Hey mama - congrats on that new baby! I know first hand that these early days can somehow be both magical and… very, very hard as you make a transition into motherhood (or to a second, third, or fourth baby)

If you’ve made it here, You may be feeling:

A little awkward in your postpartum body
Ready to feel like yourself again - but not sure where to start
Really disconnected from your partner (the roommate stage is REAL!)
disillusioned at how birth has changed your body (whether you delivered vaginally or by C-section), and those body image issues you thought you were over are sneaking back up
Tired of late-night googling if things like pelvic heaviness, painful sex, or leaking are normal postpartum (and if they will get better with time)

If you’ve reached that six week milestone, and you’re wondering why your body still doesn’t feel “back to normal”, you’re in the right place.

In this blog post we are going to talk about sex after baby - what’s normal, what’s not, and what to do if you’re having pain.

If you're experiencing painful sex postpartum, you're not alone—but that doesn't mean it's something you have to suffer through.

As a pelvic floor physical therapist who’s worked with hundreds of postpartum moms, I can confidently say this: painful sex is common, but it's not normal, and it’s absolutely treatable.

Whether you’ve had a vaginal delivery, a C-section, or are weeks—or even months—into postpartum, here’s what you need to know about returning to sex after birth, why it might hurt, and how to get support.

**What your 6-week postpartum “all-clear” check-up really means**

At your six-week checkup, your provider might give you the “green light” to resume having sex.

But here’s the truth: being medically cleared is not the same as being physically or emotionally ready.

Fun fact - the 6-week benchmark is really arbitrary - there isn’t any true medical evidence to back that up as ideal to return to sex, and starting before that could be completely fine if you’ve stopped bleeding and any tears or incisions have healed. But I’m guessing if you’re reading this, you aren’t waiting for permission to have sex before 6 weeks postpartum -

Some people feel eager to return to intimacy. Others feel completely disconnected from their bodies or too overwhelmed to even think about sex. Both experiences are valid.

You’ve just been through one of the most intense physical, emotional, and spiritual transformations of your life. Don’t be surprised if sex feels different—or even uncomfortable—for a while.

And let’s be real: if you had a vaginal birth, the last thing in your vagina was a baby. It makes sense that your body needs time to adjust.

Why sex hurts postpartum

Painful sex after giving birth—whether vaginally or via C-section—can have many root causes. Here are some of the most common:

1. You’re Still Healing Physically

Whether you had a vaginal delivery or a cesarean, your core and pelvic floor have been through a lot. Painful sex after tearing is especially common due to scar tissue and sensitivity in the perineum or vaginal walls. Even if your tear is technically closed and healed, your nerve endings may be more sensitive to touch, and your body can interpret that signal as “dangerous” - even though it’s not.

Even small tears can cause discomfort during penetration.

If you experienced a traumatic birth, your body may also be interpreting “danger” signals with touch or penetration to your vulva and vagina, and respond by sending pain signals. You may have some processing to do to allow trauma to move THROUGH your body for deeper healing that is not only physical but emotional too. (as a pelvic floor physical therapist, I see this often)

2. Scar Tissue Sensitivity

Both vaginal and abdominal scars from C-sections can restrict mobility or create hypersensitive tissue - meaning, your body may interpret something like gentle touch as painful.

In addition, scar tissue can create tension and restriction in the pelvic floor muscles, making it harder for them to relax for penetration.

3. Pelvic Floor Tension or Guarding

The pelvic floor can tense up as a protective response—especially after trauma, tearing, or painful birth experiences. That tension makes penetration uncomfortable or even impossible. This can happen after vaginal or C-section births.

As a pelvic floor physical therapist, I often see women who have a history of pelvic floor tension struggling with this - and painful sex postpartum is just one manifestation of this. It’s why I recommend moms start pelvic floor physical therapy in pregnancy - to work on opening and stretching the pelvic floor so it can function normally.

4. Hormonal Changes

If you're breastfeeding, your estrogen levels are low, which can cause vaginal dryness, thinning of the tissue, and increased sensitivity. This alone can lead to pain with intercourse postpartum, even without any tearing or trauma.

