16 Things You Must Know About Sex After Pregnancy
The naked truth
You've heard it before: Life changes when you have a baby. But psst, your postpartum sex life is different, too, sometimes in shocking ways (your boobs do what?). "Giving birth comes with big physical and emotional changes," says Hilda Hutcherson, MD, professor of obstetrics and gynecology at Columbia University's College of Physicians and Surgeons in New York City. "But sex can get you back to feeling like your normal self again—plus it's a great way to reduce stress and keep your relationship strong during this crazy time." Here's what you can expect when you get back down to business.
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You really do have to wait 4 to 6 weeks
Whether you gave birth vaginally or by C-section, it's crucial to wait to have sex until your doctor gives you the green light. "At your 6-week postpartum checkup, your doctor will check that the cervix has closed, bleeding has subsided, and that tears and cuts have healed," says Dr. Hutcherson, who is also the author of Pleasure: A Woman's Guide to Getting the Sex You Want, Need, and Deserve ($17; amazon.com). Jumping into bed any sooner can potentially lead to an infection or cause down-there tears to reopen (yikes!).
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You can still do "everything but"
During those first 6 weeks when intercourse is off limits, you and your partner can still fool around, as long as it doesn't involve penetration. Even if you've been okayed for the whole shebang, it's normal to ease into it: A study published in The Journal of Sexual Medicine found that postpartum women generally reported engaging in oral and manual stimulation and masturbation prior to intercourse. Plus, knowing certain moves are off limits can build anticipation and make the fooling around even hotter, says Ava Cadell, PhD, author of Neuroloveology: The Power to Mindful Love and Sex ($15; amazon.com).
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There's a good chance it'll hurt
Once you get the okay for intercourse, sex might feel like you're losing your virginity again. Even if you had a c-section, hormonal changes can leave your vagina dry and tender, especially if you're breast-feeding. And some women who've had vaginal births take longer than the 6-week mark to fully heal from tears or an episiotomy, Dr. Hutcherson says. Your best protection is a long-lasting silicone-based lube that coats the vagina and reduces friction against sore spots. And be sure to take things slowly and try positions that avoid sensitive areas and put you in control, such as being on top, Cadell suggests.
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There are solutions for dryness
Vaginal dryness occurs in all postpartum women, whether they had a vaginal or cesarean birth. "The type of moisture that makes sex pleasurable gets depleted after birth," Dr. Hutcherson explains. "That's thanks to a drop in estrogen—the hormone responsible for sexual arousal and lubrication levels." The dryness (and the irritation and painful sex that can come with it) will eventually ease up as your hormone levels return to normal, so keep using lube until sex gets more comfortable. If dryness is a major issue, talk to your doctor about using a vaginal moisturizer like Replens. More rarely, your doc might prescribe a topical estrogen cream or suppository.
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You definitely need birth control
Forget the old wives' tale that says you can't get pregnant if you're breastfeeding. Even if you're exclusively breastfeeding and you haven't gotten your period yet, you could still ovulate—and the chance of ovulation increases over time, Dr. Hutcherson says. Talk to your doctor before you deliver to discuss postpartum birth control options. If you plan on breastfeeding, the best options are condoms, a diaphragm, or an IUD, which can be inserted soon after delivery or at your postpartum checkup. The minipill (which contains only progestin, no estrogen) is also an option if you're breastfeeding—though there is a slight chance it could decrease your milk supply—or the regular birth control pill if you're not.
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Sex might feel different, but not in a bad way
If you've ever heard someone say that sex after vaginal childbirth is like throwing a hotdog down the hallway (or insert whatever crude version you've heard), know this truth: In the name of scientific research, 165 women who had given birth within the previous year used a vaginal pressure monitor (read: a fancy dildo) to measure differences in vaginal pressure. While those who gave birth vaginally did have "looser" vaginas than those who'd had C-sections, there was no difference in sexual satisfaction or sexual function, according to the study, published in International Journal of Impotence Research.
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Your vagina has an amazing ability to bounce back
Unlike that pair of jeans that got stretched out and never returned to their perfectly fitted state, your vagina has the superpower to push out an 8-pound (or larger!) baby and still return to its prenatal size. Kegels are the ultimate exercise to keep good muscle tone down there and should be done during pregnancy and post delivery, Dr. Hutcherson says. Still, some women do have problems with the muscles of the pelvic floor after childbirth and may require pelvic floor therapy. Talk to your doctor if you're not getting results from kegels or if you're experiencing significant urine leakage.
