When can I have sex after being pregnant?

By Lori Smith, BSN, MSN, CRNP 

Reviewed by Holly Ernst, PA-C

After about 9 months of reduced sexual activity during pregnancy, a couple may be ready to resume intercourse shortly after the birth of the baby.

A couple should generally avoid sexual intercourse in the 4–6 weeks following vaginal or cesarean delivery. However, speak to a healthcare provider before resuming sexual activity.

If a woman has had a cesarean delivery, a perineal tear, or episiotomy, a medical professional will likely recommend that a couple waits until the 6-week postpartum visit before resuming sexual activity.

Following childbirth, a woman's body enters a healing phase when bleeding stops, tears heal, and the cervix closes. Having intercourse too early, especially within the first 2 weeks, increases the risk of postpartum hemorrhage or uterine infection.

Several factors determine whether someone is ready to resume sexual intercourse following the birth of an infant, including:

• pain levels
• fatigue
• stress
• sex drive
• fear of sex or pregnancy
• vaginal dryness
• postpartum depression

In this article, we review when it is safe to have sex again following the birth of a baby, how it will feel, and which types of contraception to use.

What will sex feel like after giving birth?

While some couples might be eager to have sex as soon as possible, intercourse can feel markedly different for the first few months after pregnancy.

Due to low levels of circulating estrogen during the postpartum period, many women experience vaginal dryness. This might continue past the typical 4-to-6-week timeframe for women who are breastfeeding.

Breastfeeding can also reduce a person's sex drive. As well as reduced levels of circulating hormones, a perineal tear or episiotomy may make sex painful for several months following the birth of an infant.

Steps that can reduce painful sex, or dyspareunia, after pregnancy include:

• controlling the depth of penetration with varied sexual positions
• increasing vaginal lubrication
• taking pain medication
• emptying the bladder
• taking a warm bath

Vaginal lubrication, such as over-the-counter (OTC) creams or gels, may be useful in relieving the symptoms of vaginal dryness. When using barrier-method birth control, choose a water-based lubricant to avoid weakening the latex.

Alternatively, oral or manual stimulation might be an option during the healing process.

Sex following childbirth may feel different due to reduced vaginal muscle tone and limited capacity for stretching. This is often temporary, however.

Different factors, such as genetics, the size of the baby, the number of previous births, and the use of Kegel exercises, can alter how the vagina feels postpartum.

Hormones can cause a variety of unusual and, at times, inconvenient symptoms. For example, during sexual intercourse, a woman's breasts may leak milk following a hormonal response to orgasm. Try pumping before sex to reduce the occurrence of leaking breast milk.

Kegel exercises

Kegel exercises of the pelvic floor muscles can help provide strength and stability to the vaginal area following delivery.

They are simple, and a person can perform them almost anywhere.

The first step is to find your pelvic floor muscles. A person can locate these by stopping the flow of urine the next time they visit the bathroom. The points at which a person feels the strain are the pelvic floor muscles.

Follow these steps to perform a Kegel correctly:

1. Relax the chest, abdomen, thighs, and buttock muscles.
2. Try to stop an imaginary stream of urine mid-flow.
3. Squeeze the pelvic muscles and hold for between 5 and 10 seconds.
4. Break for 5 to 10 seconds and repeat ten times.
5. Repeat the exercises three times per day.

A person will be able to increase the duration of each squeeze, and the number of sets as their pelvic floor muscles strengthen.

Over time, this should help make sex less painful and more enjoyable.

However, some people may benefit from an appointment with a pelvic floor rehabilitation specialist to evaluate and treat painful postpartum sex.

Birth control after pregnancy

A reliable method of birth control following delivery is essential to prevent unintended pregnancy.

People interested in immediate contraception should consider barrier options, such as condoms, or progestin-only contraceptives, such as Depo-Provera or the mini-pill.

People who would prefer to use a copper or intrauterine hormonal device or a fitted barrier method of contraception, such as a diaphragm or cervical cap, should discuss options with a healthcare provider.

People wanting to use combination birth control methods containing both estrogen and progesterone, such as pills or a vaginal ring, should also speak with a healthcare provider to see if this option is right for them.

Takeaway

Pregnancy can cause some physical changes. Most doctors recommend waiting 4–6 weeks to resume sexual intercourse after delivery. The body must heal from labor, especially following an intensive surgery, such as a cesarean birth.

Kegel exercises can help a woman recover cervical strength and help reduce painful and uncomfortable sex after delivering an infant.

The point at which people decide to have sexual intercourse following the birth of a child is a personal decision. Couples should speak to each other and their healthcare team about any concerns they may have.

SOURCE: MEDICAL NEWS TODAY