Sex After Birth: How Your Sex Life Changes

Getting busy after your baby is born can be a challenge! "Babies are sex killers," says psychiatrist Gail Saltz, MD, at New York-Presbyterian Hospital/Weill Cornell Medical Center. Caring for a newborn takes a lot of time, and can sap you of energy you used to devote to your partner. Reclaiming your sex life after you have a child is a challenge most couples face. "It's difficult, but doable," says Saltz, who specializes in sex therapy and is author of The Ripple Effect: How Better Sex Can Lead to a Better Life. Have reasonable expectations of yourself and your body and you will get back into the sexual swing of things.

Before you start having sex post-delivery, make sure you don't have any postpartum vaginal discharge (lochia). Most women can resume intercourse from four to six weeks following delivery, regardless of whether you had a vaginal birth or C-section. Having sex before the discharge stops can put you at risk for infection. Some women need a lot of stitches during childbirth and this can also put sex on hold for a longer time period.

One of the biggest obstacles to resuming sexual activity is the overwhelming fatigue that accompanies the care for a newborn. For several months, most new babies require feeding every two to three hours around the clock. The National Sleep Foundation estimates up to 30% of babies still don't sleep through the night at 9 months. This lack of sleep can cause moms to lose sexual desire and sensation.

Dads are usually more interested in sex, even if they are tired as well. Men crave sex to help them feel emotionally close to their partners, and also to relax, according to Saltz. Most men can have sex on a whim, while most women need foreplay to become aroused.

Talk to your partner if you are so tired it's affecting your sexual desire, says Saltz. There may be ways you can get more rest, so you can get in the mood. Start by asking your partner to watch the baby so you can nap, or try to have sex in the morning, after both of you are rested. Keep in mind that the baby may still wake up just when you're trying to get down! To get some true alone time, family and friends, or babysitters can take over so you and your partner can be intimate without worrying about the baby.

After giving birth, estrogen levels decrease. This can cause a lack of vaginal lubrication, which may make sex less pleasurable or even painful. "Lubrication issues usually go away after you stop breastfeeding or after your period resumes," says Cleveland Clinic OB-GYN Elisa Ross, MD. In the meantime, use a topical lubricant to reduce irritation.

Hormonal changes may also result in postpartum depression, which includes feelings of sadness, anxiety, or irritability after giving birth. These feelings can interfere with sexual desire and may persist for weeks to months. Talk to your doctor if you suffer from any depression or anxiety after childbirth.

Breastfeeding is good for the baby, and good for mom to bond with her newborn, but it may also get in the way of your sex life. Constant nursing or pumping milk can make breasts feel tender and a woman may not want to be touched there. If you're worried about leakage or tenderness, try keeping your bra on during sex, Ross says. In addition, the amount of energy spent on nursing can make a new mom feel like a baby feeding machine, which can hinder sexual feelings.

Body changes and how a woman feels about her new post-baby body can have a big impact on her feelings of sexuality. Most women gain 25-35 pounds in a typical pregnancy, and many women get stretch marks. A C-section can leave a scar. All these things may contribute to a woman feeling self-conscious or depressed about her body. In reality, your partner likely still views you as sexy. You can also enlist help to regain your pre-baby body. Ask your partner to watch the baby so you can exercise, or have them help prepare healthy meals. You may also want to try buying some new sexy lingerie that can cover some new problem areas, suggests Saltz.

Vaginal delivery may also stretch the vaginal walls, which can decrease friction and reduce sexual enjoyment. It takes time for the muscle tone to return to that area. In some women, it never does, according to Ross. To help tone pelvic muscles, try Kegel exercises. These exercises can also help heal the area after vaginal tears or an episiotomy.

In some cases, lack of interest in sex after having a baby is more than just physical. There may be some things going on in your relationship that need to be examined. "Ask yourself, 'What is making me uncomfortable enough that I don't want to express intimacy with my partner through sex?'" Saltz says. A common feeling is resentment at being stuck at home changing diapers and nursing, while spouses get to go outside the house and spend time with other adults.

Self-consciousness about your body and your mental fatigue are other emotional issues that may need to be addressed. Talking to your partner can go a long way to reassure you that you are a team and are working together to care for your new family.

If you are having difficulty communicating, couples counseling may help. Ross recommends every couple should proactively seek counseling after having a baby, to help resolve small problems before they get out of control.

Remember that sex isn't just about intercourse. "Sex is about pleasuring each other and there are many ways to do that," Saltz says. Consider oral sex, manual stimulation, or erotic massage for intimacy. Even if you are not feeling sexual, try to connect with your partner by kissing, hugging, holding hands, or cuddling.

The first year with a newborn is very physically and emotionally demanding, and many couples may have to realize their sex lives may not be the same as they were before baby. However, most sexual issues women experience following childbirth improve within the first year. Even so, sexual activity does not always return to what it was pre-baby and couples may find they need to schedule sex. It may not feel as romantic as the spontaneity you used to enjoy, but it may be a necessary way to ensure you don't miss out on intimacy.

With a new child your sex life may change from what it was before and you may have sex less frequently than you used to. If you're both fine with not having sex as often, you're OK. "But it's not about how often sex you're having sex. It's about how unhappy you each might be about not having it," Saltz says, "If one partner feels denied all the time, it creates a vulnerability in the relationship.” These problems have to be addressed before it's too late."