Sex After Birth: How Long to Wait and What to Expect

Delivery and postpartum put you through a lot both physically and emotionally. That can impact sex. Here's what to know about the potential changes and how to deal with them.

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Photo: Getty Images / Jacoblund

If you've just had a baby, sex might be the furthest thing from your mind. That's absolutely fine—your body has been through a lot and needs some time to recover. But if you're thinking about getting back to some form of sexual intimacy, you may have questions about what's safe, what to expect, and what you can do to deal with any problems that crop up along the way.

Here's what the experts say about sex after childbirth.

Do you have to wait to have sex after giving birth?

There's no required waiting period for when you can have sex again, according to the Mayo Clinic. However, most health care providers do recommend that you hold off for a few weeks.

Your body goes through a lot during labor and delivery. During labor, painful contractions are your body's way of pushing the baby down and out the birth canal, as the cervix opens. If the delivery is made via C-section, there is major surgery to cut through skin, fat, muscle, and the uterus so that the baby can be taken out of the womb.

There might also be surgery with a vaginal delivery. Known as an episiotomy, the minor surgery widens the opening of the vagina, per MedlinePlus. To do this, the doctor will make an incision in the perineum—the tissue between the vaginal opening and the anus—during childbirth. An episiotomy isn't routine, but it might be necessary if your baby needs to be delivered quickly, for instance, if your baby's shoulder is stuck behind your pelvic bone. Once the baby has been delivered, doctors will stitch the incision.

More commonly, vaginal delivery will involve perineal tears. This is when the person's vagina and the surrounding tissues tear during the delivery process, according to the National Institutes of Health. Sometimes these tears heal on their own, but if a tear is more serious, the doctor will use stitches to close it.

Regardless of which delivery method was used or how smooth (or not) delivery went, you'll be advised to have "pelvic rest" while your body is recovering from the impact of childbirth, Sherry Ross, MD, a California-based ob-gyn who's written a guide book on women's intimate health called she-ology, tells Health. That means nothing inside the vagina—no douching, no tampons, and no penetrative sex.

This is not just so your body can heal, but also because the risk of having a postpartum complication, such as an infection to a healing incision or tear, is highest during the first two weeks after delivery.

How soon after giving birth can you have sex?

Again, there's no required waiting period. But the Mayo Clinic reports that most health care providers advise waiting four to six weeks.

"Usually at the six-week postpartum visit with your health care provider you will be examined, started on birth control, and given the green light to have sex again regardless of the type of delivery you had," Dr. Ross explains.

But four to six weeks is just a rule of thumb for how long to wait. Amy Hill Fife, a pelvic health physical therapist with a private practice in Grand Junction, Colorado, uses six to eight weeks as her standard. She says the wait can sometimes be 12 weeks or more as the vulvovaginal tissue heals.

The timescale is very dependent on how the delivery went and the level of tissue damage.

"If the delivery was 'uncomplicated' with minimal vaginal tearing, no episiotomy, and stage 2 labor (pushing phase) around two hours, then six to eight weeks may be an appropriate time," says Fife.

The wait may be longer if you had a vaginal tear that needed to be surgically repaired, per the Mayo Clinic.

Getting your doctor's green light—whenever it may come—is one thing. But it is another thing to actually start having sex again. In Dr. Ross's experience, most women aren't ready to jump right in at the typical six-week mark, especially after a vaginal delivery. In fact, your own feelings about any type of sexual contact should always trump the go-ahead from your ob-gyn, says Fife.

"The new mom should ultimately be the one deciding when she is ready to have sex," Fife says. Besides the healing of the vaginal and perineal tissue, important considerations about when to have sex after birth are the level of support the birthing person receives as a new mom, their level of fatigue, and their level of desire for sex.

"Many women who are breastfeeding have painful, bleeding nipples, mastitis, or uncomfortable breast tissue," Fife adds. "None of this improves the desire for sex."

If four or more weeks seems like a long time to have no intimacy, keep in mind that cuddling, kissing, fondling, and oral sex don't have a waiting period after giving birth—provided you feel ready and comfortable with it.

What can someone expect sex to be like after birth?

Sex after birth can be different than what it was before. After all, you've gone through a lot both physically and mentally.

The physical aspect

Pain and discomfort are common when you ease back into sex, says Dr. Ross.

Hormonal changes might leave your vagina dry and tender. That's especially true if you're breastfeeding, as you'll have lower levels of estrogen to help naturally lubricate the vagina.

There are several other possible reasons for physical discomfort and pain during sex, says Fife, such as a complicated vaginal delivery, a prolonged stage 2 phase of labor, internal vaginal tissue damage, damage to the pelvic floor muscles or pelvic nerves, an episiotomy, and the use of vacuum or forceps during delivery.

