Sex after a baby, and what to ask at the postpartum visit

The postpartum visit is short. Someone will ask how the baby is feeding, someone will take your blood pressure, and the question you have been turning over for weeks, which is whether sex is going to hurt, comes last, in the doorway, or not at all.

This page will not tell you when it is safe to have sex again. Nobody who has not examined you can tell you that, and a shop least of all.

Nothing on this page is an answer about your body. The answers belong to whoever provided your care.

Why you are drier than you have ever been

Women who were never dry before a pregnancy are often startled by how dry they are after one.

Estrogen is low in the weeks after a birth, and it stays low the whole time you are breastfeeding, which is the part almost nobody is told. It is the same drop, and the same thinner tissue making less of its own lubrication, that dryness after menopause works through at length. Read that page and put breastfeeding where it says menopause.

The one difference worth holding onto is that the breastfeeding version often settles as feeding winds down and estrogen comes back up. Clinicians generally describe the menopausal version as ongoing rather than temporary. Which of the two you are looking at is a question for your provider and not a thing to settle off a website.

Not breastfeeding does not disqualify you from the question. Neither does a cesarean.

Dryness is also not the only thing that can make sex hurt after a birth. A tear that is still healing, a scar, stitches, and plain dryness can feel like one another from the inside. Telling them apart is somebody's job, and it is not ours.

This is not a verdict on your relationship

Two separate things get read here as one. Whether you want your partner, and whether your body is making any lubrication of its own. After a birth the second one is running on low estrogen and the first one is running on four hours of broken sleep, and on any given night they can be nowhere near each other.

Neither of those is information about your marriage, though both get read that way at two in the morning. A body that is healing, feeding somebody every couple of hours, and running on low estrogen is doing what it looks like it is doing.

A lubricant handles friction. It does nothing about sleep, and nothing about how you feel in your own skin right now. If friction is genuinely not the problem, the bottle is not the purchase, and buying one anyway is how a woman ends up deciding the whole category failed her.

Say it before anyone stands up

Do not save it for the end. The end is when the door is already open and the next person is waiting in the hall.

• Put your questions in your phone the night before and read them off the screen. Nobody minds, and it is the difference between asking and meaning to ask.
• Take someone who can hold the baby. You will not ask the question you came to ask with a baby crying in your arms.
• Say the words sex, painful, and dry. Not that things have been difficult lately. Whoever you are seeing has heard all three already today.
• If the answer you get is vague, ask again in different words. Vague is not the same as no.

Five sentences you can say out loud

These are yours. Copy them if they fit.

• Am I healed enough for sex, and how would I know if I am not?
• Sex is painful. Not uncomfortable. Painful. I want you to look.
• I am drier than I have ever been. Is that the breastfeeding, and what do you suggest?
• What should I be using for contraception, and starting when?
• Can you refer me to pelvic floor physical therapy? Ask for that one by name, because nobody is likely to offer it. The rest of that answer is on the page linked further down.

Ask the contraception one even if your period has not come back, and ask it whether or not sex feels anywhere close.

Not one of the five has an answer a shop could give you. That is exactly why they are the five.

Do not wait for the appointment for these

Some of it is not for the visit. It is for a phone call today. None of it is an overreaction, and you will not be the first person to call.

• Bleeding that gets heavier instead of lighter, or that comes back after it had settled.
• A fever, or chills.
• A tear, a scar or stitches that feel hot, look angry, open up, or smell wrong.
• Pain that is worse today than it was yesterday.
• A hard, red, sore patch on a breast, especially alongside chills or aching.
• A headache that will not shift, changes in your vision, or swelling that came on fast.
• Chest pain, trouble breathing, or one calf that is swollen, hot or sore.
• Feeling flat, frightened, or not like yourself, and any thought that scares you. Say that one today, in plain words, to your doctor or your midwife or whoever picks up the phone.

We are not going to tell you what any of that means, because we cannot know it and neither can a website. If the first person you reach waves it off and you still think something is wrong, say so again, or ask someone else.

A cesarean does not exempt your pelvic floor

The pelvic floor is the other half of this appointment, and it is slow work. It is a whole subject and it has its own page: the pelvic floor after birth, in plain language. That one covers finding the muscle without your stomach joining in, why a cesarean does not exempt you, and what the Delice Cheri Kegel Trainer does and does not do.

What helps with comfort, once someone qualified has said go ahead

Everything below is for comfort and nothing below is a remedy. Buy any of it after the appointment rather than instead of it.

Start with lubricant, and use more of it than feels like enough. All three of the lubricants on our shelf are water-based, which means every one of them dries as you go. The answer to that is more of it, or a splash of water on your fingers, rather than a different brand.

• Simply Natural Gel from Wicked is the one that says latex condom compatible on the label. If condoms are your contraception right now, that is the bottle. It is water-based, made for sensitive skin, and it says safe with silicone toys as well.
• Aloe Lubricant from Wicked is the plain water-based bottle with aloe, made for everyday comfort, and it says safe with silicone toys too.
• Agape from System JO is water-based and formulated for sensitive skin, made without parabens, glycerin or glycol, and without oil or silicone. It does not carry the silicone toy line the two Wicked bottles carry, so we will not hand it to you for that.

Here is a recommendation that happens to point at our most expensive bottle, so it comes with the other half. If you are reading labels because your skin has been reacting to things since the birth, Agape is the only one of the three whose full ingredient list is on our site, and that list came off System JO's own page. Wicked has not published one for either of its bottles anywhere we can cite, and the retailers who do print a list keep mixing it up with a different Wicked formula, so we show nothing rather than a guess. Read the back of the bottle in your hand, and take it with you to the appointment if your skin has been unhappy. If lubricant has never given your skin any trouble, a missing ingredient list is not a reason to pay the difference. Buy the cheap bottle.

For dryness that is there when nothing is happening, a moisturizer is the other product, and it runs on a schedule rather than on the night. Foria's Everyday Vulva Moisturizer is the external one, hormone-free, a pump you work into vulvar skin with clean hands, and postpartum is named in its catalog entry among what it is for. It contains coconut oil, and Foria states it does not recommend the product with a tree nut allergy, which is worth knowing before you order rather than after. Ten minutes before sex is the wrong time to put it on, because it soaks in, which is what you bought it for. That whole distinction is moisturizer or lubricant, and when you need both.

Foria's Hydrating Melts are the internal version, individually wrapped suppositories that hydrate internal tissue with organic botanicals. Anything going inside you after a birth is a question for your provider before it is a purchase, and that includes these.

Foria's Massage Oil is the one the catalog calls made for slow and unhurried touch, which is often what comes back first. Two things to know about it. It contains sweet almond oil, a tree nut. And oil and latex condoms do not mix, so keep it well away from them.

If money is tight, buy one bottle of lubricant and nothing else, and make it one of the two Wicked bottles. They cost less than anything else on this page, and a bottle of lubricant is the most likely thing here to change your evening. The moisturizer and the melts are for a different complaint, and if that complaint is not yours, they are not for you.

And if it hurts, more lubricant is not the answer. Pain is the appointment. A second bottle is a way of putting off the call, and we would rather say that here than take the order and never hear from you again.

Put the five sentences in your phone tonight

Five sentences, in your phone, tonight. Ask them in the first two minutes of the visit rather than the last two. Buy the bottle afterward if you still want it.