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Your libido may temporarily hibernate
It's been 6 weeks (or way more) since you've done the deed. You should be dying for it, right? Not so for many women. Hormonal changes, sleep deprivation, and breastfeeding can all cause your sex drive to plummet, Dr. Hutcherson says. "I always reiterate to new moms that a lack of sexual desire after baby is perfectly normal, and not to stress over it," Dr. Hutcherson says. "In fact, I tell my patients to expect a year to return to normal." If you're not ready for sex, simply cuddling with your partner for at least 6 minutes boosts oxytocin, the bonding hormone that increases intimacy and reduces stress, Cadell says.
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Or you might be raring to go
For some women, waiting 6 full weeks for sex is torture. In fact, within those first few postpartum weeks 40% of women masturbate, suggesting that women's sex drive is still very much alive—even despite the sleep deprivation and exhaustion, according to the same Journal of Sexual Medicine study, conducted at the University of Michigan. Postpartum libido can vary from person to person and even from pregnancy to pregnancy, Dr. Hutcherson explains. Since every birth and every woman is different, don't stress over how sexy you feel (or don't feel)—there is no normal.
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Childbirth can turn him on
This might surprise you: Seeing you in screaming in the throes of labor or watching the baby being pulled from your c-section incision may actually make your partner even hotter for you. In fact, men who were in the delivery room with their partner reported stronger sexual desire post-birth compared to men who weren't in the delivery room, the same University of Michigan study found. (What boosted desire for the women? Getting plenty of support and connection from their partners.)
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Your breasts might become a no-touch zone
Between a baby eating off your boobs 10-plus times a day—and the dry, cracked nipples that ensue—you might not want them to be touched, or you might feel squeamish about your partner putting his hands or mouth in that area. (That's on top of the fact that the hormones your body produces to maintain your milk supply may actually decrease desire and increase vaginal dryness, Dr. Hutcherson adds.) Use the opportunity to have your partner explore other body parts that turn you on, Cadell suggests.
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Prepare for some leaking
Here's something your mother never warned you about: If you're breastfeeding, your breasts might actually squirt milk during sex or foreplay. That's because during sex, your body releases oxytocin, a hormone that makes you feel more bonded and connected to your partner, but is also responsible for your milk let down (read: leaking), Dr. Hutcherson says. If you're nervous about leakage, wear a bra with nursing pads or keep a towel handy. Or try pumping or nursing before you have sex to prevent letdown, Dr. Hutcherson suggests. And don't panic: It doesn't happen to everyone!
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After a c-section, some positions might be off limits
Having a caesarean is a major surgery, and while the scar is small, the area can be tender for quite some time. Finding positions that take the pressure off that area is key to keeping sex comfortable. Spooning is the safest position after a c-section birth, since the woman is in control of the angle, speed and depth without having any pressure on her stomach, Cadell says. Plain old missionary can also work as long as the guy kneels upright rather than leaning over you.
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Body consciousness is normal
Of course your body's size and shape is different than it was 9 months ago—you made a baby! But for many women, this translates into feeling self-conscious about getting naked. Instead of dwelling on insecurities, use sex as an opportunity to feel sexy in that moment by focusing on your physical sensations and admiring your amazing new boobs. Outside the bedroom, try to make time for things that promote self-love and confidence, Cadell says. Go for a power walk with your stroller or sneak out for 30 minutes to get a manicure. The more you do to nurture yourself, the sexier and happier you will feel.
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Sex can take planning
When you've got a squalling little roommate, late night feedings may end up replacing nighttime romps; sleeping in can feel more refreshing than a sexy morning wakeup. A new baby can be all consuming, so scheduling time for sex—even if you never were that couple—can help keep your sex life going, at least during those first few crazy months. Plus, planning can feel sexy, too. Don't believe us? Try sending your partner a Google calendar request for sex at 8 p.m. and see what happens.
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But it can also feel sexier than ever
Many new parents find that post-baby sex can feel especially scandalous, Cadell says—think squeezing in quickies while the baby naps or trying to keep hushed in the heat of the moment. Having a child together can also make the two of you even more emotionally connected, and that can make sex feel more intimate than ever. The truth is that having a baby changes your sex life, but it can also make it fresh and fun—embrace it!