Intimacy After Childbirth: A Guide to Reconnecting with expert Jo Robertson

The journey from survival mode back to sensuality is one almost every new parent faces, yet it's often a silent struggle. If you're wondering how to navigate the exhaustion, hormonal shifts, and emotional distance after having a baby, this episode is your guide. We're tackling the brutal truth about intimacy after childbirth, and providing a roadmap for not just coping, but truly reconnecting. Sex and relationship therapist Jo Robertson joins Dr. Kerry Winge to cut through the awkwardness and offer real, compassionate advice for new parents.

In this in-depth conversation, Jo Robertson breaks down the unrealistic expectations society places on new mothers and couples. Forget "bouncing back"—it's time to move forward. We explore the deep impact of birth trauma, from episiotomies to emergency C-sections, and why healing the emotional wounds is the first step toward physical connection. This episode offers crucial postpartum sex tips and explains the science behind a low libido after baby, including how plummeting estrogen levels and the feeling of being "touched out" are physiological, not personal. We discuss why painful sex after birth is common but not normal, and what you can do about it, from seeking help from a pelvic health physical therapist to using practical solutions like non-hormonal vaginal inserts. Jo provides a framework for reconnecting with your partner after baby using the "Three T's": intentional Time, deep Talk, and non-sexual Touch. Learn how to communicate your needs without starting a fight, why scheduling intimacy can be a game-changer, and how to understand the difference between spontaneous and responsive sexual desire to better meet each other's needs. This is a must-listen for any couple navigating the complex and beautiful season of new parenthood.

About Our Guest:

Jo Robertson is a sex and relationship therapist, educator, and speaker from New Zealand who specializes in helping couples build better relationships and intimacy. With a masters in sex therapy and as a co-founder of an antenatal business, her work focuses on guiding new parents through the postpartum season, tackling everything from body image and hormone shifts to sexual pain and communication breakdowns. Having worked in sexual health and trauma for nearly two decades, Jo brings a wealth of knowledge and personal experience as a mother of three to her compassionate, practical approach.

Introduction to Postpartum Intimacy

Welcome back to Bottoms Up, the podcast dedicated to navigating the ins and outs of pelvic health. Today we are diving into a topic that touches almost every new parent, but is often shrouded in silence, pressure, and confusion: the journey back to intimacy after childbirth. So how do you go from survival mode back to sensuality?

Our guide for this incredibly important conversation is Jo Robertson. Jo is a sex and relationship therapist, educator, and speaker who specializes in helping couples and individuals build better relationships, better sex, and better parenting. Her work has been featured on platforms like TEDx and across New Zealand media, cutting through the awkwardness to have real conversations. She has a specific focus on guiding new parents through the postpartum season and tackling everything we really want to talk about: body damage, hormone shifts, sexual pain, and feelings of being touched out. Today she is here to help us move beyond that six-week checkup and answer our biggest questions for rebuilding connection, desire, and intimacy after our babies.

Jo, I want to thank you so much for taking your time to join us on Bottoms Up today.

You are so welcome. I am happy to be here. This is really exciting.

Jo Robertson’s Professional Background

Can you tell me a little bit about your background and how you have had some programs or classes in order to help new parents navigate this new season?

Absolutely. My background is in a few different spaces. First, I used to work in sexual trauma, looking at how the things that happen to our bodies impact our relationships and our sex life. Then I was doing sex education alongside that, hearing from young people and talking to them about their expectations of sex. Sometimes that would come with a total misunderstanding around hormones and how that might shape their body and their desires.

I then went on and did my master's in sex therapy and I just loved that. I spent three years literally learning about sex constantly. It was really fun and amazing. My mom actually encouraged me to do that, which is an interesting little dynamic. Through that time doing my master's, I was having my three boys. That was a really informative season regarding what is really going on for women and for couples in the child-rearing decade of their life. We go through pregnancy, raise that child, and then often go through pregnancy again. It can go on and on depending on how many kids we have.

I felt really passionate about the space as I was experiencing it myself. I co-founded an antenatal business with a friend of mine. She was what we call in New Zealand a Lead Maternity Carer or a midwife. She would do all of the birthing and breastfeeding stuff, and I would talk about relationships, intimacy, and mental health. I did that for many years. Then, in my private practice as a sex therapist, I was seeing many couples around the postpartum season and the general parenting season. I saw the impacts of those seasons on their sense of self, their mental health, their feelings around their body, and of course, the impact of hormones on their sex life, pleasure, and pain.

