Sex after having a baby: why it comes back more slowly than you expect

“The gynaecologist said everything has healed. So things should be back to normal, shouldn’t they?”

Many couples ask themselves this question in the first months after a birth — not always out loud. Six weeks have passed, the postnatal check is done, the doctor has nodded. And then nothing happens. Or something does happen, but it is different: more careful, more tired, with one ear on the cot. One partner starts quietly counting the days; the other starts counting how many times they have already said “not tonight”. And both are privately asking the same question: is something wrong with us?

Mostly, nothing is. After a baby arrives, sex almost always returns more slowly than a couple expected, and there are more reasons for that than a single check-up can capture. In this post I will try to explain what happens in these months to the body, to tiredness, to identity, and to what mothers often describe as “someone is holding on to me all day”. I wrote about the couple after a baby more generally — about dividing the work, arguments and time for yourselves — in The couple after the baby: keeping your partnership alive through parenthood. Here I am staying with intimacy.

Six weeks is not a deadline

In people’s minds, six weeks has settled in as a kind of boundary: not before, but afterwards, back to normal. In reality it is a rough point by which, for most women, the womb has healed and postnatal bleeding has stopped, and the time when the postnatal check with a gynaecologist usually takes place. It is not the day sex automatically comes back.

Data from an Australian cohort study of first-time mothers, published by Ellie McDonald and Stephanie Brown, shows this clearly. Six weeks after the birth, 41% of women had resumed penetrative sex; by twelve weeks it was 78%, and by six months 94%. In other words, at that famous six-week mark most women had not yet started, and even after three months a good fifth were still waiting.

So if you are still at the beginning after three months, you are not the exception. You are the average that people rarely talk about.

A body that is still healing

First, the body — and here there is a clear rule: anything to do with healing, pain or unusual sensations goes to a gynaecologist first, not into a therapy room. The postnatal check is a good moment to ask openly about whatever worries you, even if it feels awkward. Gynaecologists have heard these questions countless times.

After a vaginal birth, tissues heal, often including stitches after a tear or an episiotomy. After a caesarean, an abdominal wound heals, with its own pain and its own timetable. The pelvic floor carried a heavy load during pregnancy and birth; some women later notice leaking urine, a feeling of pressure, or pain during sex. For these problems there is pelvic floor physiotherapy, which can help a great deal — it is worth asking your gynaecologist or community nurse where you can turn.

Pain during the first attempts is not rare, but it is not something you should grit your teeth and endure. If sex hurts, that is a reason to talk to a doctor. I have written more about when pain is a signal for the doctor and when fear gets woven into it as well in Painful sex in women: when to see a doctor and when to see a therapist.

Breastfeeding and hormones

Many women are surprised that after the birth the vagina is drier and more sensitive than it has ever been. The reason is often hormonal. While you are breastfeeding, prolactin levels are high and oestrogen levels low — the body is in a temporary state that in many ways resembles the time around menopause. The result can be less natural lubrication, thinner tissue and less spontaneous desire.

This is not a sign that something is wrong with you or with the relationship. It is physiology looking after a baby. A gynaecologist can advise you on what helps with dryness and check whether anything else lies behind your difficulties.

Breastfeeding also changes how you experience your own body. Breasts that used to be part of intimacy are now first and foremost a source of food. Some women experience this with complete ease; others need time before their body has room for both again. Either is fine.

Tiredness that is more than sleepiness

When couples talk about sex after a baby, tiredness is almost always at the top of the list — for both parents. Researchers Kristen Schlagintweit, Kayla Bailey and Natalie Rosen found in couples of new parents that both partners have sexual concerns — not only the mother but also the father or partner — and that among the most common are low desire, a gap in desire between the partners, and tiredness.

Tiredness in the first year is not only a lack of sleep. It is also constant readiness: a body that listens for every sound at night struggles to relax fully during the day as well. Desire, though, needs at least a little safety and space in order to arrive. When the nervous system is always on guard, sex is one of its lowest priorities.

So the question that helps is often not “when will we again?” but “when will we both be at least a little rested?” Sometimes the most romantic thing a partner can do is take over the night feed and let the other sleep four hours in a row.

“Someone is holding on to me all day”

Mothers have found an English expression for this: touched out. All day you carry, feed, change, settle. Small hands pull your hair, a head rests on your chest, your body is almost constantly available to someone. When your partner puts a hand on you in the evening, your body does not say “at last” but “one more”.

This is often the most painful misunderstanding in a couple. The partner experiences the withdrawal as a rejection of themselves. The mother feels guilty because all she wants is one hour when nobody needs her. Neither of them is doing anything wrong. Touch is simply a depleted resource that has to refill first.

It helps if the two of you name it: “It isn’t about you. It’s that I’ve had someone on me all day.” And it helps if touch is separated from the expectation of sex for a while — a hug that is just a hug, a hand on the shoulder that is not an invitation. When touch is no longer a question, the body accepts it more easily.

Who am I now?

The birth of a child is one of life’s biggest transitions — the knowledge base describes this under identity. Suddenly a woman is a mother and a man a father, and either of them may not find themselves in the new role straight away. I have written more about how this transition is experienced in Parenthood as a transition: who am I now that I am a mother or a father?

