Navigating Postpartum Intimacy: A Guide to Pain-Free Intercourse After Baby

Originally Posted August 12, 2017, updated January 17, 2025

Returning to intercourse after having a baby can feel overwhelming for many women. Whether you had a cesarean or vaginal delivery, it’s completely normal for intimacy to feel different than it did before. Common concerns I hear from postpartum moms include:

• “I had an episiotomy or tearing—will I re-injure myself if I have sex?”

• “Sex is excruciating.”

• “I feel like I’m going to pee during intercourse.”

• “I don’t have a sex drive anymore.”

• “My sensation just isn’t the same.”

Here’s the thing: these feelings and fears are valid, but they don’t have to be your “new normal.” Pain, discomfort, unintentional leaking, or weird sensations are not things you just have to live with.

Let me say it louder: you do not have to settle for painful sex!📣

Your Pelvic Floor Deserves Praise

During pregnancy, your pelvic floor muscles are the unsung heroes of your body, working overtime to support your growing baby, uterus, bladder, and rectum. As your belly expands, these muscles are constantly under pressure, often remaining in a semi-contracted state for nearly nine months.

Now, imagine walking around with your arm perpetually bent in a bicep curl for that long. By the end of those nine months, straightening your arm would be difficult. That’s similar to what your pelvic floor muscles experience, which can make relaxation during labor—and even intercourse—challenging.

Whether you had a cesarean or vaginal delivery, your pelvic floor deserves love and care before resuming intimacy. Here’s how:

1. Allow Time to Heal

If you had vaginal tearing or an episiotomy, it’s important to understand what’s healing. The perineum—the area between your vaginal opening and anus—is a key intersection of pelvic floor muscles and connective tissue. Like any other injury, this area needs at least six weeks to recover, with deeper tears potentially requiring eight weeks or more.

Would you punch a healing bicep muscle? No! The same goes for your pelvic floor. Give it the rest it needs.

2. Try Perineal Massage

Once the tissues have healed, gentle perineal massage can promote blood flow and prepare the area for intercourse. At first, the perineum may feel hypersensitive, painful, or tender—this is normal. Start with light pressure, and over time, you’ll be able to tolerate more.

Many couples incorporate perineal massage into foreplay. Use an organic lubricant like olive oil or a medical-grade product to keep things gentle and safe. (Avoid brand-name lubricants with harsh ingredients that can disrupt vaginal pH.)

Bottom line: go slow and be patient with yourself.

3. Practice Diaphragmatic Breathing

If you’re feeling anxious about penetration, diaphragmatic breathing is your best friend. This type of deep belly breathing helps calm your nervous system and encourages your pelvic floor muscles to relax.

Here’s how:

• Take a deep breath into your belly, imagining the air filling the lower lobes of your lungs.

• Visualize your diaphragm descending and your pelvic floor relaxing.

• Practice several breaths before intimacy to create a sense of calm and prepare your body for pain-free penetration.

4. Use A Natural Lubricant During Intercourse

Natural lubricants like organic olive oil can be a game-changer as you ease back into intimacy. A small amount (about the size of a dime) is usually enough, but use as much as you need to feel comfortable. Just remember that oils can stain sheets so lay a towel down to protect your favorite sheets!

5. Communicate With Your Partner

Open communication with your partner is essential. Let them know what feels comfortable for you—whether that’s a slower pace, less thrusting, or avoiding certain positions that allow for deep penetration.

Your partner won’t know what you need unless you tell them, so speak up. This isn’t about shame—it’s about healing together.

You're Body is Designed to Heal

If your birth experience wasn’t what you’d hoped for, or if labor left you feeling unlike yourself, know this: your body is designed to heal beautifully. Don’t hesitate to reach out to a pelvic floor physical therapist if you’re struggling.

As a pelvic physical therapist, I’ve seen firsthand how much our work can transform postpartum recovery. Whether it’s through pelvic floor therapy or simply giving yourself time and grace, you can find your way back to comfortable, joyful intimacy.

Never settle for “just dealing with it.” There’s a world of support out there, ready to help you.

Questions or comments? I’d love to hear from you!

From your girl on the internet who cares about you motherhood journey,

xo, Dr. Betsey