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Who here could use some tips for getting back to having sex after birth? Because trust me, you likely won’t just be hopping right back in the saddle for a while.
Fortunately, pelvic health specialist and bright ball of energy, Jeanice Mitchell (PT, MPT, WCS, BCBPMD), is here to help us out. She’s been practicing physical therapy for 25 years, and was inspired to learn more about pelvic floor therapy to learn how to meet her own needs after having a baby. A woman after my own heart.
Jeanice’s mission is to empower women around the world.
She says, “There are many people who won’t go to pelvic floor therapists because of the cost or lack of accessibility. There are even still countries in the world that don’t have pelvic floor physical therapists. The reason I’m so passionate about this is because I’ve seen the impact it has made in so many people’s lives, including my own.”
The one thing she wishes all mothers knew was how their anatomy was impacted by childbirth. For context: not only is the pelvic floor several layers deep, it’s made up of multiple muscles.
During childbirth, the perineum (the area between the vagina and anus) is frequently torn or cut to make room for baby’s head. In the worst case scenario, a tear can go all the way into the rectal canal.
Underneath your perineum are your pelvic floor muscles which are an essential connecting point. But there are simple things you can try on your own at home to improve your pelvic health. More on that later.
When is it safe to resume sex after birth?
Check with your healthcare provider, but most people are ready to resume penetration after six weeks. But there are plenty of things you can do before then to be intimate and even have orgasms without insertion. Actually, Jeanice says, orgasming may be a relief to an overly tight pelvic floor and can help with some of the residual numbness you feel in the area.
By the way: not everyone is ready for penetrative sex at the six week mark. Whether for physical, emotional, or mental reasons, and that is totally OK. “Nothing magic happens from week five to week six. It’s just a general guideline.”
So what causes the discomfort one may experience?
Causes of pain include sensitive scar tissue from your tear or cut (episiotomy). If you have a tear that went deep enough into your muscles you may have muscle scarring. Or you may have overactive pelvic floor muscles that are too tight. To clarify, she says, “Tight and healthy muscles are flexible, but muscles that are too tight don’t have the coordination to do what they need to.”
There can even be impact to the tailbone which is connected to the pelvic floor. Or orthopedic issues, pubic pain, hip pain, nerve issues, hormone changes, or other underlying factors. But those are the biggest ones.
How much pain or discomfort during sex is OK?
Although some people do say sex should never ever be painful. Jeanice says there’s not an agreed upon guideline for how much pain is OK. For example, specific positions may be a little uncomfortable, especially if a scar is being stretched. But in that case, you can try to shift to get out of pain.
Overall, a few seconds of mild pain doesn’t seem worrisome. But anything more than that should be checked out by a professional. Especially if you’re in pain the whole time or it’s intense pain.
Sex is definitely not something that should be “toughed through.” No ma’am. Apparently, a lot of people live with that mentality and it causes them to have painful sex for years and years. But the good news is you do NOT need to live like that and there is help.
So what can women do if sex after birth doesn’t feel great? Here are Jeanice’s 10 quick tips.
1. Communicate with your partner. It is normal to be nervous. Your partner may also pick up on your energy and be worried about hurting you. Being clear and direct about how you’re feeling physically (and mentally) throughout the experience is so important!
2. Use lots of lubrication. There are many types including Jeanice’s favorite: coconut oil. Creative! Just remember, you can’t use oil-based lube with a condom.
3. Explore your anatomy with your fingers first. If you’ve been cleared for insertion by your birth provider, start with something smaller first, like a finger, to see how things are feeling before jumping into intercourse. Jeanice strongly encourages getting to know your body and how it feels now. This will help you see which areas are tender or painfully tight.
4. Which leads us to the next tip: Try out perineal massage. This is when you use your fingers to massage the area between your vagina and anus. You can try side to side, up and down, moving in circles in both directions, and then going inside in a u-shaped pattern. Essentially, this action will release tight pelvic floor muscles and get the blood flow going.
This concept has also been touted as extremely beneficial during late pregnancy and even during labor to help avoid tearing or the need for an episiotomy, and to reduce pain.
