Postpartum Intimacy and Pelvic Floor Healing

Bringing a baby into the world can be an incredible experience, but it also comes with a lot of changes — especially when it comes to your body and your sex life. If you're wondering when (or how) to resume intimacy after giving birth, you are not alone. Many new moms have questions about their sexual pleasure, how their pelvic floor is holding up, and whether sex will ever feel the same again.

Let’s dive into everything you need to know about your postpartum pelvic floor, what to expect during sex after childbirth, and how to get back to pleasure on your own terms.

How childbirth affects your pelvic floor (and sex life)

Your pelvic floor is a group of muscles that support your bladder, uterus, and bowels. It plays a huge role in sexual function, and childbirth can stretch, weaken, or even injure these muscles. Here’s how different types of birth affect your pelvic floor and, in turn, your sexual experience.

Vaginal birth 

• Stretching and trauma: The vaginal canal stretches significantly during delivery. In some cases, tearing or an episiotomy (a surgical cut) may occur, leading to soreness, scarring, and sensitivity during penetrative sex.

• Pelvic floor weakness: Pregnancy, and pushing during labor, can weaken pelvic floor muscles, making it harder to control urination (hello, postpartum leaks!) and potentially reducing sensation during sex.

• Pelvic organ prolapse: In some cases, weakened muscles can cause organs like the bladder or uterus to shift downward, leading to discomfort during sex and daily activities.

C-Section 

• Abdominal trauma: While a C-section avoids vaginal trauma, the abdominal muscles are cut through, which can affect core and pelvic floor stability.

• Scar sensitivity: The incision area may be tender, making certain positions uncomfortable.

• Pelvic floor still affected: Pregnancy itself puts pressure on your pelvic floor for nine months, so even without vaginal delivery, some muscle weakness can still happen.

Regardless of how you give birth, the postpartum period triggers significant hormonal shifts that can affect your pelvic floor and sexual function. Estrogen, progesterone, and testosterone levels drop dramatically after delivery. If you’re breastfeeding, prolactin levels rise, further suppressing estrogen and testosterone. These hormonal changes can lead to vaginal dryness, reduced tissue elasticity, and delayed muscle recovery, making intimacy feel different or even uncomfortable.

Testosterone plays a crucial role in maintaining pelvic floor muscle strength, vaginal tissue integrity, and sexual desire. When levels drop postpartum, it can contribute to decreased libido, reduced orgasm intensity, and weakened pelvic support. Lower estrogen levels can also slow tissue repair, affecting healing after tearing, episiotomies, or C-sections, while reduced testosterone may impact muscle tone and overall pelvic function.

These hormonal shifts, combined with the physical demands of pregnancy and childbirth, can make postpartum recovery challenging. However, the pelvic floor is adaptable and can regain strength with time, targeted exercises, and, if needed, pelvic floor physical therapy. Understanding these changes can empower you to navigate postpartum healing and reclaim pleasure on your own terms.

What to expect from sex after having a baby

Sex after birth may feel different (at least for a little while). Here are some things you might experience:

• Decreased libido: Hormonal shifts, sleep deprivation, and emotional adjustments to parenthood can lower your sex drive. Sex might very well be the last thing on your mind. Try not to freak out, and remember that it’s normal for libido to wax and wane — regardless of whether you’ve just had a baby.

• Vaginal dryness: Postpartum estrogen levels drop, which can lead to dryness and discomfort during penetration. Lubricants and patience are your new best friends.

• Discomfort or pain: Especially if you had tearing or a C-section, you may experience pain. Go slow, try different positions, and don’t hesitate to use cushions or pillows for support.

• Emotional sensitivity: You might feel disconnected from your body or overwhelmed. Communicate openly with your partner about what you need.

Healing your pelvic floor after childbirth

Taking care of your pelvic floor postpartum is essential for preventing long-term issues like incontinence, prolapse, and pain during sex. Here are some steps to help your recovery:

• See a pelvic floor therapist: You might think that all you need is Kegels, but pelvic floor recovery should be tailored to your unique body and needs. A pelvic floor physical therapist can assess your muscles' condition and guide you through tailored exercises to help you regain strength and function safely.

• Prioritize rest and recovery: Your body has been through a lot! Allow yourself time to heal, avoid heavy lifting, and be mindful of movements that put excessive strain on your pelvic floor, such as high-impact workouts.

• Practice gentle core engagement: Since the core and pelvic floor are closely connected, engaging your deep abdominal muscles can help restore pelvic stability. Try diaphragmatic breathing and gentle core activation techniques.

