Getting Ready For Sex After Birth: Part 1

Getting Ready For Sex After Baby

Written By Mandy Rempfer-Kuncio, MScPT, BSc, CD(DONA)

My name is Mandy Rempfer-Kuncio and I am passionate about the pelvis! As a pelvic health physiotherapist and a birth doula, my dream is for everyone to feel strong at their centre.  Thank you for visiting the Nurturance Health blog!

January 30, 2022
***This article is for informational purposes only and should not substitute advice from your healthcare/maternity care professional.***

Getting Ready For Sex After Birth: Part 1

Let’s talk about SEX.

Specifically, sex after you’ve had a baby.

After you have given birth, the idea of having sex for the first time again can bring up every emotion under the sun.  Some people are really excited to get back in the sack, and others amongst us want to put on our toques and mittens and run for the hills.
yes, no, maybe, undecded

I have three kids, so having had first-time-after-baby-sex three times, I can remember feeling all kinds of crazy things:

 

🔷 At times, I was nervous and scared. I had a second degree perineal tear, was it going to hurt? Was I going to feel totally tense the whole time? Does everything look normal down there? Will sex ever be good again?

🔷 What about my prolapse… would that bother me? Would my husband notice? Would sex make it worse?

🔷 After my c-section, lots of movements still hurt. Would I even be able to lie flat on my back without pain at my scar?

🔷 Also, would there even be an opportunity??? Especially by the third baby, would there really be a time when all 3 kids were sleeping?!?!?

🔷 How could I possibly feel/look sexy? My postpartum body was completely different, and a lot of the time I hated it. I was covered in breastmilk and spit-up. Showers weren’t exactly regular.

🔷 My hormones and emotions were also all over the place. A lot of days I was a crying, hot mess. Not to mention I felt exhausted and completely touched out. Was desire ever going to show itself again?

Does That Sound Like You?

To me, it sure seemed like there were a lot of stars that needed to align before sex was even going to be considered, nevermind possible.

And then there’s the 6-week postpartum check…

When you go to the 6-week postpartum check, the majority birthers are just quickly given medical clearance to have sex. Most of the time there is no conversation about whether or not you actually feel ready to have sex (there will be more discussion about what kind of birth control you want). Much of the time there isn’t even a physical exam of your vagina. I know, doesn’t that sound crazy?!?!

You carried a baby in your pelvis for months during pregnancy. You might have even pushed a baby out of your vagina, and it might have even been injured. However, in Canada, lots of doctors don’t even look at your vulva and vagina, never mind actually evaluate internally and check how the muscles are doing. (In my opinion the 6-week check is actually terribly inadequate for sooooo many reasons, and women deserve more, but that’s a topic for an entirely different conversation).

6 week postpartum check

So, what I like to tell people is:

At the 6 week check you will likely be given medical clearance to have sex.

That means you don’t have an infection that needs treatment (like antibiotics), and you don’t need any further medical procedures or interventions.

(You might even leave that visit with more questions than you went in with.)

And just because you went to that visit does not mean that you are ready to have sex.

It does not mean you are mentally or emotionally ready, and it doesn’t even mean that you are physically ready.

You will feel ready on your own terms. Every birther is different and every partnership is different. (We haven’t even mentioned partners in this discussion yet, but of course they are a super important piece… they also have their own emotions, concerns, desires, etc. too. There are so many pieces to consider in the sex puzzle).

As a pelvic floor physiotherapist, let me also expressly give you permission to wait if that’s what you want to do. Waiting is OKAY!

We need more than the absence of stitches to be ready for sex. Be honest with yourself and your partner about how you are feeling. You don’t have to do it just because your doctor gave you medical clearance. Lots of couples will wait weeks or months after the 6 week check! And that is totally okay too!

Every birther is different and every partnership is different. (We haven’t even mentioned partners in this discussion yet, but of course they are a super important piece… they also have their own emotions, concerns, desires, etc. too. There are so many pieces to consider in the sex puzzle).

BUT… if you want to do it, or you are curious about doing it (these feelings are also normal and okay!), here are some tips to help get yourself physically ready for having sex again for the first time after having a baby.

 

  1. Know the anatomy
  2. Know your anatomy (TAKE A LOOK!)
  3. Understand the sexual response system
  4. Decrease stress and increase affection
  5. Know what “Non Concordance” is
  6. Use lube (let me tell you which ones)

 

In this blog post we are going to dive into the first two tips.

1. KNOW THE ANATOMY

In order to have the best sex possible, you need to know the typical anatomy for people with vulvas and vaginas.

Before we dive into the details though, let me preface things by saying that gender, sex, and anatomy are complex things. There is actually a bounty of beautiful and amazing variety in how folks are created and develop and feel. For clarity in this article I’m talking about the anatomical parts that would make someone declare “girl!” at the moment of birth. I’m also referring to this as “female” from the biological convention where most sexually reproducing species have participants that are referred to as “males” and “females”… humans, cats, dolphins, etc. I’m hoping these descriptions will make our discussion of sex a little bit simpler to understand – even though its actually a complex topic!

 

Here is a picture of the external female genitalia:

Vulva Anatomy

Of all the structures you see listed there, here’s what you really need to know:

🔷 The collection of all these structures together is known as the VULVA.

🔷 Females have three holes:

    • The urethral opening – where we pee out of
    • The vaginal opening – where we have penetrative sex and where babies can be born from
    • The anal opening – where we poop out of

🔷 The part between the vaginal opening and the anal opening is known as the perineum or your perineal body.

