It can be a very tricky thing to talk about, and sometimes the last thing on your mind.  Information and advice on this topic is not always volunteered at postnatal check-ups with doctors, midwives, or maternal child health nurses (MCHN’s).

Between the fatigue and change to your normal sleep patterns in the newborn phase, the constant physical contact you have with baby across the day and night, some lingering postnatal bleeding, as well as changes to the way you see your body, and possibly some apprehension about how it may feel, it may be hard to rustle up the enthusiasm and energy to engage in intimacy.

It is very much a personal choice depending on how you are feeling and if you have been given any specific instructions from your health care providers.  After a vaginal or caesarean delivery, the typical advice is approximately 6 weeks, to allow for soft tissue healing of any stitches or perineal wounds, or until the caesarean suture wound is no longer tender.

Over the last 20 years I have regularly advised, discussed, and treated women specifically regarding this topic, and one thing I do know is there is no one size fits all approach! I have managed to come up with a list of tips and tricks to try and take some of the initial awkwardness, worry or discomfort out of the equation.

1. Communicate!
– Be open with your partner about how you feel, any concerns you may have and any specific advice your care givers may have provided.
– Don’t be afraid to discuss this with your midwife, doctor, MCHN or pelvic floor physiotherapists. We have had this discission many times, but it may be the first time you have ever needed to seek help or had concerns around intimacy. We have a wealth of knowledge and understanding to guide you.

2. Prioritise your health!
– If you have any ongoing tenderness in your perineum, stitches, or abdominal suture line after the initial 4- 6 weeks of soft tissue healing, seek professional help and advice on how to manage this.
– If you have felt a change in your body image and how you feel about being a sexual partner as well as a new parent, then reach out for support or counselling.

3. Lubricant, lubricant, lubricant!
– Due to your altered sleep patterns, being “touched-out” by looking after a newborn baby all day and night, combined with any nerves you may have about returning to intimacy, your normal vaginal lubrication levels will most likely be reduced. Breastfeeding hormones can also reduce your vaginal lubricant levels.  Now is the time to use it! Speak to your pelvic health physiotherapist for more details about an appropriate one for you.

4. Intimacy doesn’t have to mean penetration!
– When you do decide it is the right time to start having intimacy again, discuss some strategies to try and experiment with different areas of your body that may be still be tender such as your vulva, perineum, or breasts.
– Aim for playful, gentle, and pleasurable touch and connection that doesn’t necessarily have to result in penetration.

5. As your confidence and knowledge of what is working for you and your partner grows, experiment with different positions that may make penetration more comfortable.

If you are still experiencing pain, discomfort, or emotional concerns after reading this or after experimenting with what feels right for you, seek advice from your doctor, midwife, or pelvic health physiotherapist.

There are so many treatments available to manage and improve sexual pain or discomfort (quite a few from the comfort of your own home) but get the right advice first.  You don’t have to work this out alone!