Sitting across from me in the office is a new mom and her 8-week-old infant. We have just spent the past 20 minutes outlining her birth story, including the part about the 3rd-degree tear she sustained during delivery.
I can see her entire body tense up as she describes to me the pain she has been experiencing. And then I ask the question that I ask all moms at their postpartum visit: “Have you attempted intercourse yet?”
Her reaction is all too familiar; a little grin, an eye roll perhaps, and then an affirmative “NO!”.
Returning to sex after baby is something that we spend a lot of time addressing with our new mamas. For so many women, the thought of penetrating or disrupting an area that was just traumatized during childbirth can be a frightening and anxiety-provoking experience.
Quite often, when women attempt intercourse for the first time after delivery, the connections between the body and the brain become rather heightened. In an attempt to prevent our body from experiencing pain, our muscles (namely the pelvic floor) can often become overactive, spasm, and tense up. This is often referred to as vaginismus and can make penetration painful, and even impossible for some.
In addition, it can also contribute to vaginal dryness. One or both of these issues can ultimately prevent a successful return to sex due to pain.
Women who have delivered via C-section can experience similar issues as well.
For fear of experiencing this type of pain, many women opt to delay their return to sex. We know from an emotional and psychological standpoint how this can affect women individually and that partnerships can also be adversely impacted.
As is standard in many European countries, we believe postpartum care should include pelvic physical therapy. Evaluating the muscles and tissues directly involved with intercourse can help facilitate a safe and enjoyable return to sex.
Patients are able to learn strategies to help relax the involved muscles, massage or stretch tissues that may present with adhesions, and desensitize areas that may be overly irritable, tender, or painful. Learning strategies to relax the mind in conjunction with the body are also crucial steps in recovery for some women.
Pain with intercourse is quite common in the postpartum period, but should not be thought of as “normal” or unavoidable.
We strongly encourage all women with these concerns to seek treatment as soon as possible. Our goal at Grace Physical Therapy and Pelvic Health is to help ensure all mothers are receiving the best possible care, in a safe and welcoming environment.
Reach out to us for a free consultation and to discuss any and all concerns related to pregnancy and the postpartum period.
Dr. Moses is the Clinic Director of Grace Physical Therapy & Pelvic Health’s Raleigh location. She received her Doctorate of Physical Therapy from Northwestern University and holds a Bachelor’s degree in Kinesiology/Exercise Science from Indiana University. She completed sub-speciality training at Herman and Wallace Pelvic Rehabilitation Institute and has extensive experience treating a variety of musculoskeletal injuries. She has a passion for men’s and women’s orthopedic and pelvic rehabilitation. In addition, Dr. Moses works with children and their families to address bladder and bowel issues.
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