When Sex After Baby Hurts!

Tuesday Jul 22 | BY |
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Sex After Baby

“Your first few postpartum years will go by quickly. But your days will be long. Some days, just a few hours with a new baby can feel like an eternity.”

I have a special place in my heart for new moms. It can be quite a shock to the system to wake up (probably at 3:00 a.m. for a feeding) and realize that you’re on your own and it’s up to you.

For months leading up to the birth, you’re literally showered with gifts, attention, love, and adoration. There are special clothes, parties, and it can feel like you’ve entered an exclusive club.

Then, for the first few days after you give birth, life’s a whirlwind of friends and family wanting to meet the baby and bring you dinner. You’re attention is 100% focused on learning the basics of swaddling, diaper changes, and feeding.

A few weeks later, the excitement and newness of it all dies down. Your helpful family members have headed home, those frozen casseroles you prepared before the baby arrived have run out, and your partner has gone back to work. Now, you’re on your own, sleep deprived, and feeling like a 24-hour feeding machine.

Dealing with Postpartum Pelvic Pain

You’ve just returned home from your six-week follow up at your doctor’s office, and you’ve been given the green light that all is healed, and you’re free to get back to your regular sex life.

The problem is that you don’t feel normal, and when you have a glass of wine that night and jump back into bed, everything hurts!

In France, women have access to government-sponsored postpartum pelvic floor re-education programs in order to heal the muscles of the pelvic floor that have been, at minimum, strained in nearly all births.

What if you have a C-Section, or tear or episiotomy that requires stitches? In my years practicing as a physical therapist, pregnancy related surgeries are the only surgeries I am aware of, after which, you’re sent home without rehabilitation and expected to take care of a helpless infant basically on your own.

If you’re a new mother who is just a few weeks postpartum, exhausted, and have pain in your vulva, vagina, or C-section scar, and your libido has take a leave of absence, know that there are lots of resources to help you heal, and feel well again.

Despite what your doctor may have told you, it’s not “normal,” and there is something that you can do about it.

What Causes Painful Postpartum Sex

There are a few common things that can cause painful postpartum sex.

1. Low Estrogen Levels

First of all, low estrogen levels are normal for breastfeeding women. This is good news for lowering your postpartum fertility, keeping your milk volume high, and lowering your risk for breast cancer. But having low estrogen means that you’ll have very dry and thin vulvar and vaginal tissue, similar to the tissue of a woman who is post-menopausal.

Dry, thin vulvar and vaginal tissues hurt when exposed to the friction of sexual intercourse. The first, and simplest thing to try is a new lubricant. I prefer those that are low in endocrine-disrupting chemicals to limit further impact on your hormones like those by Good Clean Love and Yes.

2. Muscle Damage

Second, the muscles of the pelvic floor can be damaged even if you did not have a vaginal birth. The weight of carrying your 8- (or 11-!) pound little butterball for all of those months can stretch and strain the muscles of your pelvic floor. The ligaments can also be overstretched, and you can even have nerve damage from pregnancy or labor and delivery.

For some women, the muscles are weak and over stretched. For others, the muscles are tight and in knots. Finding a local physical therapist who is well trained in pelvic floor muscle therapy can help you relax the knots, improve your muscle strength and coordination, and heal any nerve damage before these issues progress to more serious chronic pain conditions. Just heading home and doing Kegels on your own could do more harm than good.

3. Diet & Stress

What you’re eating and your stress level can have a huge impact on the recovery of your pelvic floor muscles, vulvar and vaginal tissues, and even your sex drive. Strangely enough, your digestion has a direct impact on your vaginal health. Your digestive system is where all of the nutrients for your recovery have to be absorbed. And, within your digestive system there is a giant colony of bacteria that have to be balanced so that they will work for you and not against you.

Absorbing the nutrients that you need postpartum requires that you eat foods that are easy to absorb even if your digestive system is inflamed. It’s important to eat foods that are anti-inflammatory to lower both the digestive inflammation and the post-delivery inflammation, especially if you had a surgical delivery, or required perineal stitches.

Also, it helps to eat foods that will keep your stress hormone (cortisol) levels low. Foods that keep your blood sugar in balance will help to lower the physical stress (and cortisol swings) that can come with late night feedings, and lead to energy crashes. Your emotional stress level impacts your recovery, too. When you’re feeling physically or emotionally stressed, your body prioritizes using it’s valuable resources (like healthy fats, vitamins, and minerals) to make stress buffering hormones (cortisol) instead of sex hormones. You need healthy levels of sex hormones to recover your vaginal tissues, mental focus, moods, and energy levels.

Foods that Make Healing Easier

Now, you’re surely wondering what you should eat, and how you can keep your stress level in check when you’re home alone all day with a colicky baby.

Let’s start with what you should eat. Eating foods like bone broth, slowly cooked green vegetables, clean proteins like organic chicken, grass-fed beef, wild fish, and organ meats, and healthy fats like avocados, coconut and olive oils will give you the nutrients that your body needs to heal in the most easily absorbed forms.

