When you become parents, you already find it hard to make time for some love-making, and if that pains or hurts in anyone, it can be a huge disappointment.

Studies reveal that sexual discomfort and pain is not uncommon in women, with 9 out of every 10 new mothers going through pain during their first intercourse after having a baby. About 1/4th of women complain of painful sex even after 18 months after their delivery. Let’s look into probable causes and what can be done about them.

When Is The Right Time To Have Sex After Delivery?

As a generic rule, new moms are advised not to have vaginal sex till about 6 weeks after delivery, which is also the time for 6 week post-partum appointment with the doctor. Some women may be advised to abstain from sex even longer especially if they have had a tear or an episiotomy. Sex needs to be pleasurable, hence it is important that there is no risk of infection or injury to lacerations. Thus, a go-ahead from the doctor is mandatory. You should not be bleeding, there should not be any injuries and you should be feeling like making love. Not only your body, but your mind should also be willing to be intimate with your partner.
So what if you have waited long enough, the contraceptive has been taken care of, the baby is giving enough time and you are very much in the mood, but wham! Sex is not like before, and it hurts. Though common, painful sex (dyspareunia) after childbirth is not normal and needs to be addressed. More on sex life after childbirth here

What Is Dyspareunia?

The medical name for pain during intercourse is dyspareunia. This may be defined as pain that occurs in the woman’s genitals, before, during or after h aving sex. This pain can be recurrent or persistent. About 45 % of women suffer from dyspareunia at some point in their life. Sexual problems in women are highly prevalent, though they are poorly understood.

How Common Is Dyspareunia After Childbirth?

Dyspareunia after delivery is quite a common condition. In fact, a study was conducted on the subject with a sample of 1244 first time mothers in Melbourne, Australia. Of the 1244 women sampled, 49% had a spontaneous vaginal birth, two thirds of whom sustained a sutured tear and/or episiotomy, 10.8% had an operative vaginal birth assisted by vacuum extraction and 10.7% gave birth assisted by forceps. Additionally, 9.7% were delivered by elective cesarean section and 19.9% were delivered by emergency cesarean section. With regards to dyspareunia following childbirth, most of the women (85.7%) who had resumed sex by 12 months postpartum experienced pain during first vaginal sex after childbirth. Dyspareunia was reported by 44.7% of women at 3 months postpartum, 43.4% at 6 months, 28.1% at 12 months and 23.4% at 18 months postpartum. Of the women who reported dyspareunia at 6 months postpartum, a third (32.7%) reported persisting dyspareunia at 18 months postpartum. This study has been published in detail on BJOG online journal and you can read the same in detail here.

What Can Be The Reason For Painful Sex After Delivery?

Some common reasons that sex may not be as comfortable as before you had a baby can be:

1. Low estrogen levels: Breastfeeding can deprive your body off estrogen, which is actually necessary for keeping the vagina supple and well-lubricated. You can try using some lubes, or using a small amount of vaginal estrogen can also help
2. Problems with sutures or tears: If you have had an assisted birth or needed an episiotomy, you will be likely to have some issues when you resume your sex life. The scars may not have healed, the tears may still be hurting or the episiotomy could still be causing trouble. After about 8 weeks, if sex still hurts, you should get yourself evaluated by your doctor
3. Muscle Spasm: C-sections or vaginal deliveries, both can leave your pelvic floor muscles somewhat tighter which can make sex a painful experience. Muscle spasm can also result due to multiple episodes of attempts of sex, which are painful. You may need some specific pelvic floor therapy to combat this problem

Will A C-section Delivery Imply That I Do Not Have A Painful Intercourse?

This seems to be a common misconception that women who delivery through cesarean will have no pain when they resume their sex life after childbirth. If you thing that sex will be better after a C-section, then you are wrong and this is generally a myth. In fact, women who have c-section deliveries run double the risk of dyspareunia after 18 months postpartum, compared to women who have vaginal deliveries that are not accompanied with tears or episiotomy. So do women who have vacuum extraction or elective c-sections. Hence, opting for a C-section thinking that you will have no pain after childbirth when you resume your sex life is a myth, and should not be encouraged. A cesarean is not a guaranteed way to protect a woman’s sex life or avoid urinary incontinence.
The point to conclude is that sex is not supposed to be painful, and if it is, there is something that your body is trying to tell you and it needs specialized medical assistance.