How We Think Sex Changes After Childbirth Versus How It Actually Changes

This article originally appeared on Broadly

The perception that performing a vaginal delivery will negatively impact subsequent sex is pretty common. A pair of researchers at Queen’s University in Ontario, Canada, sought to find out how pervasive that assumption is, and just published the results of the study in the journal Birth. It’s the first large-scale endeavor to ask women who’ve never given birth how they think the method of delivery (vaginal or cesarean) will impact their future sex lives.

The study’s authors surveyed 1,428 women over the age of 18 who expressed an interest in giving birth in the future. They were asked to share how they preferred to deliver, and rate how much they agreed with statements such as “my partner will not like the look of my vulva after I have a vaginal birth” and “my vagina will be ‘loose’ after I have a vaginal birth.”

While most (85 percent) said they’d prefer to have a vaginal delivery, about a quarter of respondents said they thought their sex life would not be the same afterwards if they did go that route. Almost half (48 percent) of those surveyed believed their vagina would end up being “loose,” and 21 percent said they thought having a C-section would prevent future sexual issues.

Caroline Pukall is a psychology professor at Queen’s University and one of the authors on the study. She tells Broadly that because sexuality is such an important aspect of people’s lives, it may be something they consider when thinking about their birth plan. “Some people may be influenced by media sources when making this decision, [and] media portrayals of sexuality after childbirth tend to suggest that vaginal birth has a harmful effect on a couple’s future sex life and that C-sections are protective of a couple’s postpartum sexuality.”

To illustrate, Pukall and the lead author, grad student Jackie Cappell, turned to Keeping Up with the Kardashians. In one episode they cite, Kim raises the question about whether sex after a vaginal delivery is really like “throwing a hotdog down a hallway.” In another example, Pukall and Cappell note that a doctor in Life in Pieces “warns new parents not to ‘look down there’ after a vaginal birth, and when the new mother does, she comments that her vulva looks like ‘predator took off his mask’ and questions whether she and her husband will ‘ever be able to have sex again.’”

But these assumptions are not based on actual research. In fact, Cappell determined that after perusing the literature, there was “no clear evidence” that C-sections would help prevent postpartum sexual problems.

So what does sex look like for women after having a baby? It depends on the person, Pukall says. “In some, sex will be similar to that which was had before kids. In others, it will change—sometimes for the better, and sometimes not. Sexuality evolves over time (just like we evolve in our roles, for example), and with big changes come other changes, and some of those affect sexuality.”

“Specific to those who experience vaginal births with significant tearing or the use of instruments to aid in childbirth,” she continues, “research shows that these factors may be associated with genital pain associated with penetrative activities—but this pain tends to disappear by six months postpartum for most individuals.”

The goal of their research, Pukall explains, was to help dispel misinformation and to encourage people “to think critically about what they may see in media, especially when it comes to how sex and sexuality are represented.” But, she adds, these misconceptions certainly raise some flags about “the larger narrative surrounding female genitals in North America.”

“There is a pervasive idea,” Pukall says, “that female genitals need to be tight and youthful-looking to be desirable for male penetration, and that idea can be related to patriarchal ideologies related to female sexuality that still, unfortunately, exist today.”