5. Perineal stretching can also be helpful. You can use a variety of poses including sitting butterfly style with your feet joining and knees spread wide, the whole idea is to open up the pelvis and stretch the perineum out once again.
6. Use a dilator intra-vaginally if you’re experiencing a lot of tightness or pain. Ideally, this would be under the guidance of a trained professional, such as a pelvic floor physical therapist, to avoid additional pain or injury. They may guide you to use a static or dynamic stretch. There are various sizes used, depending on what your pain level is.
Additionally, if your deep internal muscles are tight, there is a hooked wand tool that can be used to help reach them.
7. Taking deep, slow breaths helps calm our nervous systems and loosen our bodies up. This can help calm your partner as well.
8. Practice opening your vagina before and during penetration. When inserting something, you want the vagina to be loose and open to make insertion possible and avoid pain. After the object is inserted, it may feel good to squeeze, but this isn’t recommended if you have any pain. For now, focus on opening things up.
Jeanice’s pro tip: Practice using a mirror to look at your anus. First, squeeze up and in, then relax and soften. Repeat this a few times until you feel like you have a good connection with your body. That way, when you go to have intercourse with your partner, you’ll be able to do it easier and have more confidence with what you’re doing. Woohoo!
9. Here’s an easy one: Choose a position putting the postpartum mama on top, to put her in charge of the pressure, depth, and speed that feels best for her.
10. I warn you: this last one may sound silly, but it’s still really helpful. Jeanice says right now… like right this instant, you should cup your hands underneath your bottom, so you can feel your sit bones. Then say “EEEEEEEK!” You will feel your pelvic floor lift and tighten. Now, try saying a low “grrrrr,” “shhhhh,” or “moooo.” Did you feel those muscles lengthen and soften into your fingers? That is the feeling you want during intercourse, mama.
Incorporating one of those low sounds into your experience can help make it a more pleasant experience for you physically. But she says, you may want to warn your partner about it first. Ha.
Wondering when your vagina will feel the same again?
Jeanice reminds us during pregnancy, your pelvic floor can stretch up to four times it’s regular length. Generally by 6 to 12 months, most of the healing is done. So, give it time. But there’s no guarantee it will feel exactly how it did before, and that’s ok. In her words, you may need to simply “find your new normal.”
Jeanice leaves us with a few final thoughts.
If pain persists, you have decreased sensation, or issues orgasming: please, please visit a pelvic floor Physical Therapist. And yes, you do want to see a specialist because they will be doing intra-vaginal or intra-rectal work.
By the way, this sort of specialist, can also treat a whole range of things including another common postpartum symptom: urinary incontinence, AKA loss of bladder control. And yes, even if you have a c-section, you can still have pelvic floor issues from your pregnancy.
On the other hand, if you are bleeding or hemorrhaging from sex after birth, you’ll want to follow up ASAP with your OBGYN. Chances are, you may have not healed properly or even torn your stitches.
Overall, it’s a much better idea to be seen by a medical professional than to hope your problems go away on their own. And again, there are many tools and options for treating whatever you’re experiencing.
Wow. Did you learn as much as I did? Here’s where to find more from Jeanice.
This was just the tip of the iceberg on all the amazing and important information she shares daily including on the topic of sex after birth. Check out our live interview on IGTV, to see her props, visual examples, and me blushing while talking about sex on social media. And while you’re there, follow her on Instagram for info on a ton of other topics and to have your day majorly brightened.
Visit her site, My Pelvic Floor Muscles, to shop her online courses and digital downloads. And be sure to check out this exclusive offer for 20% off her Postpartum Pain with Sex E-Course for WAM readers with my special code: WHATABOUTMAMAS. It’s a 2-hour course that goes more in depth with a tons of helpful research, graphics, and demonstrations.
And feel free to check out my little self care gift shop if you want to treat yourself (or pamper a friend) with something special today while supporting mama-owned businesses!
Psst… if you enjoyed this article, share it with another current or future mama! You can also save it for future reference on your “Motherhood Inspiration” Pinterest board.