Is your sex life not what it used to be?

If you are worried about the state of your sex life after a traumatic birth, you are not alone. In a recent Canadian report (1), 59% of the new parents surveyed reported experiencing sexual concerns that were causing them significant stress. That actually means the majority of new parents are struggling when it comes to sex! And that’s before we even start talking about sex after birth trauma.

Becoming parents can make sex challenging for a range of reasons. Most new parents are extremely short on both sleep and time. Mothers are often dealing with changes to their body image and the physical demands of caring for a baby. Both parents are undergoing huge identity shifts and getting to know how the other is as a coparent. There is usually far less energy to invest in each other and with less spontaneous desire for sex, it can be difficult to keep a romantic connection in place.

Whilst there is a definite physiological element to postnatal sex struggles (thanks hormones), we know that psychological wellbeing also plays a role. The transition to motherhood is a vulnerable time for mental health. Some women will experiencing postpartum depression, anxiety or post-traumatic stress disorder (PTSD). Importantly, many new mothers may not meet the threshold for a clinical diagnosis but still experience emotional struggles that impact their relationship and sexuality.

Sex after birth trauma

If a couple are dealing with the emotional distress of a difficult birth whilst adjusting to life with a newborn, its probably no surprise that sexual intimacy takes a hit. Around 1 in 3 women describe their birth as traumatic and couples who have a traumatic birth actually report lower levels of satisfaction (2) with their relationship overall. Many couples find it pretty hard to support each other after a difficult birth. Both partners are vulnerable to higher levels of anger, guilt and blame, so conflict can increase. Other couples describe feeling emotionally detached, which is distressing when they had hoped to feel closer than ever after having a baby together.

A traumatic birth can further complicate sexual intimacy as many women want to avoid sex for some time if the experience of childbirth was negative. Getting the all-clear to return to sex at the six week check does not mean a woman is emotionally or psychologically ready to resume intimacy! Many new mothers find sex after birth trauma can be physically painful and trigger upsetting memories of the birth. It’s not uncommon for women to avoid intimacy because they are extremely worried about pregnancy and the idea of having to go though childbirth again.

If birth trauma has resulted in physical birth injuries, perhaps resulting from an episiotomy, stitches or tearing, these can significantly lower a new mothers’ sexual confidence. Coping with incontinence, flatulance, scar tissue or skin tags can make a woman feel highly self-conscious. This can sometimes result in total avoidance of sexual intimacy with their partner.

How to find your way back to a satisfying sex life

Whilst sex can be challenging for couples after a difficult birth, it is important to know that it can revived. In fact, a 2017 review of the literature (2) found evidence that birth trauma led some couples to work together to recover and heal, ultimately strengthening their relationship.

So how can you be one of those couples?

Take the time to give your birth the attention it deserves

Accessing support to emotionally process a traumatic birth can help reduce ongoing feelings of distress. Talking about and reflecting on what happened during the birth is an essential step for psychological recovery, and many couples benefit from doing this together. After emotionally integrating the birth experience and gaining new perspectives, it can feel easier to move forward.

Whilst it can be difficult for new parents to make time for themselves, investing in mental health and emotional wellbeing has probably never been more important than during this critical time. Nurturing the couple relationship can increase each parents’ capacity to cope with the challenges of parenthood – as well as making it possible to rediscover their desire for intimacy.

Commit to adapting and exploring what your new sex life can bring

Remember that when there are bodily changes to get used to, confidence might take some time to return and pleasure might not exist where it used to. Anxiety about sex triggering pain or traumatic memories needs to be handled sensitively, but if a couple can talk honestly they don’t have to become barriers. Seeing these challenges as something to be temporarily adapted to, creatively and collaboratively over time, can be a positive way forward for many. Support from a woman’s health physio can also make a huge difference in recovery from birth injuries and improving sexual functioning.

A wonderful Spanish study (3) explored the strategies women used to rediscover sexual intimacy after a difficult birth. The authors found that women naturally sought out understanding and emotional support to help them cope and adjust to the impact of giving birth on their sex life. Changing and adaptating sexual practices was a key strategy for coping with their new sexuality, especially if it had been affected by pain, discomfort, or physical changes. Taking time way from the demands of motherhood also helped, by providing opportunities for self-care and emotion-regulation.

Rather than waiting for desire to re-emerge by itself, some couples find it works best to agree a time to come together and commit to reconnecting. It can help to take some time alone beforehand to counterbalance the sense of being ‘touched out’ that comes with motherhood. Take the pressure off by remembering that sex includes far more than just penetrative sex. Instead, use the time to explore what each partner needs for intimacy to feel good going forward.

When resuming sex can be reframed in this way – as a pathway to emotional reconnection – it no longer has to feel like a burden or a pressure. If a couple can come together and communicate honestly and sensitively about how things have changed, then sex can even be a positive way to connect amidst the challenges of parenthood.

Interested in more evidence-based information on psychological recovery after a difficult birth?

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1. Schlagintweit, H. E., Bailey, K., & Rosen, N. O. (2016). A New Baby in the Bedroom: Frequency and Severity of Postpartum Sexual Concerns and Their Associations With Relationship Satisfaction in New Parent Couples. The Journal of Sexual Medicine.

2. Delicate A, Ayers S, Easter A, McMullen S. The impact of childbirth-related post-traumatic stress on a couple’s relationship: a systematic review and meta-synthesis. J Reprod Infant Psychol. 2018;36(1):102–15.

3. Delgado-Pérez, E.; Rodríguez-Costa, I.; Vergara-Pérez, F.; Blanco-Morales, M.; Torres-Lacomba, M. Recovering Sexuality after Childbirth. What Strategies Do Women Adopt? A Qualitative Study. Int. J. Environ. Res. Public Health 2022, 19, 950.