Navigating Postpartum Expectations

So I guess my first question to you is, how do you actually help couples navigate that physical and emotional timeline, the readiness to return to intimacy after childbirth? Where do we start? What can we do to help them?

That is a great question. The first place for me to start is expectations. People are not educated or given any information about what is realistic, common, or normal. I put that in inverted commas because "normal" is a tricky word given that we have such a diverse range of experiences postpartum and with childbirth. The expectations piece for me is: what is it going to be like, and what can they expect from their bodies?

I hear over and over again, and heard in the classes, people expecting that once they were physically recovered from childbirth, everything would kind of go back to normal. Their "normal" is usually pre-pregnancy, and for lots of people, that is pre-kids altogether. They have never experienced the level of tiredness and exhaustion. They have never experienced the hormonal shifts. They don't know what it is like to have someone be dependent on you physically, particularly if you are breastfeeding for months or years. They are expecting to go back to a season of life where none of those things were present.

The starting point for me is debunking that. What can we expect from the body? We can expect it to not perform in the way that it used to. In relationships, the experience of a relationship a year in versus the first few dates is fundamentally different. We need to abandon the idea of going back. I don't even like the concept of going back because the depth of connection or intimacy of the relationship after you have a baby can be so much greater than what it was initially. Why would we want to go back when there is so much potential moving forward?

Couples pre-children typically would be having sex about once a week. Couples post-children, particularly in that first one to two years, are really struggling to have penetrative sex, for example, in the first six months. Then they are really struggling to have regular intimacy for that first two years, and even more struggling to actually feel it is pleasurable or really satisfying. That is what is common. It doesn't mean the relationship is in a bad place; it is just commonly how the body responds to having a baby.

The Impact of Birth Trauma on Intimacy

I treat a lot of moms pre- and postpartum. There are moms who really want to have a vaginal birth and end up with, say, an emergency C-section. Sometimes there is a grief within that mom. That is a trauma piece. As a practitioner, when I see moms, they really need to be honest with themselves and heal through that. Because if you don't, how can you connect with your partner and navigate the new space? I find in my practice it is often ignored. Have you seen that happen?

Absolutely. It actually brings up personal memories of being that mother and having those kinds of birth experiences. I think of my first boy, who is 12 now. I ended up with an episiotomy and there was quite a traumatic postpartum experience. My bladder completely lost function. I didn't have sensation for two years after having him. I felt really afraid of penetrative sex after that point. I felt anxious about the scar, thinking it was going to tear.

That is a "how are you feeling?" piece, because it is not rational or logical. It is a feeling and a fear based in the trauma of the experience. It wasn't what I expected or hoped for. It is a really common experience to get an episiotomy, of course, and some people never think about it after that point. But the feelings I had were that I couldn't trust my body and it wasn't going to respond well to any kind of physical pressure.

It took me probably a year to work through that trigger that would come up every time we would go to have connection or sex. This little trigger would come up: "Oh, it's going to open, it's going to tear." The feelings attached to fears are so important to be able to talk through. I never told anyone that out loud. If I had talked about it with someone, we probably wouldn't have gone a year with me feeling that fear. I would have been able to process it much more quickly and recover more quickly.

That is what comes up for me when you say that. With my first child, I had a very traumatic birth, which was one of the reasons why I am a pelvic health physical therapist now. I specialized in manual therapy and orthopedics the rest of my career, doing this for over 30 years, but it was the trauma I had gone through that changed things. If somebody had listened to me or said, "Yeah, this is normal, you are going to be able to get back," it would have helped.

Instead, it was just checking the boxes: episiotomy looks good, C-section looks good, you are not bleeding, you are fine, there is no swelling. But they forget that emotional trauma that moms go through. My feeling is that sex and connection are emotional; the physical happens afterwards. You have to be able to feel safe in your body and trust those feelings. Sometimes it is just a conversation that you can be okay not being okay. This is a healing process. To be able to explain to your partner, "Wow, this happened, here is where we are, and we can work through that," is vital. That is why those antenatal classes where you can sit down and talk about how you are really feeling, not just what a practitioner is seeing, can really make a difference.

Hormonal Shifts and Libido

If I can throw something on top there, you talked about physical checks—wounds, scars, bleeding. Then there is this added layer of the emotional checks. What I find couples and even medical practitioners expect is that as long as everything looks physically okay, they should be able to return to a "normal" sex life. But they are not taking hormones into account.

