Sex After Childbirth – 7 Unsexy Sins

You know what’s hard to talk about? Painful sex.

Even though it’s pretty damn common – especially after childbirth – people are a little bashful to talk about it.

So I thought I’d ask Sara from Sullivan Physical Therapy to write a little bit about it seeing as she knows all about the good china and how to keep it in good working condition.

On a side note, it’s almost impossible to find a stock photo of ‘normal people’ having sex. They all look like bronzed gazelles and not sleep-deprived parents just trying to get a little together time while Dora is blaring in the other room. If you’re a photographer, there’s a niche, man.

– Amy

Let's cut to the chase – sex can suck after having a baby.  It's not just that you still look pregnant, your nipples are leaking and you're freakin' tired, it's that sex can actually hurt.  No one will tell you this either!  Your OB won't tell you, your mom won't tell you, your friends might not tell you.  So why does it have to be this way?

Oh...let me count the ways....

Really.  I'm counting the ways sex can hurt after having a baby and I can think of seven of them.

The Seven Unsexy Sins (cuz painful sex isn’t sexy)


1.  The extra stitch

If you had a vaginal birth and tore naturally or the doctor cut the perineum (the space between the vagina and the anus) and you needed stitches and you have a really, really old-fashioned's very possible you got "the Husband Stitch".  This is an extra, unnecessary stitch at the perineum that is supposed to make your vaginal opening smaller.  Sometimes women ask for this, most of the time they don't.  The doctors take it upon themselves to do this because they think they are doing you a favor – for your sex life.  How thoughtful, right?  Some women don't even know they got this, all they know is that their vagina feels smaller and they have "no idea why".  This can cause pain with sex.  It's not that the stitch doesn't heal correctly, it's that your vagina is smaller.  This opens up a whole can of worms that this post isn't going into.


2.  No extra stitches – just the ones you needed.  

So, if you needed stitches and had an ethical physician, then you got exactly what you needed. These stitches will heal well, but sometimes they can leave you with scar tissue at the perineum. This can be really problematic with sex because scar tissue makes everything tighter and more sensitive.  It can make your muscles in your vagina way too tense when they are supposed to be relaxing.


3.  No stitches – just natural tearing.  

Same thing as #2.  Even with natural tearing you are going to have some scar tissue.  If you don't work through this scar tissue and massage it and knead it (yes, like bread) then it can create painful sex.


4.  Breastfeeding and dryness and low libido

Breastfeeding can lower your natural hormone levels inside and outside the vagina making sex dry and lowering your sex drive.  This is a snowball problem.  No, not that kind of snowball problem  (you are nasty!).  But, if you don't have sex drive, your vagina will not get wet.  When your vagina doesn't get wet enough, there is friction and this feels like sandpaper and tearing. You must, must, must use some sort of lubricant.  I think that the most gentle lubricants for painful sex are coconut oil and olive oil or something water-based like Slippery Stuff.  I really hate KY and Astroglide.  They do great marketing, but they're really not made for the sensitive vagina.


5.  Having sex and worrying about the baby waking or being in the room

So, the really cool thing about the pelvic floor (the support muscles in the pelvis that keep up all your organs and span from all around your vagina and clitoris to all around your anus and from one hip to the other, basically)  is that they respond to what we're thinking.  They are mind readers.  Your pelvic floor is a mind reader.  That is amazing, right?  When you are scared, nervous, anxious or uncomfortable, your pelvic floor muscles will automatically respond and tense up.  This makes your vagina and your anus smaller – in that moment.  It's a really primitive response.  It's your body's old-fashioned way of trying to protect your reproductive parts so that you will survive and continue to make more humans.  It's fascinating!  I really stress that if you have pain with sex, you really have to have sex when the timing is right for your mind.  When your brain is more relaxed, your vagina is more relaxed.


6.  C-section

Just like the stitch scenario, C-sections leave scars.  If you don't work this scar, the scar tissue will grown down into the layers beneath it and really create problems.  This can cause bladder problems, bowel problems and...painful sex.  No one really enforces how important it is to work that scar.  And if you've had repeat C-sections - holy moly cannoli! – work the scar!  You might not have problems now, but if you don't work that scar, you will have problems later.


7.  Attempted vaginal delivery and a c-section

You're fucked.  No, not really, I just thought that was funny.  But, it’s not really funny because both your pelvic floor and abdomen have been through Hell and back.  You might have perineal tearing and a C-section scar.  You’ve got a lot of reasons why sex could hurt, so work the scars in both places to minimize and eliminate the problem.  


So, if you've found yourself with any of the Seven Unsexy Sins, there is good help available. Pelvic floor physical therapy is a specialty of physical therapy that is completely devoted to pelvic issues – whether it's pain or incontinence.  In many countries (the United States not included) pelvic floor physical therapy is a standard aspect of care after delivering a child.  In our country, you really have to ask your physician to send you to a therapist or you have to find one yourself.