• Address any pain or discomfort: If you experience ongoing pain, tightness, or discomfort in your pelvic floor, seek medical advice. Some women develop hypertonic (overly tight) pelvic floor muscles, which can make sex painful and require specialized treatment.

• Take your time with intimacy: Don’t rush back into penetrative sex before you feel ready. Allow yourself time to heal, explore non-penetrative intimacy, and communicate with your partner about what feels good and what doesn’t.

Tips for resuming intimacy after giving birth

Get the green light from your doctor

Most healthcare providers recommend waiting around six weeks before having sex after childbirth, but everybody is different. Recovery can be different from person to person, and even from one birth to another. If you’re unsure, check in with your doctor, especially if you had stitches, or complications, or are experiencing prolonged discomfort.

Start slow

Your first time postpartum might feel awkward or even uncomfortable, and that’s okay! Take your time, focus on foreplay, and ease into penetration gradually. If it doesn’t feel right, take a step back.

Set realistic expectations

You will have a lot on your plate — from healing physically to adjusting emotionally and taking care of a newborn. Sex may not feel the same as it did before, and that’s okay. Knowing that things will be different for a while can help ease any pressure or frustration. Your first attempts might not be perfect, but patience and a sense of humor can go a long way. Give yourself grace, and remember that intimacy is about connection, not perfection.

Look after your pelvic floor 

Your pelvic floor plays a crucial role in your sexual pleasure, and taking care of it after childbirth can help improve sensation, reduce pain, and enhance your confidence in the bedroom. A strong and well-functioning pelvic floor improves blood flow to the vaginal area, making arousal and orgasms more intense. It also supports bladder and bowel control, preventing any unwanted leaks during intimacy. If you're experiencing discomfort or weakness, consider seeing a pelvic floor specialist who can guide you through gentle recovery exercises and lifestyle adjustments that will help you feel stronger and more connected to your body.

Try lube and moisturizers

Postpartum hormones can make things drier than usual. Postpartum vaginal dryness is primarily caused by a significant drop in estrogen levels after childbirth. 

During pregnancy, estrogen levels are high, keeping vaginal tissues thick and well-lubricated. However, after delivery, and especially during breastfeeding, estrogen plummets, leading to thinner, less elastic vaginal tissue that produces less natural lubrication. This can make intercourse uncomfortable or even painful. 

Using a water-based or silicone-based lubricant can help reduce friction and make intimacy more comfortable. Additionally, vaginal moisturizers can provide longer-lasting hydration to the tissues.

Explore different positions

Some positions may feel better than others. Try side-lying, being on top (so you control depth and speed), or using pillows to support your body.

Communicate with your partner

Talk about what feels good, what doesn’t, and what you need emotionally and physically. Your partner might not know what you’re going through, so being open helps both of you navigate this new chapter. Try to see this as an opportunity to deepen your bond with your partner, and find new ways to be intimate with one another. 

See a sexual health specialist 

Pelvic floor dysfunction isn’t the only factor affecting postpartum sexual health — hormonal shifts, nerve sensitivity, and tissue changes can also contribute to pain. If sex remains uncomfortable, a sexual health specialist can evaluate underlying causes like estrogen or testosterone deficiencies, nerve irritation, or conditions such as hormonally mediated vestibulodynia (HMV). They can recommend targeted treatments, including hormone therapy or topical therapies. 

Don’t rush it

If you’re not ready, that’s okay! There are other ways to be intimate, like cuddling, massage, or non-penetrative sex. Your pleasure matters, and there is no universal timeline for getting back into sex. 

Your postpartum journey is unique, and there’s no "right" way to resume intimacy. Be kind to yourself, communicate with your partner, and prioritize what makes you feel good. Whether it takes weeks or months, your sexual pleasure will return — on your terms and in your own time.

FAQ

Can you still feel pleasure after giving birth?

Yes! While things might feel different for a while, your pleasure is absolutely still possible. It may take time for your body to heal, and strengthening your pelvic floor can help improve sensation. Plus, finding new ways to connect with your partner can be exciting.

How long should you wait to be intimate after giving birth?

Most doctors recommend waiting at least six weeks, but there’s no one-size-fits-all answer. If you had complications, severe tearing, or a C-section, healing might take longer. That said, some women may feel ready to have sex again earlier than six weeks. The key is to wait until you feel physically and emotionally ready — and for your doctor to give you the thumbs up.

How do I satisfy my wife after giving birth?

Support and patience go a long way. Encourage her to take things at her own pace, be open to non-penetrative intimacy, and communicate about what feels good. Helping with the baby or household chores can make her feel more relaxed and open to intimacy. Most importantly, don’t put pressure on her to have sex — she’s been through enough.