Postpartum, the female sex hormone, estrogen, plummets through the floor. If your female sex hormone is plummeting, that shuts down desire and libido. It often shuts down self-lubrication. Sex becomes drier, and as a result, it can become more painful. That has nothing to do with physical scars. You cannot see that or touch that, but it is what is happening in your body.

I have women come to me all the time and say, "Why don't I even want sex? I literally don't want it at all. I don't even really want to be touched." They don't understand that their body is doing a physiological process they are not in control of. They didn't choose that. I have to tell their partners that all the time. They are not choosing a lack of libido. Their body doesn't want to get pregnant again, so it is shutting down libido and discouraging sex. It doesn't mean you can't do it, but it does mean you need to be more intentional, more careful, do more foreplay, and get good quality lube. The physical checks of wounds and scars just don't cut it regarding the physical impact of having a baby.

Especially when you are breastfeeding, that estrogen stays away a lot longer. If it elevated, your milk would dry up. Your breasts become nature and nurture; you are feeding a baby. They are not for sexual pleasure at that point in time for mom. Mom has a connection to the baby, but it is not very sexy for your breasts to be touched in a sexual way when the brain is saying no.

Managing Lubrication and Arousal

As far as lubrication goes, there is actually a product that we love called Revaree with a company called Bonafide. It is a non-hormonal vaginal insert. It is a suppository that we use every three days. There are a lot of physiological changes that happen with the body, and when they don't have the estrogen, you are going into postpartum tissues which are drier. Revaree has hyaluronic acid and coconut oil in it. The hyaluronic acid pulls the water back into the system, regenerating those tissues so you have increased blood flow and water content. A healthy tissue will slide and glide and not hurt.

I give them to all my postpartum moms and have them use the product throughout their journey, whether they are bottle feeding or breastfeeding, or until their hormones get back to normal. You know they are back to normal when they start having their normal cycles. That is one of the things that will help. It is safe and couples aren't allergic to it. Of course, it doesn't prevent pregnancy, so be very careful of that.

There are also some natural supplements we use for arousal. When you have a product you are using for arousal, that is increasing the amount of blood flow to the area. That is not increasing your libido; that comes with connection to your partner, going slow, and being intentional. But when the blood flow is there, that increases the amount of stimulation to those tissues.

The Two-Year Recovery Timeline

That is so good. There is the piece around talking, getting help, and understanding your body. Then there is the piece around what we can actually do. Understanding leads to getting practical help. In New Zealand, where I am, you can actually get free public support now under government health. That is amazing. That only got implemented last year, and you can get that support particularly after a birth injury. I am really excited for the direction things are moving in, but it has been a hard road to date.

You talked about when the cycle comes back, we know that estrogen is returning and bodies are getting into a better place. I don't have medical input or scientific understanding for this, but my observation as a therapist is that women really take two years to recover from having a baby. I am not grounding that in data, just in having talked for years with couples day in and day out. Their libido or feeling of satisfaction often doesn't return for a couple of years.

The body is doing a process that we don't fully understand. It is wanting to orient itself to connection with the baby and is managing connections elsewhere. You are tired and touched out. I want to manage people's expectations that when their periods come back, that doesn't necessarily equate to being like before. Often people have another baby after two years, so they are pushing that process out even further. That is not a reason not to do it; it is just to understand what is going on.

Impact of Age and Career on Postpartum Adjustment

Sex and intimacy are going to look different, and every couple is completely different. When you were doing the classes and talking with couples, did you see trends? Is it based on where the couple was in their decade of life, like early 20s versus 30s or 40s? Was this people being career-focused? Does any of that matter?

Interestingly, nobody has asked me that question before. That is a deep level of reflection. I found that the couples who were having babies earlier, in their 20s, took a much more fluid approach. They tended to have lower expectations and be a bit more relaxed about what it was going to look like. They tended to say things like, "Oh well, we'll see how it goes," and "Hey, this is great." I really liked that they didn't have as much expectation around life looking a particular way or managing a particular lifestyle. Maybe those pregnancies were less often intentional and more spontaneous, so they had a more playful approach.

Couples who were more established in their careers, income streams, and lifestyles struggled more with the idea of flexibility. They wanted to return more quickly to how life had been. I think part of that is they were more formed in their identity. They thought, "This is who I am and what I am about, and this is what my life will look like." What they probably didn't anticipate is that all of that goes up in the air.

