Sex after pregnancy: Set your own timeline

Sex after pregnancy happens. Honestly. First, however, vaginal soreness and exhaustion might take a toll. Whether you’re in the mood or you feel as though intimacy is the last thing on your mind, here’s what you need to know about sex after pregnancy.

After the baby is born, how soon can I have sex?

While there’s no required waiting period before you can have sex again, many health care providers recommend waiting to have sex until four to six weeks after delivery, regardless of the delivery method. The risk of having a complication after delivery is highest during the first two weeks after delivery. But waiting will also give your body time to heal. In addition to postpartum discharge and vaginal tears, you might experience fatigue, vaginal dryness, pain and low sexual desire. If you had a vaginal tear that required surgical repair, you might need to wait longer.

Will it hurt?

Hormonal changes might leave your vagina dry and tender, especially if you’re breast-feeding. You might experience some pain during sex if you’re healing from an episiotomy or perineal tears.

To ease discomfort during sex:

• Seek pain relief. Take pain-relieving steps beforehand, such as emptying your bladder, taking a warm bath or taking an over-the-counter pain reliever. If you experience burning afterward, apply ice wrapped in a small towel to the area.
• Use lubricant. This can be helpful if you experience vaginal dryness.
• Experiment. Discuss alternatives to vaginal intercourse, such as massage, oral sex or mutual masturbation. Tell your partner what feels good — and what doesn’t.
• Make time. Set aside time for sex when you’re not too tired or anxious.

If sex continues to be painful, consult your health care provider about possible treatment options.

Will it feel different?

Pregnancy, labor and a vaginal delivery can stretch or injure your pelvic floor muscles, which support the uterus, bladder, small intestine and rectum. To tone your pelvic floor muscles, try Kegel exercises. To do Kegels, imagine you are sitting on a marble and tighten your pelvic muscles as if you’re lifting the marble. Try it for three seconds at a time, then relax for a count of three. Work up to doing the exercise 10 to 15 times in a row, at least three times a day.

What about birth control?

Sex after pregnancy requires a reliable method of birth control. If you’re less than six months postpartum, exclusively breast-feeding and haven’t resumed menstruating, breast-feeding might offer about 98 percent protection from pregnancy. However, research suggests that the contraceptive effectiveness of breast-feeding varies.

To reduce the risk of pregnancy complications and other health problems, limited research suggests waiting at least 18 to 24 months before attempting your next pregnancy. Your health care provider will recommend thinking about your desire to have more children and pregnancy spacing before you deliver your baby.

Your options immediately after delivery include:

• A contraceptive implant, such as etonogestrel (Nexplanon)
• A copper or hormonal intrauterine device (IUD)
• Progestin-only contraceptives, such as the contraceptive injection medroxyprogesterone (Depo-Provera) or the minipill norethindrone (Camila, Ortho Micronor, others)

Birth control methods that contain both estrogen and progestin — such as combined birth control pills — pose an increased risk of blood clots shortly after delivery. For otherwise healthy women, it’s OK to begin using combined birth control pills and other types of combined hormonal birth control one month after childbirth. Although birth control methods that contain both estrogen and progestin have long been thought to decrease the milk supply of women who are breast-feeding, recent research suggests that this is not true.

Talk to your health care provider during your postpartum visits about birth control options.

What if I’m not interested in sex?

There’s more to intimacy than sex, especially when you’re adjusting to life with a new baby. If you’re not feeling sexy or you’re afraid sex will hurt, talk to your partner. Until you’re ready to have sex, maintain intimacy in other ways. Spend time together without the baby, even if it’s just a few minutes in the morning and after the baby goes to sleep. Look for other ways to express affection.

If you’re still struggling, be alert for signs and symptoms of postpartum depression — such as severe mood swings, loss of appetite, overwhelming fatigue and lack of joy in life. If you think you might have postpartum depression, contact your health care provider. Prompt treatment can speed recovery.

Remember, taking good care of yourself can go a long way toward keeping passion alive.

Dec. 06, 2022

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