Not in the mood? When you have a new baby in the house, your sense of time may become warped as the line between night and day is blurred by a steady rhythm of feedings and diaper changes. For your partner, though, there is likely one date circled in red on the calendar: your postpartum checkup. That’s when, if all goes well, your doctor will give you the green light to have sex again.
Wait, hold on, sex?
There are many reasons — both physical and emotional — why a new mom may have very little interest in sex. Six weeks is definitely not a magic moment when all systems are go again for all women. After delivery, new mothers should take their time, get plenty of self-care and communicate with their partner.
Here are five ways to help you get your groove back after baby and help rejuvenate your sex life.
1. Allow your body to recover
If you required an episiotomy or had any tears in your perineum during childbirth, it can take from six weeks to several months to heal. But even after your doctor has examined your lacerations and informed you that you can return to normal activity, you may feel anxious about using that part of your body again.
It’s very important to have adequate foreplay. I tell my patients to ease into it and use plenty of lubricant and go very slowly. Taking over-the-counter pain relievers before you get started can also help.
Pregnancy and childbirth can also stretch and weaken your pelvic floor muscles, making sex uncomfortable and making it more likely that you will leak urine, which can also dampen the romantic mood. To get those pelvic muscles back into shape, I recommend starting with Kegel exercises, but really the best way to recover quickly and more adequately is to see a pelvic floor physical therapist.
The first time you resume having sex may not be as comfortable or as wonderful as you remember, but it will definitely get better over time.
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Ride out the hormonal rollercoaster
During pregnancy, your body produces much more estrogen and progesterone. Levels of these hormones drop very quickly after delivery, within the first 24 hours.
This dramatic hormonal shift can trigger mood swings. This combined with the sleep deprivation, physical discomfort, emotional strain and possible difficulty with breastfeeding that many new moms face could not only leave you feeling uninterested in sex but also contribute to postpartum depression (PPD).
Up to 75% of women experience a temporary case of the “baby blues,” and 15% or more will develop a more severe case of PPD.
Unlike the worry, fatigue and unhappiness of the baby blues that most new mothers face, PPD symptoms are more severe and can linger and affect a woman’s ability to take care of herself and her baby. These serious symptoms include:
- Crying more frequently or for unexplained reasons
- Feeling very sad, hopeless or empty
- Feeling overly worried, irritable or anxious
- Having trouble concentrating or making decisions
- Feeling enraged, angry or inadequate
- Avoiding friends or family members and losing interest in once enjoyable activities
- Sleeping too much or not enough, even when the baby is asleep
- Having thoughts of self-harm or hurting baby
If you’re experiencing any of these warning signs, talk to your OB/GYN provider right away. We can help and provide you with resources to help you during this emotional time.
Aside from your mood, the drop-in hormone levels after delivery can also lead to some physical changes, which can affect your desire to be intimate There is less moisture in your vagina, and the vaginal walls become thinner, often making it more painful to have intercourse. Consider using water-based lubricants, available without prescription in most drugstores.
If those aren’t sufficient, ask your doctor about using a topical estrogen cream or vaginal moisturizer. These treatments can make the vaginal tissue more supple, decreasing friction and making everything more smooth.
3. Consider your birth control options
Taking care of one small, helpless human being can be challenging enough — and the thought of having another one right away can be enough to make you take a temporary vow of celibacy. But discussing birth control options could help you relax and feel more comfortable with the idea of resuming your sex life.
Sometimes, we can place an IUD or birth control implant while you’re still in the hospital postpartum. The American College of Obstetricians and Gynecologists recommends that when possible, IUDs be placed while new mothers are still in the delivery room. Although this increases the risk for expulsion, or the IUD falling out of the uterus, this and the Nexplanon implant are still the most effective way to prevent unintended pregnancies, especially among women who may not go to their postpartum follow-up visit.
Other option for new moms who are breastfeeding include progestin-only birth control pills, the shot, the implant and condoms. And remember, though breastfeeding exclusively (meaning at least every two to three hours during the day and every two to four hours at night, without supplementing with formula) can be somewhat effective as a form of birth control for up to six months if you haven’t started menstruating again, although it is not foolproof.
For those who are not breastfeeding, all of the above options are still available in addition to estrogen-containing contraceptives, which can be started at six weeks postpartum.
4. Reach out for help so you can rest
When you finally fall into bed at night, the most wonderful thing you can imagine is a few sweet hours of uninterrupted sleep, so trying to stay awake for some nighttime nookie may not be at the top of your to-do list. You’re so fatigued as a new mom, that could really lower your desire.
Talk to your partner and your family about getting the support you need. It can take a village to care for a new baby. Come up with a few compromises:
- Have your partner help feed the baby in the middle of the night
- Enlist grandparents to watch the baby for a few hours during the day so you can have some me time
- Set up a meal train so you don’t have to worry about meals
- If you have someone who can watch the little one, schedule a couple of hours during the week to spend with your significant other however the two of you choose.
5. Find time for self-care
In addition to exhaustion, there are many reasons you may not feel confident and ready for intimacy. You spend half the day covered in spit-up, you’re still carrying around extra weight and you barely have time to comb your hair, much less put on makeup or find a pair of jeans that fit. And as much as you love your partner, it can be a challenge to feel romantic right now.
You may be super stressed because you’re responsible for this new baby, and if your social, physical and emotional needs aren’t being met, it’s really hard to feel that desire to be intimate. If you can set aside some time to walk or be physically active and de-stress, it could have a positive effect on your libido. Regular exercise and strength training could help improve your mood and your post-baby body image.
No matter how you think you look, your partner probably thinks you look beautiful. After all, you just gave birth to your baby. If you can get into a mindset of taking care of yourself and having someone take care of the baby so you can dress up and go out, that can really help.
And keep in mind that it does get better. After all, how do you think all those younger siblings arrived?
Sarah Baldassaro, MD, is an OB/GYN with Town Plaza Women’s Health – part of HCA Midwest Health. 
For labor and delivery expertise, more moms in Kansas City choose an HCA Midwest Health hospital. Our OB/GYN teams at our delivering hospitals – Centerpoint Medical Center, Menorah Medical Center, Overland Park Regional Medical Center and Research Medical Center – ensure every woman has access to top-quality maternity care, including specialized services for women with high-risk pregnancies. By delivering more babies than anyone else in the region, our maternity hospitals deliver experience and safety. Learn more at hcamidwest.com/delivers.
