After giving birth, the last thing you’re probably thinking about is getting it on. After all, between your fluctuating hormones, crazy body changes, vaginal soreness and perhaps even postpartum depression, you’re probably not in the mood for more than an episode of Friends with a side of “please don’t touch me.” This is why, as a general guideline, doctors instruct patients to abstain from sex for six weeks postpartum. This allows your body time to heal, so you can eventually start feeling frisky again. In addition to the six-week rule, here's what else you need to know about sex after childbirth.
When can I have sex after pregnancy?
As we mentioned, the rule of thumb is to hold off on sex for six weeks after giving birth, following either a vaginal or cesarean delivery. Doing the deed too early, especially within the first two weeks, ups your odds of postpartum hemorrhage or an infection. And if you had any type of vaginal tear that required surgical repair, you might need to wait longer than six weeks. As always, consult your doctor for the time frame that’s right for you.
Will sex hurt after childbirth?
Yes, probably. At the six-week mark, sex might be painful due to several factors including vaginal dryness and any possible trauma from the delivery like tears or an episiotomy. You did just push a bowling ball-size baby out of your vagina after all.
“The vaginal canal and especially the opening to the vagina gets pretty stretched during vaginal birth, and there can be small and not-so-small tears in the vagina walls,” explains Dr. Maria Sophocles, an obstetrician and gynecologist and medical director of Women’s Healthcare of Princeton. “The opening of the vagina can be torn or can be intentionally cut (an episiotomy) and any of these can require stitches. This may take up to a few weeks to heal depending on the degree and extent of lacerations and sutures.” Even moms who had a C-section might experience painful sex after their pregnancy thanks to hormonal fluctuations.
“If you’re breastfeeding, hormones [like estrogen] are suppressed, and the vagina will be dry and feel like it does when in menopause for several months,” explains obstetrician and gynecologist Dr. Carolyn DeLucia. “It takes the body a few months to return to normal ovulation patterns after delivery.”
How can I make sex less painful?
First of all, don’t rush into it. Dr. DeLucia says it’s best to wait the appropriate amount of time to allow your body to heal. Once you’re feeling ready to go, try some simple techniques to ease any discomfort like using a lubricant during sex to eliminate friction caused by dryness. Dr. Sophocles suggests a vaginal moisturizer like Replens to help alleviate any dryness.
Also, before sex, empty your bladder to relieve any pressure, take a warm bath to soothe your nether regions or try OTC pain meds as a preventive measure. Afterward, if needed, apply ice to help calm any pain or burning. Plus, keep in mind that sex doesn’t just mean vaginal intercourse. Talk with your hubby about other pleasurable alternatives, such as oral sex or mutual masturbation, which might feel better than penetration.
What other changes might affect my sex life?
Be prepared: Your vagina “may never feel quite the same as it did before the baby,” Dr. DeLucia cautions. And we know what you’re thinking but are too afraid to ask. The answer is, yes, your vagina will seem “looser.” That’s not surprising considering it had to stretch a lot during delivery: “The walls of the vagina tend to go from being a cylinder to a rectangle, with the tissue falling in from each side wall, the top and the bottom. The muscles are overextended like overstretched rubber bands.”
Dr. Sophocles adds that sometimes the distended vaginal tissues never fully regain the tone or tightness of their pre-delivery days. And this gets multiplied by the number of vaginal deliveries you have. “So a woman who has had four vaginal deliveries will likely not have the same strength or tone as a woman with no vaginal deliveries,” she explains. “This varies of course, and some women really have very little anatomic change at all.”
To get your vagina back in shape, you can work with a physical therapist who specializes in pelvic floor exercises. Dr. Sophocles says that this is common in France where every woman receives postpartum pelvic floor rehab as part of her care. Or do Kegel exercises on your own. To do them: Practice stopping an imaginary stream of pee. Squeeze your pelvic muscles to interrupt the flow and hold for five to ten seconds. Repeat ten times.
But if Kegels just aren’t cutting it, you can also try a non-invasive procedure or device that’s designed to help with incontinence, another common post-pregnancy problem. For example, Emsella is like a high-tech chair that stimulates the pelvic floor with thousands of contractions to tighten and rebuild those muscles.
Is it normal not to be interested in sex after pregnancy?
One thousand percent. “The stress of pregnancy and the changes in a woman’s body, not to mention the wild hormonal fluctuations, can leave many women uninterested in sex,” Dr. Sophocles says, “either because they are tired from being awake with a newborn during the night or reluctant due to anticipating pain from penetration or they just don’t feel attractive with excess weight or a C-section scar.” On the flip side, she says that some women actually experience an increase in sexual desire after giving birth because of the intimacy of having a baby with their S.O.
Plus, biology might be working against you. That’s because breastfeeding releases oxytocin, that feel-good cuddle hormone, to help you bond with your baby. But it also suppresses your libido. This is designed to keep your sex drive low so you won’t get pregnant too soon after giving birth. (The World Health Organization suggests waiting at least 18 to 24 months before your next pregnancy, while a recent study, published in Jama Internal Medicine, recommends that women should wait at least a year between giving birth and getting pregnant again.)
Even if you’re not feeling up to a full-blown sex sesh, it is necessary to maintain some form of intimacy with your mate, so you don’t start to feel like boring ol’ mom and dad. And don’t worry if things seem supremely non-sexy at the moment. Life will get spicier…and less covered in baby barf.