while in the first few days and weeks after a birth, regardless of the type of birth, so that the previous "couple" system can transform into the "family" or "parent" system. New behaviors have to gradually establish themselves, this takes time and a lot of mutual understanding, sex is no longer so much in focus. The focus is now not primarily on the couple relationship, but on the child.
From a purely biological point of view, this archaic process is one of the most natural in the history of the world. On the other hand, the experience of becoming a mother or father, the transformation of two individuals into parents, is a magical and spiritual experience.
The state of mind of the partner
In addition to all the understanding for the woman, the state of mind of the male partner is just as important: it is also a challenging phase of life for him, in which he is expected to be understanding and considerate. Of course, the young mother is often tired and has to be there for the baby. On the other hand, she experiences a lot of satisfaction from being needed, being able to soothe her child with her milk and having a lot of physical closeness. It is a truly symbiotic relationship between mother and child. The man as father does not experience this elementary form of importance for the child, at least not for the baby.
At the same time, the woman is constantly present in her physicality. He often sees his partner completely or partially naked, her magnificent cleavage or even full, plump breasts and nipples. His sexual appetite is constantly stimulated, but sex does not happen - not easy to take.
The end of abstinence
When more everyday life has gradually returned, the topics of lust and sexuality come to the fore again. I can only recommend actively dealing with this and openly discussing all thoughts and any existing fears with each other. Of course, mutual empathy and understanding is also immensely important here. Everyone knows how beneficial it is to feel seen and accepted. This opens the way to more closeness and intimacy, and it is now important to have an active sexuality again. You are now parents, but you shouldn't repress the topic of "first sex after the birth" or keep putting it off.
Unfortunately, some couples remain in abstinence (for too long)...
First sex - how long after the birth?
There is no defined time for the first sex after childbirth, every couple is different and can find their own way. Penetration is not the only way to start having sex again, and the pelvic floor also plays a role. But if it's primarily about that: around 6 weeks is the rule, but in my experience sex before that is also absolutely normal. To protect the mother, I recommend sexual intercourse with a condom as long as there is still menstrual flow to avoid infection of the uterus.
Very important: Clarify contraception
It is quite possible for a woman to get pregnant again just a few weeks after giving birth! Worrying about getting pregnant again straight away due to a lack of contraception or using the wrong contraception is a real pleasure killer! Contraception is therefore an extremely important issue.
How to avoid frustration and arguments
To avoid (sexual) frustration and arguments, I recommend the following measures as a couples therapist:
Patience and calm for "the second first time"
Patience and calm are extremely important, and take it with a sense of humor if it doesn't work right away. The pelvic floor is still weakened, penetration can be a little uncomfortable at first, and fear of pain can also be the cause. This also means that if you, the man, are very hot, you can include masturbation in your lovemaking beforehand so that you have more patience. Then carefully try penetration - but be sure to use a good lubricant, as hormones often prevent the vagina from getting wet in women who are still breastfeeding.
Of course, it's up to you, the woman, to decide how far you want to go. If there is pain in the vagina, there is at least no point in having intercourse (yet).
The lost penis syndrome
That can also be the case: You try it and it goes "too" easily! Although the pelvic floor is weakened after giving birth - our medical love balls are an excellent remedy - the vagina usually remains more receptive than before the birth. The man sometimes feels "lost" with the penis in the vagina, the sensation during intercourse is weaker than usual or there is almost no sensation at all. The so-called "lost penis syndrome", i.e. a lack of contact between a (too) small penis and a very receptive vagina, can also be remedied with a viball of a suitable size.
When sexual needs change
If your sexual needs and preferences have changed during the period of abstinence, you absolutely need to talk to each other!
"What are your secret fantasies during sex? What images do you see? What role do you / do I play?" etc. It's not always easy to "confess" this openly or to ask questions. Sometimes it helps to avoid eye contact, e.g. playfully in a kind of "interrogation game" with blindfolds, in the dark, back to back or in a very close embrace.
Here are a few tips for a constructive conversation:
State your real needs
Basically, try to be really honest and formulate your real need, don't water it down (out of shame or consideration) and don't use other reasons to get rid of frustration.
Open up and show understanding for your partner's needs instead of rejecting them or even judging them for them.
Giving sexuality a fixed space
Sexuality within the family system requires new time habits, and that's a good thing: organize regular couple time for undisturbed, fulfilling sex. Bring your child to your parents or friends for this - important! be sure to be alone in your "space"!
Yes, it is possible to plan sex instead of relying on spontaneity and hoping that an opportunity will arise. Which often leads to frustration because this is rarely the case in the family. So there is room for "safe sex", spontaneous sex is still possible.
Sexuality is important for the partnership, even for "mom and dad". Don't leave it to chance, but give it priority within mutually agreed intervals.
Sexuality as development
Explore your lust again and again: with creativity, time and humor. Classic sexual intercourse is not the pinnacle of sex, but merely a CAN and not a MUST anyway. And the roles of men and women are not fixed (even) during sex: Neither penetrating a body is reserved only for the man, nor being penetrated only for the woman. And the experience of "the other side" creates completely new perspectives that go far beyond sexual pleasure and enrich the whole personality.