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

Childbirth and postpartum life puts you through physical and emotional changes that can impact your sex life.

If you've just gone through childbirth, sex might be the furthest thing from your mind, which is 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 you should know about having sex after childbirth, according to experts.

Why Should You Wait To Have Sex After Childbirth?

There's no required waiting period for when you can have sex again. However, most healthcare providers recommend holding 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 fetus down and out of the birth canal as the cervix opens. Or if you have a Cesarean section, also known as a C-section), your skin, fat, muscle, and uterus are operated on.

Vaginal delivery might also involve surgery. An episiotomy is a minor surgery that widens the opening of the vagina. The healthcare provider will make an incision in the perineum, the tissue between the vaginal and anal regions, during childbirth.

Vaginal delivery commonly involves perineal tears, which happens if the vagina and surrounding tissues tear during delivery. Sometimes those tears heal on their own. But if a tear is more serious, the healthcare provider will use stitches to close it.

Regardless of what method was used or how smooth the delivery went, a healthcare provider may advise you to have "pelvic rest" while your body recovers, Sherry Ross, MD, an OB-GYN based in California and author of She-ology: The Definitive Guide to Women's Intimate Health. Period., told Health. That means you should avoid putting anything inside the vagina—so, no douching, tampons, or penetrative sex.

Pelvic rest allows your body to heal and reduces the risk of postpartum complications. For example, there is a risk of infection, which accounts for 10% to 15% of maternal deaths globally, in the weeks following childbirth.

So, even though waiting to have sex after childbirth isn't technically necessary, a healthcare provider may recommend it to keep you safe and healthy.

How Long After Giving Birth Should You Wait To Have Sex?

Again, there's no required waiting period for sex following childbirth. Still, most healthcare providers advise waiting four to six weeks.

"Usually, at the six-week postpartum visit with a 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," explained Dr. Ross.

But the waiting period depends 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," Amy Hill Fife, a pelvic health specialist in Colorado, told Health. 

The waiting period might be longer than that if you had a vaginal tear that required surgery. Fife added that the period could sometimes last as long as 12 weeks as the vulvovaginal tissue heals.

And even after getting the green light from a healthcare provider, you should also consider your feelings. According to Dr. Ross, most people aren't ready to jump right in at the average six-to-eight-week mark, especially after a vaginal delivery. Your feelings about any type of sexual contact should always trump the go-ahead from your OB-GYN, added Fife.

"The new mom should ultimately be the one deciding when she is ready to have sex," said Fife. Besides the healing of vaginal and perineal tissue, important considerations include how much support you need, your fatigue level, and your desire for sex.

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

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

How Sex May Change After Childbirth

Having sex after childbirth can be different than what it was before. After all, you've gone through a lot, both physically and mentally. So, here's what you may anticipate before having sex again. But keep in mind: Every person's experience is different. 

Pain or Discomfort

Pain and discomfort are common when you ease back into sex, explained Dr. Ross. For example, fluctuating hormones might leave your vagina dry and tender, especially if you're breastfeeding. While breastfeeding, your body produces less estrogen, which helps naturally lubricate the vagina.

In addition to vaginal dryness, there are several other possible reasons for physical discomfort and pain during sex, such as:

  • Perineal laceration
  • Stress and fatigue
  • Episiotomy
  • Use of vacuum or forceps during delivery

To ease some of the pain or discomfort you may feel during sex, it may help to take a warm bath or an over-the-counter (OTC) pain reliever. Additionally, lubricants can help with vaginal dryness that causes pain and discomfort.

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, it may help to talk to a healthcare provider about it.

Weakened Pelvic Floor

Pregnancy, labor, and a vaginal delivery can stretch or injure your pelvic floor, a group of muscles that support your uterus, bladder, small intestine, and rectum.

According to a study published in 2015 in the Iranian Journal of Nursing and Midwifery, your pelvic floor also plays an important role in stimulation and orgasm. In other words, losing pelvic muscle strength after giving birth may lead to a lack of sexual satisfaction.

To build up your pelvic floor muscles, you can try Kegel exercises. Tighten and relax your pelvic floor a few times a day for a few weeks. The 2015 study also demonstrated that women who performed Kegel exercises in the eight weeks following childbirth increased sexual self-efficacy.

Postpartum Sexual Dysfunction

Some evidence suggests 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.

For example, a review published in 2020 in Sexual Medicine found that breastfeeding and severe perineal trauma significantly affected postpartum sexual function. The researchers also found that women experienced low levels of sexual pleasure and emotional satisfaction more than 18 months following childbirth.

Additionally, the researchers pointed out that more studies investigating treatments for postpartum sexual dysfunction are needed.

Emotions

Emotionally, after going through childbirth, you may feel completely overwhelmed and exhausted, meaning sex is low on your list of priorities. 

"Around 80% of women experience the postpartum 'baby blues' during the first couple of weeks after giving birth, [which] includes mood swings, irritability, anxiety, and feelings of inadequacy," said Dr. Ross.

Additionally, Dr. Ross pointed out that partners may struggle with emotions during the first few weeks and months after childbirth. Transitioning to life with a newborn, navigating postpartum hormones, and figuring out their place within the new family setup can also affect the non-birthing parent.

For both parents, many of those normal emotional symptoms improve within a couple of months, according to Dr. Ross. So, even if sex is the last thing you want, 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 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," noted 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."

What To Consider Before Having Sex After Childbirth

Fife stated that educating the birthing parent and their partner on how to build non-sexual, non-penetrative intimacy is essential to postpartum care.

Additionally, remember it's OK to give yourself time to heal. After all, you've just birthed a human. To help in that healing process, Fife recommended beginning gentle perineal, pelvic muscle, or scar tissue massage, guided by a pelvic physical therapist, at around eight to 10 weeks postbirth. 

"That helps you understand the cause of your discomfort," noted Fife.

To keep up the intimate emotional connection in that waiting period, spending time with your partner without the baby and looking for other ways to express affection may help. 

When you feel you are physically and emotionally ready to have sex, you must know how to communicate with your partner during intercourse. Understanding the need to pause or stop if you start to experience discomfort or pain is essential.

Finally, don't forget about contraception. If you're under six months postpartum, exclusively breastfeeding, and haven't resumed menstruating, breastfeeding might offer about 98% protection from pregnancy. Still, even if you are breastfeeding, it's possible to get pregnant soon after childbirth.

The American College of Obstetricians and Gynecologists recommends waiting at least 18 months between each childbirth before becoming pregnant again. So, using a reliable method of contraception is key.

"There are many birth control options that [a healthcare provider] should explore with you prior to resuming sex with your partner," said Dr. Ross.

A Quick Review

Having sex after childbirth is technically permitted, but a healthcare provider may recommend waiting four to six weeks. That waiting period may lengthen, especially if you had a C-section, episiotomy, or perineal tears. 

Everyone experiences sex differently after childbirth. Some people may have pain or discomfort, a weakened pelvic floor, or fluctuating emotions about sex. It's not uncommon for some people to experience postpartum sexual dysfunction. 

Communicating with your partner about your physical and emotional feelings is essential to navigating postpartum sex.

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Sources
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