Pregnancy and delivery change many things about your body, including your sexual desire. Having a baby lowers levels of oestrogen and progesterone, which are crucial for sex drive.
Most doctors recommend waiting four to six weeks after childbirth before resuming sexual activities. They will check your vagina, perineal area and cervix at your postpartum checkup before giving you the all-clear.
Vaginal Delivery
Whether you delivered vaginally or via Cesarean section, your body goes through quite a bit during labor and delivery. If you had a vaginal birth, your cervix may have been torn or cut during the process and will require time to heal. The same goes for a perineal tear or episiotomy. It’s important to wait at least four weeks to resume sexual activities if you had these procedures as doing so can leave you susceptible to infection.
Vaginal delivery can also lead to urinary incontinence as a result of the stress of childbirth, lack of sleep and breastfeeding, which can reduce prolactin levels (a hormone that inhibits sexual desire). Women who delivered vaginally are more likely to experience pelvic organ prolapse, which is when your organs slip into your pelvis.
As with any surgical procedure, most doctors recommend waiting at least six weeks before resuming sexual activities after your C-section. This gives the incision time to heal, and your practitioner will be able to examine your uterus and vagina to ensure that it is healed and ready for sexual activity. It’s also a good idea to talk to your partner about expectations and comfort levels in the bedroom during this time, so you can discuss how to handle any pain or discomfort that arises. Then, when you’re cleared for sex, it’s best to use proper birth control to prevent pregnancy until after your next menstrual period begins.
Cesarean Delivery
Sex can feel like a distant dream after childbirth, and while every person’s body is different, most doctors recommend waiting several weeks after a cesarean section before getting intimate with your partner. That’s because, even though you’re no longer bleeding, your incision will take time to heal. Plus, having sex too soon can introduce bacteria into the uterus—where the placenta was attached—and increase your risk of complication.
If you had a cesarean section without complications, it may be easier to resume sexual activity sooner because your uterus will have healed more quickly. Still, most providers will want you to wait until you’ve seen a practitioner, at the six-week mark, to make sure that you are ready to return to your normal sexual activities.
For those who have a cesarean, it may also be a good idea to abstain from sexual activities for the first six weeks after childbirth because of a high risk of infection. This is because a cesarean is an incision, and your pelvic floor will have to heal, as well as the area of your vulva where the episiotomy was created or laceration may be present.
For those who are breastfeeding, it’s important to have a plan for contraception because lowering estrogen levels can suppress your libido and decrease your desire for sex. You’ll also need a safe, effective method of birth control to use while you’re breast-feeding (because breast milk offers about 98% protection from pregnancy). Talk to your healthcare provider for more information about birth control options.
Perineal Tear or Episiotomy
If you had a vaginal birth and a perineal tear or episiotomy, it takes between two to four weeks for the area to heal. Sex before then could cause an infection in the cut (episiotomy) or perineal tissues. If you’re having sex before the area is fully healed, it may be painful for both partners and difficult to enjoy.
Your doctor uses stitches to close the incision in the area between your vaginal opening and anus, also called the perineum. You can help speed up healing by icing the site to reduce pain and swelling. A warm sitz bath (soaking the area with warm water) may help, too. Use a water-soluble lubricant for penetrative sex to decrease friction on the sex organ.
Regardless of how you gave birth, your practitioner will likely want to see you within three to 12 weeks postpartum to check your wounds. He or she can then give you the go-ahead for sexual activity.
Of course, every woman is different. Your feelings about when you’re ready to have sex should always trump the go-ahead from your practitioner, even if that means waiting a little longer than six weeks to resume sexual activities. However, every new mom should consider her personal comfort level, and whether she’s physically or emotionally ready to return to sex before doing so.
Scars
When a woman has a baby, her focus is on caring for the newborn. Sex is probably the last thing on her mind, and may not return until she feels ready to initiate it. However, there are other ways to be intimate with her partner and restore sexual satisfaction.
After childbirth, hormone levels are low. This can make vaginal tissue thin and less stretchy, and it can cause pain during penetration. It also can reduce libido, especially if breastfeeding is involved.
The uterus and cervix must also return to their pre-pregnancy size. This can take a while, and it is important to avoid stressing these structures. It is also a good idea to wait until after a doctor gives the all-clear.
If there is a perineal tear or episiotomy, a scar is formed that requires time to heal. This scar is thinner and less elastic than the surrounding vaginal tissue, making it easier for infection to enter. Serial attempts of sex can help to stretch and soften the scar, allowing for greater sexual pleasure and a more comfortable experience.
All women should listen to their bodies and talk to their obstetrician or family doctor about when they feel physically and emotionally ready to resume sexual activity. Every woman’s pregnancy, birth and recovery are different.
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