What's it like this pelvic floor physical therapy I speak of?  Well – it's intimate and it's invasive, but it's really not as uncomfortable as people expect it to be.  A pelvic floor physical therapist will do an exam on your pelvic floor muscles, determine what your exact reason for painful sex is, then they will teach you things that you can do at home and they will do hands on work inside the vagina and outside the vagina.  This is a really private, closed-door therapy.  Literally - closed-door.  You are not in an open gym.  It's just like being at the gyno – just with a therapist, no speculum, a lot more time, a lot more answers about painful sex, a lot more compassion and a lot better results.

If you have any questions, please email me at or leave them in the comment section below.

Sara K. Sauder PT, DPT is author of the blog Blog About Pelvic Pain | by Sara K. Sauder PT, DPT.  She is a pelvic floor physical therapist from Sullivan Physical Therapy in Austin, Texas. Sara's primary interest is pelvic pain.  Her goal is to help people living with chronic pain learn how to manage, improve and abolish their symptoms. She feels patient education is vital to recovery and she works to have open communication with each patient's medical team.  Sara believes that the mind and the body work together to both create and eliminate pelvic pain.  Interesting facts about Sara: She was a contestant in the 2013 O'Henry Pun Off. Her guilty pleasure is watching The Bachelor and The Bachelorette while eating Doritos and yogurt. She can hula hoop for over an hour. In junior high she was voted “Most Likely To Become President”, but she has never served as President of the United States of America.


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Baby Sign Language – Hurt or Help?

I am always floored at how many people still think that teaching a child sign language will delay their speech, so I asked Shira from Tiny Talkers to write a little post on it. Tuck it in your back pocket for when your Auntie Barb tells you that you’ll raise a mute if you teach your baby ASL –  or just flip her the bird. See, sign language works!

– Amy

A common misconception among people who are skeptical about teaching a baby sign language is that doing so will slow down their verbal development. In fact, the exact opposite is true. Baby sign language actually speeds up the process. This phenomenon has been studied by doctors and in every test, the babies who signed were more advanced than the non-signers in language skills. Signing babies also typically become smarter adults since it has been proven to raise IQ an average of 12 points!
Why does signing work so well with babies? To start with, they are exposed to three modes of learning:

  • Visual – they see the sign being made.
  • Auditory – they hear the sign being made.
  • Kinesthetic – they feel the sign being made.

Babies hear the spoken word and store it on the left side of their brain and they see the sign and store it on the right side of their brain as an image. This allows them two places to recall one word. Whenever we bridge the two hemispheres of our brain, the more ‘brain power' we are building.  Every time a baby signs, they are helping to strengthen the circuitry in their brain which will make verbal language come quicker to them.

Signing won’t inhibit language development any more than crawling will inhibit learning to walk. When a baby figures out that walking is faster than crawling, they will stop crawling. The excitement a baby experiences with communicating with signs helps to motivate them to communicate with words as well. When they do start talking, signing helps give those caring for them an extra clue as to what it is they are trying to say since some of their early spoken words tend to be so hard to understand.

Signing babies also become early readers since reading is no longer a passive experience. This also allows them to build a larger vocabulary earlier than their non-signing peers!  Now, the next time that somebody questions you about your interest in baby sign language, you can tell them all of the facts.

Win one of three Tiny Talkers Workshops! 

Anyone can enter so hop on over to my giveaway page to get in on it! 

Shira is the mom to two amazing human kids and one furry kid who is prone to throwing up a little too frequently on the new carpet.  She wishes that she could teach her cat sign language for things like "NO, POOP, IN HALL." Alas, some students don't want to learn. Shira is also a closet karaoke singer…well maybe she’s fully out of the closet by now and she applies those mad skills to her "Sign, Sing & Play" classes as well as for her music classes that she teaches. Shira loves working with parents and babies and hopes that the feeling is mutual. Shira eventually became certified by a speech and language pathologist and started her own company called Tiny Talkers.

Adorable Kids Signing!

I asked you guys if you had any pictures of your kids signing on Facebook so I could use them as examples in this post. Man, did you ever come through! Here are all the images (and some videos too!) Thank you for posting them!

[I'm signing "I love you"here, you just can't see it.]

Hover over the images to see the captions.


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Baby Sleep Cheat Sheet

When I was cruising around, I noticed their FAQs were really handy. I thought, “Shit, I totally needed this when I had a newborn” because I was forever googling how many naps they were ‘technically’ supposed to be having and how many hours in total they should be sleeping a day (I was usually doing this when they weren’t remotely close to those hours.)

So I asked them if I could have Ryan make up an infographic so you would have a little cheat sheet.

I know every baby is different, but it will give you an idea of what ballpark you should be in at any given time.

I hope you find it handy!

courtesy of

courtesy of


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