🔷 The external part of the clitoris – is really just the tip of it! It’s a much larger structure… more on that below

🔷 Females have two sets of labia (sometimes called lips). Internal and external labia come in ALL KINDS OF SHAPES AND SIZES. They are all normal! (And honestly, I would say more often than not, what I see in the clinic on a regular basis does NOT really look this this picture).

🔷 Are your labia normal? YES. Don’t believe me or want to see more? Check out this awesome website (warning, it shows graphic, explicit images)

Now let’s zoom in on the vulvar anatomy and visualize both the outside and the inside parts of the clitoris:

Female Clitoris
We don’t need to get into the nitty gritty details here… but what I want you to appreciate from this picture is that the clitoris is NOT a tiny little structure above your urethra. It’s actually WAY BIGGER, it’s just mostly under the skin, instead of outside your body.

It reminds me a bit of a really fat, waddling penguin 🐧🐧🐧 (I know, now you can’t unsee that, right? 🤣🤣🤣 I mean, look at those little yellow feet! Ooops, I mean those bartholin’s glands.)

 

But seriously, if you have a clitoris, you need to understand it’s structure and how it works. If you don’t, you are leaving a lot of pleasure out of the picture.

2. Now that you know what structures exist for people with vulvas, that’s a good start. But its not enough. YOU NEED TO GET TO KNOW YOUR VERSION OF THOSE PARTS.

 

How do you get to know them? 

YOU LOOK AT THEM. YOU TOUCH THEM.

 

There is this pervasive advice circulating in the postpartum world where some mothers (and even some care providers) tell other mothers not to look at their vulvas and vaginas after birth. “Just don’t look!”, they say.

Many women also come into my clinic and tell me they have been scared to look since giving birth.

Birthers are worried that their bodies have been ruined, that they will look ugly now, that their vaginas are stretched beyond recognition.

Whoa. Not Cool.

We need to stop this cultural phenomenon now.

I understand the hesitancy. There are a lot of cultural underpinnings that have conditioned us to feel shame and guilt around our bodies and around sex. This isn’t easy to overcome, especially since we’ve been bombarded by the media and external societal pressures basically since our own births.

And I don’t want to sugar coat it for you either – things could look different.

But honestly, they should look different! Especially if you actively laboured and/or had a vaginal birth. Please do not discount the amazing and miraculous adaptations your body went through to grow and birth another human from scratch!!

We should expect change. Our culture has also done us a huge disservice in all of its many suggestions that we shouldn’t change, and we should just bounce back to our pre-baby bodies in 6 weeks.

THIS IS NOT REALITY.

So much of you has changed. You are a different person. You are a mother and a parent now. You have learned so much and experienced so much. Your brain and emotions and heart are all different. Why shouldn’t your physical body be different too?

And more importantly, this is YOUR body!

It doesn’t belong to anyone but you, and you only get one.

You need to know what it looks like.

You need to understand how it works.

And you need to understand if its changed. Especially if you have worries about sex (or if you want better sex!).

To quote Emily Nagoski from her amazing book (which inspired this post), Come As You Are: The Surprising New Science That Will Transform Your Sex Life:

“Knowing where the clitoris is is important, but knowing where your clitoris is is power.”

{***Sometimes perineal injury (stitches from a tear or an episiotomy) can change how things look too.  If you want more tips on how to help yourself heal when you have stitches, check out this blog.***}

I hope at this point you are feeling some curiosity. About your own body and even about other bodies. And if your curiosity isn’t great enough to push you to look yet, then I want you to muster up your courage.

Curiosity and courage are fabulous practices that will take you a long way towards great sex.

 

And please, stop reading the article right now and go and find your clitoris… get to know how your body has changed.

Still not sure how? Here are some directions:

✴️ Use a hand mirror if you have one (if you don’t, you can use your phone!!! Seriously, you can! Delete the pics after if you prefer.)

✴️ Get comfortable in a reclined sitting position on your bed; you can also do this over the toilet (but I wouldn’t recommend using your phone then 😂)

✴️ Comfort is queen here; prop yourself up with pillows; keep yourself warm

✴️ With one hand, spread your outer labia (the larger, often hairy ones – hair is also okay by the way!!)

✴️ Find your vaginal opening

✴️ Find your urethral opening

✴️ Look for the little tip of the clitoris (like a little nub) at the top of your vulva

✴️ If you want, continue to look for the other structures, like your perineum and your anal opening

✴️ And now gather all your curioisity and courage and find your clitoris with your fingers. Touch it. Just get acquainted with it. Explore it as much or as little as you want 😉)

✴️ At any point if you are not comfortable, stop. This is your body! You can do whatever you want! However, know that you don’t have to push through and put up with discomfort either. Be gentle with yourself. (Note: I would encourage you to get curious with your discomfort too…)

✴️ Take note in yourself as you are exploring and getting to know your body. What feelings and emotions come up? Please also know, any feelings that arise are okay too. No judgment here!

If you still have questions or concerns, that’s normal too.  You can always seek help from your friendly neighbourhood pelvic health physiotherapist, or your doctor.  Emily Nagoski’s book, Come As You Are is also an excellent reference!

 

And good news – there are more tips coming to help you get back to good sex after baby.  These first two form a super starting point, but there is so much to talk about and lots I’d love to share with you.  Stay Tuned!

 

~Mandy

 

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***This article is for informational purposes only and should not substitute advice from your healthcare/maternity...