Relationship dynamics post-children are fundamentally different. No matter who is being the primary caregiver—whoever stays at home or takes the mental load—they often have no idea how much that is going to impact the relationship. All of a sudden, they are doing more work in the home. They feel like they are serving the other person. They feel like they have abandoned previous goals, roles, dreams, and ambitions while watching another person continue to aspire to their dreams while they are doing the dishes. It is really confronting for your identity if you are the primary caregiver. That is never expected and can take years of processing.

Reconnecting Through Time, Talk, and Touch

What are some things couples can do to start so they don't get too far apart?

I tend to think in terms of the three Ts: Time, Talk, and Touch.

"Talk" is actually saying what is going on for you. It isn't just saying, "I have decided to introduce potato into the solid diet," though incorporating your partner into the million micro-decisions is important. Talking at more depth means asking: How are you feeling in this new role? How are you feeling about being a parent, a mother, a father? How are you feeling about your body? How is your mental health? Do you feel isolated or connected? How is your relationship with friends and parents changing? You need to do some intentional talking.

"Time" is spending time together outside of just doing jobs and being a colleague in the house. Pre-children to post-children, you often transition into colleagues. You are teammates getting something done. But quality time looks like having fun together. Most people conflate time and talk, spending all their quality time talking about intense things. Play and fun are essential. I am a big fan of people watching their favorite show together. My husband Dave and I would make a creative drink once a week or have different types of food—something not super intense, but fun and enjoyable. We recently introduced games into our relationship, like card games. It is just a laugh, maybe only 20 minutes a week where you do something playful together.

"Touch," again, people tend to think of as sexual touch. I want to pull that back into non-sexual touch. Everybody in relationships wants to feel desired, craved, and wanted. That often looks like a handhold, a touch on the back as you walk past, an extended hug of 20 seconds as opposed to two, or a slightly longer kiss. It might look like touching while watching TV rather than sitting on opposite ends of the couch. Integrating non-sexual touch helps everyone feel wanted. As a sex therapist, I hear from the person wanting more sex that they just want to be touched. Their skin is hungry for touch. They want connection no matter how it looks. We tend to devalue those kinds of touch, but they are even more important in the postpartum season.

Building Intentional Habits

When you are working with couples and working on lowering expectations and having the talk and time, how do you set that into their world? We always say it is a great idea, but then life starts going and they forget. How do you make it a priority?

You have to establish first that they want that. You need to want the relationship and a deeper connection. You need to want the partner to be there in 40 years. You have to be motivated because it is not going to happen accidentally. I have couples say, "We started something, did it for a couple of weeks, and then life just hit and we stopped." I tell them nothing will change if you live accidentally, but everything can change if you live intentionally.

You have to grow a muscle. When Dave and I first started dating, we got advice that every week we should sit down and talk. We did Saturday morning breakfast every single week to talk about what went well, what didn't go well, and what we would like to do a little better for each other. At the beginning, that felt awkward and hard. It didn't come naturally. It would have been easy to plan other things. But we made a decision to make it a concrete, non-negotiable part of our relationship. We did that for two years. Only then did the culture of our relationship change so much that we were able to do that anytime and didn't need the discipline as much.

You have to build the muscle up of it feeling a little bit forced and structured in order to change the culture. People will say, "That's going to feel awkward," or "That seems really forced." My answer is: yes, it is. But that is living intentionally. If you have turned up in my room, it means it hasn't worked so far. So we need to pivot, be disciplined, and be a little bit forced to create long-term change. I recommend an everyday intentional practice and an every-week intentional practice. The research shows couples really need twice a week intentional connection to really thrive. Once a week is surviving. If there is nothing, you are probably going to be struggling.

Effective Communication Strategies

Sex is a difficult subject for couples to talk about, especially with a new baby. How do you encourage couples to communicate about their feelings without the other person feeling attacked?

People become defensive really quickly if the existing culture of the relationship is not affirming. If you are about to approach your partner and say, "I think we should have more sex," how often are you praising them prior to that conversation? If you are not praising them a lot and offering encouragement, it makes sense for them to get defensive because there is not a soft landing place. Timing is important, but timing over a long period involves praising how they have been parenting and lifting them up so they feel like a teammate.

We tend to come to conversations that could be hard with a criticism, but also with a perceived solution. The beginning point is really that the person is craving physical connection and intimacy, and they perceive the solution being having more sex. They come into the conversation with "this will change the feeling I am having." Usually, they don't express the feeling, they rarely offer affirmation, and it stops being a team conversation because they are already proposing the solution.

