Sex After Childbirth: Embracing Changes and Expectations

Postpartum sex is one of the least discussed topics in any arena. After childbirth, a woman goes through a physical, psychological, and emotional transformation. In the postpartum period, a couple’s attention is on caring for the newborn, and sex might be the farthest thing from their mind. But as the couple begins to settle into a new routine, they start thinking about whether they are ready to resume sexual intimacy. Recommendations regarding when it’s safe to engage in sexual intercourse after giving birth will mostly depend on the circumstances of childbirth.

While there’s no required waiting period before one can have sex again, many healthcare providers recommend waiting to have sex until four to six weeks after birth, regardless of vaginal birth or a caesarean section. The risk of complications is highest during this time. Waiting also provides the woman’s body adequate time to heal. In addition to postpartum discharge and vaginal tears, a woman might experience fatigue, vaginal dryness, pain, and low sexual desire. If there was a vaginal tear that required surgical repair, one might need to wait longer.

Hormonal changes might leave the vagina dry and tender, especially if one is breastfeeding. There may also be some pain during sex if one is healing from an episiotomy or perineal tears.

Postpartum sexuality also depends on factors such as:

1. The woman’s sexual drive (appetite for sexual activity) and motivation.
2. Her general state of health, quality of life and body image.
3. Her emotional readiness to resume sexual intimacy/ her relationship with her partner
4. Her adaptation to the maternal role and ability to balance her identity as a mother with her identity as a sexual being.
5. Hormonal changes, particularly if breastfeeding.
6. Fatigue/lack of sleep.
7. Postpartum depression.
8. Vulvar and vaginal pain related to tearing during delivery/childbirth trauma.

Making sex pleasurableFor sex to become pleasurable after childbirth:

1. Seek pain relief. Take pain-relieving steps beforehand, such as emptying the bladder, taking a warm bath or taking an over-the-counter pain reliever. If there is burning afterwards, apply ice wrapped in a small towel to the area.
2. Use lubricant. It can be helpful for vaginal dryness.
3. Experiment. Discuss alternatives to vaginal intercourse, such as a massage. Tell each other what feels good — and what doesn’t.
4. Make time. Set aside time for sex when not too tired or anxious.
5. There’s more to intimacy than sex, especially when adjusting to life with a new baby. If there is no libido or fear that sex will hurt, talk to each other. Until you are ready to have sex, maintain intimacy in different 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.
6. If you are 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 these symptoms are present, contact your healthcare provider. Prompt diagnosis and treatment can speed up recovery.

Sex after pregnancy requires a reliable method of birth control. Research suggests that the contraceptive effectiveness of breastfeeding varies. Hence, a couple must use a reliable birth control method. Remember, taking good care in the postpartum period can go a long way towards the couple’s emotional well-being.