DEAR OB: Next Time Clear Me for a Nap, Not Intercourse
You’re Cleared for Sex at 6 Weeks Postpartum… But Are You Ready?
Let’s just say it:
Being “cleared” for sex at 6 weeks postpartum is one of the most misleading milestones of modern motherhood.
Your OB gives you a nod, maybe a quick glance at your stitches or a “How are things feeling down there?” and boom, you’re sent off with a baby in one arm and the silent expectation that you’ll be back to “normal” sex (whatever that is) by the weekend.
Let me be clear:
Getting “cleared” doesn’t mean your pelvic floor is ready.
It doesn’t mean your brain is ready.
And it definitely doesn’t mean your desire is magically back online.
And that’s ok!
As a pelvic health occupational therapist, I get up close and personal with the intersections of healing, sensory overwhelm, identity shifts, daily routines, nervous system regulation, and yes, intimacy. So let’s unpack this whole “6 weeks = sex” myth and talk about what’s really going on when you’re told to “resume intimacy.”
The Truth About Your Pelvic Floor at 6 Weeks
By six weeks postpartum, your pelvic floor is still healing. In fact, research suggests it’s functioning at less than 50%. That means the muscles that support your bladder, bowels, uterus, and vagina are still regaining strength, coordination, and responsiveness.
You wouldn’t ask a healing ankle to go for a jog, so why are we asking a healing pelvis to just slide back into intercourse?
(And for the record: an ankle isn’t expected to hold your identity, your motherhood, your relationship, and your sense of self-worth. But your pelvic floor? She’s got range.)
What About Lubrication and Hormones?
Let’s talk dryness.
Vaginal dryness isn’t just personal, it’s hormonal. Estrogen levels drop after birth, especially if you’re breastfeeding or chestfeeding. And estrogen plays a starring role in keeping your vaginal tissues comfortable and responsive.
So if things feel dry or tight or even closed for business, that’s not weird or failing. That’s postpartum.
Lube helps. A lot. And no, needing it doesn’t mean anything bad about you. It’s not a red flag, it’s just part of the picture right now (or even, always. The right lube can have many benefits!)
Lube is a tool, not a commentary.
Let’s Talk About Desire
Desire is not one-size-fits-all. It’s not always spontaneous (like the light switch moment people think you should be having). For many people, especially postpartum, desire is responsive. That means it wakes up after a sense of safety, connection, calm, and care is already present.
And guess what? That’s completely normal.
Maybe desire shows up after rest.
Maybe it shows up after your body has been honored in a nonsexual way, like a back rub or a quiet bath.
Maybe it shows up after a real conversation with your partner about how they help carry the load.
Or maybe it’s still hiding, because everything else is louder right now, and that’s not broken. That’s just life in a tender season.
Desire needs space, not pressure.
It needs gentleness, not deadlines.
Where Occupational Therapy Comes In
Occupational therapy is about how you move through your daily life, your routines, your roles, your environments, your values. And intimacy? That’s part of the picture. You don’t just “go back” to sex after birth. You rebuild your relationship to touch, connection, and pleasure, often from scratch.
That might look like:
Exploring what kinds of touch feel safe again
Processing body changes and identity shifts in real time
Supporting your nervous system as it tries to regulate after so much overstimulation
Reimagining intimacy on your terms, not how it used to be, not how someone told you it “should” be
Addressing pain or discomfort, but also building capacity for pleasure again
Pleasure isn’t an afterthought. It’s part of healing. And it can be rebuilt with care, curiosity, and support.
Intercourse ≠ Intimacy
Let’s say that again: Intercourse is not the same thing as intimacy.
Sometimes intimacy looks like:
Holding hands while you both collapse on the couch
Laughing about the weirdness of it all
Touching in ways that aren’t goal-oriented
Making eye contact without a child needing something in between you
Tending to your own body in ways that have nothing to do with someone else’s needs
Those moments count. They matter. They lay the groundwork for desire to show up in its own time.
What You Actually Deserve
You deserve more than a pat on the back and a “You’re good to go” at six weeks. You deserve…
Support that’s not focused only on fixing or rushing you
A chance to understand your own version of desire
A safe space to be curious about intimacy again
Permission to say “not yet”, or “yes, but differently”, or “I’m not sure how I feel right now”
There is no right time. There’s only your time.
Let’s Rewrite the Timeline
If you’re ready at 6 weeks? That’s great.
If you’re not? Also great.
If you’re somewhere in the messy middle? You are exactly where you need to be.
Desire is layered. Healing is non-linear.
You are not behind. You are not broken. You are allowed to take your time.
And if you want support from someone who gets the whole-person picture, who knows how to hold space for function, healing, pleasure, identity, and joy, Medusa is here. We offer in-person and virtual sexual health counseling.
Let’s rebuild this together. On your terms.
#PostpartumDesire #SexAfterBaby #PelvicHealthIsWholeHealth #OccupationalTherapyForRealLife #PelvicFloorOT #HealingIsNotLinear #NotJustCleared #ThisIsYourTimeline