🔥 Pro tip: Don’t skip the lube—and choose a good quality, non-irritating one. Your postpartum vagina deserves the best. In addition, you can discuss a topical vaginal estrogen prescription with your OB provider.

5. The Mental Load and Emotional Shifts of Motherhood

Sleep deprivation, constant caregiving, postpartum anxiety, or depression can all make your nervous system more reactive—and your pelvic floor more tense. Emotional pain often has a physical expression.

What About Low Libido Postpartum?

If you feel like your libido is nonexistent… that’s completely normal. Many moms feel disconnected from their sexuality postpartum. Hormones, fatigue, stress, and mood changes can all play a role. Not to mention - your body is serving your baby, making milk, and comforting them overnight.

Even medications used to treat postpartum depression or anxiety can impact sexual desire and arousal.

It can be a big transition to go from your body really being your own to being very acutely reminded on an hourly basis that your body isn’t all your own right now. That’s ok, and it will get better. You’re not broken, but some general education around sexual arousal can be really helpful here, help from your partner managing the mental load, and working with a pelvic floor PT.

When sex feels different after baby: reframing intimacy

Sex might not look or feel the way it used to—and while that can feel like a big shift, it’s not wrong or bad. In fact, it’s a great opportunity to reconnect with your partner in new, pressure-free ways.

Emotional connection
Touch and massage
Cuddling and closeness
Non-penetrative intimacy

All of these are part of your sexuality and your relationship. Sex is more than just intercourse. (And since no one may be telling you this, it's really okay to take it off the table while you figure things out.)

How pelvic floor physical therapy can help with painful sex after baby

If you're struggling with painful sex postpartum, pelvic floor PT can help you:

Reduce pain and tension in the pelvic floor
Mobilize scar tissue (vaginal or abdominal)
Improve blood flow, sensation, and healing
Address core dysfunction, prolapse, or weakness
Reconnect to your body and regain confidence

You don’t have to “just wait it out.” Whether you're 6 weeks, 6 months, or 6 years postpartum, it’s never too late to heal.

You’re not alone, mama!

Painful sex after childbirth isn’t talked about enough—but it should be. You're not the only one going through this, and you're absolutely not overreacting.

If you’re experiencing:

Painful sex after tearing
Painful sex after C-section
Pain with intercourse postpartum
Or simply feeling unsure about intimacy again...

Know that help is available, and healing is possible. You DON’T have to just “wait and see” for it to get better.

I’m a pelvic floor physical therapist seeing clients in New Orleans and virtually worldwide through my 1:1 hybrid and digital postpartum coaching programs. Together we can tackle ALL of the pieces contributing to painful intercourse and low libido postpartum, get you moving in a way that feels joyful and healing, and feel like yourself in your body again.

Ready for more support?

If you're ready to feel confident in your body and your relationships again, I’d love to help.

Hi! I’m Jackie, a doctor of physical therapy specializiing in the pelvic floor, and holistic pregnancy, birth, and postpartum coach.

I help moms feel confident and strong in their bodies in pregnancy and postpartum with healing movement, holistic emotional support, and pelvic floor physical therapy. Learn more about my 1:1 postpartum pelvic floor programs here or fill out a contact form and I will personally reach out to discuss working together.
You are deserving of the juiciest support, mama!

Learn more

Next on your reading list:

Postpartum pelvic floor physical therapy exercises - a few of my favorite exercises to get you started in your pelvic floor strengthening and return to exercise after baby

Postpartum exercise essentials - Gear Every Mom Needs for fitness at home and on-the-go

The Best Nursing and Pumping bras for breastfeeding mamas - a few of my tried and true favorites as a breastfeeding mom (x2)

If you want to stay connected, make sure to Follow me on Instagram@drjuicyjackie for more expert (and no-TMI) postpartum advice.

Painful Sex Postpartum: Why sex hurts after baby and how pelvic floor physical therapy can help you heal

**What your 6-week postpartum “all-clear” check-up really means**