To ease discomfort during sex, the Mayo Clinic suggests you:

  • Take pain-relieving steps beforehand. This can include emptying your bladder, taking a warm bath, or taking an over-the-counter pain reliever. If necessary, you can also take pain-relieving steps afterward—if you experience burning after sex, apply ice wrapped in a small towel to the area.
  • Use lubricant. This can help with vaginal dryness.
  • Experiment. Consider options other than vaginal intercourse, such as massage, oral sex, or mutual masturbation. Be honest with your partner about what feels good—and what doesn't.
  • Make time. Set aside time for sex when you're not too tired or anxious.

How long you experience pain during sex postpartum can vary, lasting even months for some people who had an episiotomy. But if you're concerned with how long your pain or discomfort lasts, you can talk to your health care provider about it.

Pain and discomfort might not be the only physical changes.

Pregnancy, labor, and a vaginal delivery can stretch or injure your pelvic floor muscles, a group of muscles that sit as the bottom of your torso and support the uterus, bladder, small intestine, and rectum. These muscles also play an important role in the stimulation and orgasm in women. That means that the loss of pelvic muscle strength you can experience after giving birth may lead to a lack of sexual satisfaction.

To build up your pelvic floor muscles, you can perform Kegel exercises, where you tighten and relax your muscles a few times a day for a few weeks. A small study among women in Iran showed that new moms who performed Kegel exercises in the eight weeks after giving birth had increased sexual self-efficacy, meaning they had a stronger belief in their abilities to perform sexual acts.

Changes to your pelvic floor muscles isn't the only reason why sex might feel less satisfying after delivery. A 2020 review published in the journal Sexual Medicine found that while neither the mode of delivery nor an episiotomy had a significant effect on postpartum sexual function, lactation and severe perineal trauma did.

Research has shown that anywhere from 41% to 83% of women experience sexual dysfunction—any physical or psychological problem that prevents sexual satisfaction—at two to three months postpartum. Some studies suggest that women have "markedly lower levels of sexual pleasure and emotional satisfaction" even more than 18 months after giving birth. The review authors point out that research on postpartum sexual dysfunction treatment is majorly lacking.

The emotional aspect

Emotionally, new moms may feel completely overwhelmed and exhausted—meaning sex is low on their list of priorities. "Around 80% of women experience the postpartum 'baby blues' during the first couple of weeks after giving birth, with includes mood swings, irritability, anxiety, and feelings of inadequacy," says Dr. Ross.

She points out that partners may also be struggling with their emotions during the first few weeks and months—transitioning to life with a newborn, navigating postpartum hormones, and figuring out their place within the new family setup.

For both parents, many of these normal emotional symptoms improve within a couple of months, says Dr. Ross. So even if sex is the last thing you are interested in doing, time and patience can help it feel enjoyable again. But even if it takes longer than a couple of months to feel in the mood for intimacy and sex, that's absolutely fine.

"After around six to nine months, women tend to have more hormonal stability and this helps them feel more in the mood for sex," says Dr. Ross. "Emotionally and physically, you feel like your pre-pregnant self, making you feel more excited to actively participate in sexual intimacy.

"I always tell my patients that it takes you nine months to go through the pregnancy process, so allow yourself nine months to fully recover—including your vagina," Dr. Ross adds.

How to get back into the swing of things

Fife hopes educating the birthing parent and their partner on how to build non-sexual, non-penetrative intimacy with each other as they welcome their new baby will one day become a standard part of postpartum care.

Until then, remember it's OK to give yourself time to heal—you've just had a baby.

To help in that healing process, Fife recommends beginning gentle perineal, pelvic muscle, or scar tissue massage, guided by a pelvic physical therapist, at around eight to 10 weeks postbirth. "This helps you understand the cause of your discomfort," she says.

To keep up the intimate emotional connection in that waiting period, the Mayo Clinic suggests spending time together without the baby and looking for other ways to express affection.

When you feel you are ready to have sex—physically and emotionally—it's important that you know how to communicate with your partner during intercourse and that you both understand the need to pause and/or stop if you start to experience discomfort or pain.

Finally, don't forget about contraception. Because, yes, it is possible to get pregnant soon after giving birth—even if you are breastfeeding.

True, if you're less than six months postpartum, exclusively breastfeeding, and haven't resumed menstruating, breastfeeding might offer about 98% protection from pregnancy. But research is mixed on the effectiveness of breastfeeding as a contraceptive. And since, according to the American College of Obstetricians and Gynecologists, many experts recommend waiting at least 18 months between pregnancies before having another baby, using a reliable method of contraception is key.

"There are many birth control options that your health care provider should explore with you prior to resuming sex with your partner," says Dr. Ross.

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