If I could encourage people with a script, it is to say something like: "Hey, what I am struggling with at the moment is X, Y, Z. I can see that you are trying so hard in all these other areas, and I appreciate that. I am really impressed by how you are doing this. I would love more physical connection with you. I think you are so attractive and I desire you. I really want to touch you, but I want to respect your boundaries. What could we do? How can I help your libido? How can I help you feel more comfortable with touch? Do you want more time out or more sleep?" Coming at it as a team player means asking them what they think rather than having a perceived solution.

A Critique of Love Languages in Postpartum

That is phenomenal. It is a complete 180 from somebody saying, "I want to have more sex." I have heard the buzz about the five love languages. How do you feel about that?

I am going to be honest and say that the love languages drive me a little bit crazy. I think it has been slightly overused. It is good in terms of language, but it is not a rigid framework. I think it was designed as a brainstorming exercise, not as "I like touch, so you need to offer me touch because that is what I need." To be honest, a lot of the time it gets used as blackmail and emotional manipulation.

People often crave the thing they don't feel they are getting. That is not a love language; that is a deficit. It drives me crazy when I am working with a couple postpartum and the primary caregiver says, "My love language is affirmation and acts of service." What they are really saying is, "I want to be praised more and please do the dishes." Then the working partner will say, "My love language is physical touch," and what they are saying is, "You are not having sex with me enough." It feels like manipulation, implying "You owe me something." I don't think it should be used in the postpartum season. We should leave it at the door and really talk about what we are craving and hoping for with more openness, compassion, and empathy.

The Myth of Spontaneity

So, Time, Touch, and Talk. Try to do it two times a week. What else irks you about what couples are seeing today versus reality?

I find that in the postpartum baby/kid season, which is 10 to 15 years of your life, our responsive partners don't tend to do well with spontaneous initiation. They tend to need a little bit more mental prep. They want to go for a walk, see a friend, go to the gym, or eat good food. They need to do something life-giving before they give out.

They usually need a plan. The spontaneous piece often results in a "no" because they are not in the zone. It tends to be a good season to be more planned and intentional. It might be that on the afternoon you give the kids takeaway dinner, they watch a movie so you are more relaxed. If you have a cleaner, they come that day. You do things you know are going to be life-giving and put you in a better mental space.

I think of planned intimacy like a birthday party. Birthday parties don't happen spontaneously, but they are fun. Nobody gets to the end of a birthday party thinking, "I wish I didn't do it." A really good party requires a fair bit of planning, admin, and structure, and that tends to make it an even better experience. How can you ensure your intimacy is really great? By being intentional and planning. What does one person need prior in order to bring their best self? Very rarely does someone get to the end of intimacy and think, "I wish we hadn't done that," unless we are talking about pain.

One thing I love that you said was it is a "day off." A lot of times, for the person at home with the children, that is their office. They are working all day. It is hard to switch your brain off when you are surrounded by work. But having that scheduled, intentional, intimate connection—say, Tuesday at 5:00—means that is not your work day. Like planning for that birthday party, you are excited about connecting. Just shifting the environment and what is happening internally is pretty cool.

For the partner, they need to know what to do in the lead-up. My husband Dave knows that he needs to really turn up to the household and keep the environment cleaner so I am more relaxed. He knows that is the night he is going to cook, make me a drink, and make me feel treasured. It is not just personal responsibility, but asking: how can I help my partner if they are the one working inside the home? How can I praise their body that day if they are feeling insecure? I might tell them to go for a good long walk while I put the kids to bed, so they can return in a much better headspace.

Resources for Couples

I think that is amazing. Are there any last takeaways you would like to tell couples?

I have an online postpartum sex course. It is designed for you to do with your partner to understand the biopsychosocial model of intimacy: what is happening in the body, the mind, and the relationship. Then, what are some tips and strategies you can do to change things up? If you want to do that, you can jump onto my website, jorobertson.org.

How long does it usually take?

It is about 12 modules, and they are anywhere between five and 20 minutes each. I recommend couples just do one a week over that three-month period. It is just that intentional use of time to spark conversation. We cover birth trauma, being touched out, breasts feeling like a workstation, difference in identity, and roles. You can do it at your own pace.

That is fantastic. I am so excited and I really appreciate everything you have given to us today. Thank you, Jo.