Let’s face it. After delivering a baby, regardless of the method of delivery, sex may be one of the last things on your mind. Between the physical changes to your body from the delivery, the exhaustion of caring for a newborn, and the emotional changes induced by hormones, there are just a few barriers to sex after having a baby. If you feel this way, the good news is these feelings are very normal, common, and temporary. But, it is also normal, common, and good to want to have sex with your partner as soon as you can. But how long do you need to wait to have sex after having a baby? And why?
How long do I need to wait to have sex after having a baby?
Most providers will recommend waiting four to six weeks after delivery to resume intercourse. During pregnancy, labor, and delivery, your body undergoes many major changes, and it takes time to recover and heal. Multiple factors are changing and healing during this time, determining the best time to start having sex again.
Even if you were one of the lucky ones that got through delivery without a laceration, there was still stretching and pulling in your pelvis and vagina that needs time to heal. If you had a C-section after laboring, you likely had multiple cervical exams and still experienced labor pains and have vaginal soreness. If you had a planned C-section, your abdominal scar also needs time to heal. Letting your incision, laceration, scratch, or stretched vaginal walls have time to heal is the most important thing. If you resume intercourse too soon, you could re-open a not completely healed wound, leading to further complications.
At your postpartum appointment, your provider will examine your perineum to ensure healing is complete before you resume intercourse. Occasionally, you may need additional time or treatment to ensure complete healing. You’ll want to put in the extra time now to avoid long-term complications with wound healing.
Risk of Postpartum Hemorrhage and Infection
The highest risk of complications, including infection and hemorrhage, is during the first few weeks after delivery. This risk can be increased with early intercourse. Immediately postpartum, the uterus begins to involute (shrink back) to its normal size of about a fist. Given that the uterus is the size of a watermelon before delivery and remains large enough to be felt at your belly button immediately postpartum, the fact that this process only takes about six weeks is pretty remarkable. Involution is achieved by the uterine muscles contracting, and sex can disturb this process. These same contractions also prevent postpartum hemorrhage. Therefore, having sex too early can increase your risk of postpartum hemorrhage.
At the same time, your cervix is shrinking back to its pre-pregnancy size, and the cervical os, or opening, is closing. Early intercourse can introduce bacteria into the vaginal canal. An open cervical os can significantly increase the risk for postpartum uterine infection or endometritis. Endometritis can be a severe infection requiring hospital admission for treatment with intravenous antibiotics. And it can lead to further complications, including postpartum hemorrhage and rarely surgical treatment.1
Is It Going to Hurt?
When you’re ready to have sex again after baby, my best advice is to go slow. Your vagina went through a lot during delivery. Even though your provider has cleared you to resume intercourse, most women are scared of pain with intercourse. Some of this is psychological and will improve with time. However, some can be a physical concern because of lacerations, scar tissue, or dryness. Vaginal dryness is a common complaint in the postpartum period. It can be worse and stick around longer in women who are breastfeeding. Using a lubricant and going slow will help. However, sometimes this isn’t enough, and your provider may recommend an additional supplement to improve your symptoms.
What if it Doesn’t Feel the Same?
During pregnancy and even more so during delivery, the pelvic floor muscles are placed under a tremendous amount of pressure, stretching, and pulling. It is common for women to have incontinence or pelvic pressure after delivery, regardless of the delivery method. Starting Kegel exercises early and performing them often can significantly impact how you feel. They also decrease your likelihood of developing pelvic organ prolapse in the future.
To perform a Kegel exercise, I recommend practicing while using the restroom. While mid-stream, contract the pelvic floor muscles, which allow you to stop the urine stream, then release it. Once you have the movement down, you can perform these exercises frequently throughout the day – while at a stoplight, waiting at the pediatrician’s office, etc. Ask your provider if they would recommend physical therapy, as well as this because it can be highly beneficial to re-building pelvic floor strength after pregnancy.
Most providers will recommend waiting four to six weeks post-delivery to have sex after the birth of your baby. But this timeline can vary based on the exact circumstances of your delivery. Therefore, it is always a good idea to discuss this with your provider. If something feels off, don’t be scared or embarrassed to ask your provider – I promise, we’ve heard it all! If six weeks have come and gone, and you still don’t feel up for having sex, don’t fret and don’t give up. Your body has been through a lot, and each person heals at a different rate. At the end of the day, you need to do what makes you happy.