This matters for sex because desire is not only physical. Desire also needs a sense of yourself as someone who wants — not only as someone who looks after. Many women say that in the first months they no longer feel like a woman, only like a mother. Some men say that after a birth they were present at, they experience their partner differently for a while: with more respect, but also with a kind of hesitancy, as if they might hurt her.

In relational family therapy, in which I am training, it is well known that the birth of a child also awakens patterns from each partner’s family of origin: how our parents looked after each other when we were small, whether there was room in the family for tenderness between the adults. These images wake up precisely now that we have become parents ourselves, often without words.

When desire doesn’t come on its own

More than twenty years ago, the Canadian physician Rosemary Basson described how for many people — especially in long relationships — desire often does not come before closeness, but out of it. First there is a willingness to open up to touch; only then does desire gradually awaken. I described this model in more detail in When your desires don’t match: sex in a long relationship, and you will find it in the knowledge base under differences in sexual desire.

After a birth this is particularly important. If you wait for spontaneous desire to appear by itself, you may wait a very long time. But if you know that desire can also arrive during closeness, a different path opens up: small steps, with no goal and no pressure, and with the right to say “that’s enough” at any moment.

One thing matters, though: responsive desire does not mean you have to force yourself. It means you can choose closeness when it feels pleasant and safe, and see what happens. If your body says no, that is an answer to be respected.

How it sounds in a couple

This is how a conversation many couples dread might sound (composed, not a real person):

“I feel like you don’t even see me any more.”
“I do see you. I just have nothing left in the evening.”
“But it’s been four months.”
“I know. I’m scared too that it won’t come back.”
“Really? I thought you just weren’t interested.”
“I am interested. I just don’t know where to start.”

Something important happens in this short exchange. As long as the subject was “you don’t want to, I do”, they stood facing each other. When one of them said that they were scared too, they found themselves on the same side. Sex after a baby rarely comes back to life through negotiating frequency. Far more often it does through talking about what each of you misses and what each of you is afraid of.

It also helps if the partner who wants more expresses that wish as missing, not as reproach. “I miss you” lands completely differently from “nothing again”. The first invites closer; the second pushes the other into defence. I wrote about how a couple learns to speak in the language of needs instead of blame in From blame to needs: how a couple learns a new language.

And one more thing: the partner who did not give birth has their own experience. They are tired too, they are learning a new role too, they may also miss closeness and feel selfish for it. That feeling needs to be heard, not mocked. Brian Doss and colleagues followed couples for eight years and showed that satisfaction with the relationship often drops noticeably for both parents after the first child is born — the transition is hard for both, not only for the one who gave birth. When both get room for their side, conversation becomes possible.

Exercise: a map of closeness for this week

You can do this exercise tonight, once the baby is asleep. It takes fifteen minutes and has no goal other than talking.

1. Each of you writes down three kinds of touch or closeness that feel good right now and don’t ask for anything more. For example: holding hands on the sofa, a shoulder massage, a shower together, a hug in the kitchen.
2. Write down one more thing you can’t manage at the moment, and say it without apologising: “For now I can’t …”
3. Read each other’s lists and look for where they overlap. Start there. Not with what you “should” be doing again by now.
4. Agree on one moment in the week when one of these kinds of closeness gets room — without phones and without expectations about where it leads.
5. Come back to the list after a week. What felt good? What changed? The list is allowed to change from week to week.

The exercise is not a plan for getting sex back. It is a way for closeness to become something you choose together again, rather than something you quietly negotiate over.

When waiting is not enough

Everything I have written applies to the expected changes after a birth. But there are also circumstances in which waiting is not the right path.

If sex hurts — even after a few months, even when you are careful — that belongs with a gynaecologist. Pain is not something you have to get used to, and it can often be treated.

If desire has gone along with your joy in everything else, if on most days you feel low, without energy, tearful or full of guilt, it may no longer be just tiredness. Postnatal depression is common and treatable; I wrote about it in Postnatal depression: when you “should” be happy and you are not, and there is a short explanation in the knowledge base under postnatal distress. Talk to your GP or gynaecologist. If you are having thoughts of harming yourself, in Slovenia you can call the crisis line Klic v duševni stiski on 01 520 99 00 (from 7 pm to 7 am), the Samarijan helpline on 116 123 (24 hours), or in an emergency 112.

If the birth was traumatic and the thought of intimacy takes you back to those hours, then it is not a lack of desire but a body that still remembers. This too is worth talking about with a doctor and with a psychotherapist.

If sex in the relationship had already stopped before the pregnancy, the baby is not the cause — only the reason the problem became visible. In that case waiting for the child to grow up doesn’t help; what helps is talking about what had already happened between you before.

And one more boundary that matters to me: I am neither a sexologist nor a sex therapist. In couples therapy, intimacy can be one of the topics we talk about — how a couple hears each other, how they speak about missing each other, what wakes up from their families of origin. But when it comes to physical problems or sexual dysfunction, the right place to go is a doctor or a specialist in sexual medicine.

What to remember

• Six weeks is not a deadline. At the postnatal check most women have not yet resumed sex, and even after three months more than a fifth are still waiting.
• The return is shaped at the same time by the body, hormones, tiredness, being touched out and identity — for both partners.
• Always take pain and physical problems to a gynaecologist first; pelvic floor physiotherapy can help a great deal.
• Desire often doesn’t appear by itself but comes out of closeness — start with touch that carries no expectations.
• Instead of negotiating how often, talk about what each of you misses and what each of you fears.