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Physical Challenges with Postpartum Sex

Updated: Sep 3, 2020

Whether you gave birth vaginally or by cesarean section, with or without complications, physically things just feel different after having a baby.

It's common to experience physical challenges with sex during the postpartum period, but it doesn't mean you are broken or that your sex life is over. Healing is possible. But you have to get to the source!

(If you're interested in a broader lens, check out our blog post Sex Postpartum - What Nobody Talks About)

Scar Tissue

Scar tissue is very dense connective tissue that forms where the body and energy field has been disrupted. A scar can be passive (contained) or active. When it’s active, it can grow, gather, and adhere surrounding tissue, causing discomfort or pain. It can affect all other pelvic floor issues including prolapse, incontinence, and diastases. The body holds memories and scar tissue brings them to the surface so the trauma can be fully experienced, integrated, and released.

Before Birth

Scar tissue can occur before we even get pregnant from things such as inserting dry tampons, rough sex, abortions, medical procedures, rape, etc. If not discovered and healed before birth, it can prevent the cervix from fully dilating. Seeing a sexological body worker before or during pregnancy can resolve this issue.

Belly Birth (Cesarean)

Sex can even be painful when you’ve given birth through your belly instead of your vagina. If a c-section scar is active, it can adhere to the cervix, which then cannot move up and out of the way during sex. Because the body did not complete a vaginal birth, the vagina is confused and muscles can become really tight. The body needs to complete the experience. It may take simultaneous internal and external work with a specialist to heal this issue.

The Perineum & Tearing

The perineum is the area between the anus and the vulva or scrotum. The perineum is the foundation of our energy system. It is how we mobilize ourselves in the world. Why we may feel so ungrounded and dispersed after having a baby is because literally our pelvic floor is full of scar tissue and it’s not allowing full sensation or presence. Some people experience trauma in birth like episiotomy, tearing of the perineum or labia, or other disruptions that may not be clearly visible. How the muscles are intertwined and related when we heal after birth can cause pain. *add protecting your perineum podcast

Healing Scar Tissue

With the right manual manipulation, presence and witnessing skills, scar tissue can dissolve. A specialist might use castor oil, heat packs, and manual pressure while also helping you to move through the emotions that were present when the trauma occurred. Once scar tissue is dissolved, it is a contained scar. It can become active again if there is more emotion to work through or if the body experiences more trauma, inflammation or shifts in biomechanics. You can learn more at


It’s considered normal to pee yourself for the rest of your life altering having a baby. How sexy is that?! Yes, things change after birth, but this does NOT have to be the new normal. With proper posture, alignment and awareness of our pelvic muscles, we do not have to be burdened with incontinence.


Prolapse is when the pelvic organs (bladder, uterus, or rectum) descend into the vaginal area. You may feel like something’s just not quite right, a bulge, or more pressure than usual. The key to healing naturally is catching it early. Get an individualized diagnosis from your care provider so you know if you have prolapse, how advanced it is, and what your options are for treating it. It can always help to get a second opinion, and the best person to see is a pelvic floor specialist. You may be able to heal prolapse with specific exercises and if it’s more advanced, further treatment may be necessary.


Your alignment has to be spot on for your pelvic and core muscles to fire appropriately and support your pelvic organs. These muscles will be weak if your posture is slumped because there is more downward pressure on the pelvic organs.


Most of us don’t know how to do them correctly. Kegels must be done correctly and in moderation for them to be helpful. If you’re doing them too often or incorrectly, it can cause more damage than benefits. The best way to do this is with resistance. Check out the work of Kim Anami.

Vaginal & Pelvic Rehabilitation

It is so important to find out if there’s physical trauma that’s preventing you from having a smooth birth or enjoying sex after birth. Before and after birth, see a pelvic floor therapist or someone who specializes in sexological body work. They can feel if something is off and help create the perfect individualized healing for you. Vaginal mapping to explore the layout of your pelvic area can also be very healing as you can experience your own anatomy outside of a medical or sexual context.


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