Sex after pregnancy: When can I resume intercourse?
In general, it is recommended that sexual intercourse is avoided for the first 4-6 weeks following a vaginal or cesarean (C-section) delivery; however, it is important to speak with your health care provider before resuming sex.
Most often, especially in cases of a C-section, perineal tear or episiotomy, it is recommended to wait until after you are seen for your 6-week postpartum visit for the green light from a health care provider to resume sexual activity.
Following childbirth, your body is in a healing phase in which bleeding stops, tears heal and the cervix closes. Having intercourse too early, especially within the first two weeks, is not recommended due to a risk of postpartum hemorrhage or uterine infection.
When a woman is ready to resume sexual intercourse following the birth of a baby depends on several factors, including:
- Pain levels
- Fatigue
- Stress
- Sex drive
- Fear of sex or pregnancy
- Vaginal dryness
- Postpartum depression.
Due to the hormonal changes experienced during the postpartum period, many women experience vaginal dryness, which may continue past the typical 4-6 week timeframe if breastfeeding; this is due to low levels of circulating estrogen.
Breastfeeding can also lower your sex drive. In addition to lower levels of circulating hormones, painful sex may accompany a perineal tear or episiotomy, which can last for several months following the birth of a baby.
Steps that can reduce pain associated with sex after pregnancy include:
- Controlling the depth of penetration with varied sexual positions
- Increasing vaginal lubrication
- Taking pain medication
- Emptying the bladder
- Taking a warm bath.
Vaginal lubrication such as over-the-counter creams or gels may be useful in relieving the symptoms of vaginal dryness. If you are using barrier method birth control, using a water-based lubricant is recommended to avoid weakening the latex.
Alternatively, oral or manual stimulation may be an option during the healing process. For some people, an appointment with a pelvic floor rehabilitation specialist may be recommended to evaluate and treat painful postpartum sex.
Sex following childbirth may feel different due to decreased vaginal muscle tone and stretching. Typically, this laxity in vaginal tone is temporary, however, and is affected by factors such as genetics, the size of the baby, the number of previous births and the use of Kegel exercises.
Instructions on how to do Kegel exercises can be accessed here.
Hormones can cause a variety of interesting – and, at times, inconvenient – symptoms. For example, during sexual intercourse, your breasts may leak milk due to the hormonal response to orgasm. Try pumping before having sex to reduce this symptom.
Having a reliable method of birth control following delivery is important to prevent an unintended pregnancy. If you are interested in immediate contraception, you can consider barrier options such as condoms or progestin-only contraceptives (Depo-Provera or the mini-pill).
The timing for a copper or hormonal intrauterine device or utilizing a fitted barrier method of contraception such as a diaphragm or cervical cap should be discussed with your health care provider.
If you are interested in combination birth control methods containing both estrogen and progesterone (such as pills or a vaginal ring), speak with your health care provider to see if this option is right for you.
Learn more about birth control methods, including hormonal contraception, barrier methods and implanted devices.
The timing when a woman and her partner resume sexual intercourse following the birth of a child is ultimately a personal decision. Women should speak with their partner and health care team about any concerns that may be present.
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