One of my followers asked me to talk about the post partum period and sexuality. I think this is a very important topic, especially because it is something that is not talked about and parents might not feel comfortable discussing it with each other or with their health care providers. The Society of Obstetricians and Gynecology of Canada (SOGC) has a guideline that they put together in 2012 that discusses this topic. They state that most couples have some problems with sexual intercourse postpartum. In a study, it was found that more than half of women have pain with intercourse after delivery. Women who had assisted vaginal deliveries (forceps or vacuum) have the highest risk of pain, while women who had c-sections have been found to have earlier intercourse in the postpartum period likely due to fewer traumas to the area.
Other than pain due to trauma in the area, sexual desire may be decreased in the post partum period due to lack of sleep, level of comfort with one’s body, challenges to relationships and so on. Studies have shown that most women resume sexual intercourse 6-8 weeks post partum after they have received the OK from their obstetrical provider. But frequency usually remains low in the first post partum year.
Interestingly, women who are breastfeeding are found to have lower sexual satisfaction, sexual desire, decreased frequency of intercourse and delayed resumption of sexual intercourse. It is hypothesized that this is due to hormone levels (estrogen and androgen) being lower while breastfeeding. Finally, some women are worried about milk expression during intercourse. For this it may be helpful to empty your breasts prior to intercourse.
With all of this being said, it is important to know that you are not alone if you are feeling less desire in the postpartum period. The importance should be placed on quality rather than frequency to help with both partner’s feelings of sexual satisfaction. If you are having pain with intercourse, you should feel comfortable discussing this with your health care provider- this is something we are trained to discuss.
As a healthcare provider, it is important to address these fluctuations and provide reassurance, counseling and potentially discuss management such as lubricants for your patients.