Q&A: Sexual Difficulties After Childbirth

“About 2 years ago I delivered a gigantic baby for my little frame. In the course of delivery I had to have an episiotomy and I tore all the way through to my anus. This has caused lots of problems ever since. I’ve had trouble with my bowel movements but it has also affected my sex life with my husband. I used to enjoy anal play a lot. Now, that was obviously put on hold for a long time while I was healing. I expected to recover fully after a few months, but pain and bleeding still plague me. This was a particularly fun spice to our sex life, but can now be a source of frustration. I was wondering if you had any advice that may bring back the enjoyment we once shared.”

I can totally relate to the traumatic birth.  My first child was so large that I received a 4th degree tear almost to my anus as well.  Not fun.  I, too, struggled with how to get back to our normal sex life after giving birth.  It wasn’t easy and it did take a long time.  In fact, it wasn’t until after our second child was born that things ever got back to some kind of normal for me.  I understand your frustration.

Give it time.  I remember hearing other women say that they were all healed up by their six week postpartum check up, and doing just fine.  Naturally, I expected it to be the same way for me.  So you can imagine how I felt, when, a year after giving birth, I was still experiencing pain with penetration during sex, and couldn’t even think about anal (like you, anal play/sex was always a fun spice for us).  As time went on, things improved.  I was able to finally have intercourse without that initial pain, and we were able to bring back anal play/sex for the most part.  It just took much longer than I had thought it would take.

Just because other women heal quickly doesn’t mean that your body will respond in the same way.  You may need more time than you think.  Try not to frustrate yourselves by continually trying to have anal sex each time you are intimate.  My advice is to stop trying (for now).  Yes, it used to be something that you looked forward to, but your circumstances have changed.  It may just be that you need more time for your body to heal.

You also need to prepare yourself for the possibility that your body will not be able to incorporate anal sex anymore.  Things change, and sometimes we just have to accept it and move on.  Your season for that may be over, and if you find that to be the case, then I encourage you to look for something else to spice up your bedroom.  Don’t let it frustrate and discourage you.  You and your husband can use this as an opportunity to do some exploration and see what other things you two can find to spice things up!  There are so many other options that you two can investigate together, and you may find that process exhilarating!


  1. I also exprienced a 3rd to 4th degree tear after my VBAC and went back to my OB several times during my healing process. If you are still having pain with vaginal intercourse at 5-6 months postpartum I would strongly urge you to visit with your OB/GYN again. I was able to get treatment (silver nitrate) to reduce scar tissue/skin tags along my internal repair that were causing pain and things are getting much better.

  2. I too had a 4th degree complete tear from stern to stem (no time for a nice clean episiotomy)! In addition, I had a wonderful gaping tear straight down the birth canal (that’s on the inside people!). I had a drug-free delivery with my 1st, only to have 2 hours of repair surgery – in the OR following the traumatic delivery. I remember my OB/GYN commenting to the OR nurse, “I’m not sure which way to stitch here, bottom to top or top to bottom”. It was a freaky incident, one which she had never seen in her 25+ years of practice – Ouch!

    Anyway, I too had horrible pain and discomfort – for months. I remember getting the all-clear at about 8 weeks and thinking during sex, you got to be kidding me. My poor husband couldn’t even get inside me an inch! After 4 months post-partum (I was a basket case), I went to see the doc again. She told me I had “secondary vaginismus” brought on by childbirth – basically involuntary vaginal muscle spasms. Through a lengthy period of vaginal exercises (and toys :), and the patience, understanding and gentle care of my wonderful husband, I recovered. It took 20 months.

    Anal sensitivity is a different ball game. You should see a Dr.

    I will say that the learning curve my husband and I embarked upon 11 years ago was quite liberating! We have always had a great physical relationship, but now I even had my Dr. tellling me to “get liberated!” Honestly, I look back on the experience and see that the Lord really used it to bring a new level of intimacy to our marriage bed. That painful process birthed a great sexual revolution in our hearts and has allowed me to be a source of information and encouragement to many wives.

  3. I can relate to this as well. I didn’t have such severe trauma like you ladies had (YIKES!) but I recieved an episiotomy because I guess it was something they did as a regular thing (I was stationed overseas at a Korean hospital, they spoke very little english!). What’s even crazier is that she was a premie so I don’t see why it was done. Anyway, the birthing process as a whole left my vagina trumatized period! I was not looking forward to sex AT ALL. I was terrified to have sex, and I felt that my husband wasn’t understanding at all. I was literally shaking with fear of pain when I reluctantly tried to have sex after two months. It has taken three years to be liberated and to actuallly enjoy sex and I’m even enjoying it now while I’m pregnant again.The spot that is at the bottom of my vagina is still the no-no zone, but I am blessed to be in this place finally.
    It takes time to heal. Everyone is different. Having children brings changes that are sometimes hard to get through but you can get through it. Take your time and pray for you and your husband’s understanding. I think there is so much pressure on women in this age, appearance, performance, and celebrity obssesed society today. You see countless magazine stories every week in the store about how fabulous they look and feel three weeks after and they just bounce back and ta-daaa! Don’t listen to it and don’t read it anymore. You can make it through this and the Lord will bring you through in HIS time.

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