Chewing each bite 40 times makes it far easier to absorb the nutrients. (Even if you’re eating slowly while pacing up and down the hall rocking your almost asleep infant.) To lower the post-delivery inflammation and feed the healthy gut bacteria, eat foods like ginger, garlic, turmeric, berries, broccoli, collard greens, kale, spinach, sweet potatoes, peppers, and fermented foods like plain whole coconut yogurt, and sauerkraut.

Cooking vegetables in bone broth and adding some fat (like olive or coconut oil) to the soup will make is easier for your weakened digestive system to absorb their anti-inflammatory nutrients. Sugar, processed oils (like partially hydrogenated and processed seed oils), and grains containing gluten (and for some people, all grains) are pro-inflammatory and will slow down your recovery. Avoid these as much as possible.

To lower the physical stress of eating, be sure to eat a healthy protein, fat, and vegetable (fiber) with each meal or snack. Eating in this way will keep your blood sugar stable, helping you to avoid energy crashes or excessive stress hormone levels.

Manage Emotional Stress by Being Present in the Moment

The best tools that I have found for new moms to deal with emotional stress is to practice their ability to be present, and to surround themselves with webs of support.

Your first few postpartum years will go by quickly. But your days will be long. Some days, just a few hours with a new baby can feel like an eternity. When you’re tired, frustrated, and lonely, being a new mom is very stressful.

Presence is the simple practice of focusing only on the moment at hand. Worrying about the future or fretting about the past worsens stress. The more you can train your brain to stay in the present moment, the calmer you will feel. Practicing mindfulness meditation is one way to develop this skill. Most mindfulness classes will teach you to do this in a quiet sitting position.

As a mother myself, I understand that these moments are very rare. Instead, go about your day, making baby food, nursing, doing the laundry, changing diapers, cleaning up messes, going to the grocery store and focus your mind only on the task and interactions at hand. Smile at your baby, observe her new eye-hand coordination, listen to the clerk at the store, gently put your packages in the trunk, smell your dinner as you cook it, and exhale as you observe the one spot on your countertop that you just cleaned.

Focusing only on the moment at hand could slow you down. Eventually, you will learn to do just the most important things each day, and let go of the rest without guilt, frustration, or fear. Having a new baby in the house changes things, and eventually everyone will adjust (including you.) Be patient with yourself.

Find Webs of Support

For the days that the exhaustion, frustration, and pain take over, surround yourself with webs of support. Join a new moms group or invite your neighbor for tea (or water if that’s all you can manage that day.)

Simply connecting with a tribe of new mothers, older mothers, and helpful friends and learning to give and receive help from each other are valuable skills that have been lost by many of us in our fast paced, transient, individualistic society.

To more efficiently and lovingly enlist your partner’s help, keep a journal for each other where you can write out your needs (and he or she can write theirs). This is such a useful communication tool in my marriage and in the relationships of my clients.

For example, let’s say your husband keeps a blue journal on his nightstand where whenever you think of it you can write down something that will feel supportive for you—your favorite salad, your favorite flowers, having a foot rub, even a new way that you like to be touched as your body is healing and feeling more able to consider sensual and sexual touch.

Then, whenever he has time, he can do something for you that he will know with 100% certainty that you will appreciate and enjoy. That is so empowering. And, likewise, if you keep a red journal on your nightstand, he can write that he’d like you to send him a loving text at work from time to time when you think of him, or call to order dinner from a specific restaurant, or touch him a certain way in bed. Even if you’re not fully healed enough to return to sexual intercourse, at least he feels loved and you can maintain your bridge of intimacy with each other as your body and mind heal and strengthen.

If you’re reading this a few weeks after your new baby has been born, if you’re exhausted, sex hurts, and your feeling lonely, know that you’re not alone and that there are resources for you.

  • Try a clean lubricant.
  • Find a pelvic floor physical therapist through online directories like this one or this one. (You can even send out an SOS request on twitter using the hashtag #pelvicmafia, seriously!)
  • Nourish yourself with nutrition and support.
  • Connect with us at The Integrative Pelvic Health Institute for personalized support.
  • Have hope, postpartum healing is available for you and you don’t have to do it alone.

Have you suffered painful sex after the birth of your baby? Please share your story and tips.

Jessica Drummond

Jessica Drummond

Jessica Drummond, MPT, CCN, CHC, the Founder and CEO of Custom Hormone Healing and The Integrative Pelvic Health Institute, is passionate about caring for and empowering women who struggle with women’s health conditions such as endometriosis, PCOS, bladder pain, low libido, hormonal imbalances, weight gain, period pain, painful sex, and post-surgical, orthopedic, or pregnancy related pelvic conditions. She is equally passionate about educating and supporting clinicians in confidently and safely using integrative tools to treat chronic pelvic pain, bowel and bladder, and other women’s health issues. Having over a decade of experience as a women’s and pelvic physical therapist plus owning a private women’s health clinical nutrition and coaching practice gives her a unique perspective on the integrative, conservative options for pelvic pain management.

Jessica was educated at the University of Virginia, Emory University, The Institute of Integrative Nutrition, and Duke Integrative Medicine.

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