Everyone is different, and how you feel about sex after having a baby will vary. It depends on what type of birth you had, the state of your perineum and whether or not you are breastfeeding.
Some women find that sex is painful for the first few times, especially during penetrative sex. This is normal and should improve with time and with the use of a water-based lubricant.
Waiting for the Perineum to Heal
During birth, the skin and muscles between your vaginal opening and anus (back passage), also known as the perineum, stretch so that your baby can be born. Sometimes, the tissue tears. A first-degree tear is minor and heals easily. A second-degree tear is deeper and may need stitches. A third-degree tear is more serious and must be repaired surgically.
Infection is uncommon with second-degree tears, but it’s important to keep an eye on your condition so that if you notice any signs of infection, you can contact your doctor and start antibiotics immediately. Also, it’s important to drink plenty of water to help prevent constipation, which can strain your perineal area.
You should avoid any exercises that may put pressure on the area, such as wide-legged squats or sitting crossed-legged. If you have to do these types of activities, use a pillow to prop up your hips. You can also ease the pain and itching by putting something cool on your perineal area, such as a cold gel pad or ice pack wrapped in a light towel.
Most healthcare providers recommend waiting until the perineal tear, episiotomy or C-section incision are fully healed before attempting to have sex. You’ll also want to wait until your ovulation and menstrual cycle have returned, as this can increase your risk of pregnancy.
Talking to Your Provider
The first six weeks after baby is born can be a challenging time for new parents. They’re settling into a new routine that involves feedings, nap times and lots of laundry, and are recovering from the birth itself. Sexual intimacy may be the last thing on their minds, especially if they’re experiencing pain or discomfort during penetration due to scarring from a tear or episiotomy.
The fact is, a lot of women don’t feel up to it for months after giving birth, which is totally normal. It can be due to hormone shifts, sleep deprivation, pain or a loss of confidence in their bodies following a C-section, or even symptoms of postpartum depression (PPD) like mood swings and feelings of guilt or sadness.
It’s worth remembering that you can still be intimate with your partner without penetration – kissing, stroking and mutual masturbation can all be pleasurable and satisfying. And you should always use some form of contraception when having sex, even once your periods have resumed, to prevent getting pregnant again.
At your four or six week postpartum checkup, your healthcare provider will examine you to make sure you’re healing well, and that your stitches from the vaginal or C-section delivery are ready to come out. They’ll also discuss your contraceptive options. Typically, it’s best to start with a barrier method of contraception until you’ve finished breastfeeding and your periods have resumed.
Taking It Slow
Having sex too soon after delivery can increase the risk of postpartum hemorrhage, or uterine infection. It can also cause problems with the perineal wound, such as pain, pus-like discharge and a feeling of unease. It’s recommended that women who have a perineal tear or episiotomy wait at least two to six weeks before having sex. Taking it slow means starting with massage, oral sex and mutual masturbation instead of penetration. If these activities aren’t pleasurable, a woman can always try using a water-based lubricant to make things more comfortable.
If pain occurs during penetrative sex, a woman should talk to her partner about it. She should let her partner know that if sex hurts, she isn’t interested in continuing to engage in it. A woman may experience pain during penetration because of the scar tissue that has formed, or because low levels of estrogen, which is normal for new moms who are breastfeeding, can make vaginal muscles tight and sensitive.
It’s also possible that a woman simply doesn’t feel like having sex. This can be due to a variety of factors, including the baby blues (also known as postpartum depression), sleep deprivation and being overwhelmed by caring for a newborn. It can be helpful for couples to communicate openly about how they’re feeling and agree on other ways to stay close.
Taking Care of Yourself
Whether you delivered vaginally or by C-section, your body went through a lot to prepare for, and facilitate, childbirth. Your uterus may still be dilated, you might have lochia (healing bleeding), and your vagina may not be quite healed enough for sexual activity.
If you’re going to resume sexual activity, be sure you have a good supply of lubrication and try to avoid positions that put pressure on sore areas. You might also notice reduced lubrication, which is normal and can be easily remedied with some time or a special water-based lubricant. It can also help to talk about sexual intimacy with your partner. Discussing your feelings and needs can help you feel more confident and in control.
Many new moms experience a jumble of powerful emotions after delivery, including mood swings, guilt and anxiety. While they’re usually short-lived, these feelings can make it harder to find the motivation to have sex. If you’re struggling with these feelings, it’s important to seek support from friends, family and a trusted health care provider.
You’ll probably visit your doctor between four and six weeks postpartum to see how you’re healing from your vaginal or C-section delivery. Your health care team will discuss whether you’re ready to resume sexual activity, and how best to do so without risking complications. They’ll also check your perineum to ensure it’s fully healed, and if you had a cesarean section, that your incision has closed.