For anyone who’s had a vaginal birth or C-section, you may be wondering when it is safe to start having sex again. You may also really not feel like having sex of any kind, at all, for quite a while. Both are normal reactions to becoming a parent, and there is no right or wrong way to feel about sex after giving birth.

How long after giving birth can you have sex?

It’s generally recommended that after having a baby, you wait four to six weeks before having vaginal, penetrative sex. But NHS Choices says there are no rules and it’s up to you to decide when you feel ready.

‘Even after a “normal delivery”, your vagina and vulva are likely to feel battered and bruised,’ says Dr Deborah Lee, from Dr Fox Online Pharmacy. ‘Your vagina has been stretched, and pulverised, by the passage of your baby’s head through the birth canal. Your cervix has also dilated to more than ten times its non-pregnant size – and needs to gradually shrink back again. During the mechanical process of labour, your pelvic muscles will have been bruised and damaged.’ Lee says you will be likely also be bleeding or passing what’s know as lochia, for up to six weeks.

With rest, it’s likely your soreness will go back to normal within a few weeks, but Lee warns that this could take longer if you’ve had a more difficult birth.

When it comes to oral sex, or any other kind of non-penetrative sex, there is no guidance. So you can just go with how you feel.



How does sex feel after birth?

Penetrative sex may feel uncomfortable initially, but it should not feel painful, says Dr Karen Morton, of Dr Morton’s the medical helpline. ‘Pain in the vagina after trying a few times probably means there is something wrong. If it just feels tight you should persevere but if there is an exquisitely tender spot, perhaps with some bleeding, you should go to the doctor. Exquisite tenderness means as you touch it you screw up your face and lips and take a sharp in draw of breath,’ she says.



Sex after a C-section

For anyone who gave birth via C-section, Lee points to the Royal College of Obstetricians and Gynaecologists (RCOG) recommendation that you delay having sex until you’re fully recovered from the operation. This may take six weeks or longer, she says.

‘A 2013 Australian study, published in the British Journal of Obstetrics & Gynaecology, reported the findings of more 1500 women who had given birth for the first time. In women who had had a C-section, 45 per cent had resumed vaginal sex by six weeks,’ she adds.

What are the risks of having sex too soon?

Having vaginal intercourse too soon after birth increases the risk of postpartum haemorrhage or a uterine infection, warns Dr Shirin Lakhani, women's intimate health expert from Elite Aesthetics and The Cranley Clinic .

If you have no cuts or tears that you’re worried about, the biggest risk that comes with having sex again is discomfort, says Mr Narendra Pisal, consultant gynaecologist at London Gynaecology. However, ‘There is a risk of affecting the healing of cuts or tears if you start too early.’

How soon can you get pregnant?

Do also bear in mind that despite having just had a baby, you can get pregnant again almost immediately – although Pisal says in most cases, it is more likely within three months or so. ‘Make sure you have contraception on board if you want to have some time to heal and recover from this pregnancy and delivery,’ she says. She recommends condoms, IUD and the mini Pill as the most common contraceptives after delivery.

Lee says that although many people believe breastfeeding means you don’t need contraception, this isn’t the case. ‘Guidance from the Faculty of Sexual and Reproductive Health (FSRH 2017) states that if women are fully breastfeeding, although this has a marked contraceptive effect, the failure rate is around 2 per cent. Many women choose to use additional contraception even when they are breastfeeding.’ She advises this is something you should discuss with your doctor.

How to start having sex again safely

Make sure you talk about how you’re feeling with your partner, before you start having sex again. Be honest about your fears and anxieties, and any pain you’re experiencing. And as Lee puts it, ‘The best advice is to take things slowly and not to rush.’

Pelvic floor exercises

Pisal recommends pelvic floor exercises to help get the strength back and support the bladder and bowel function.

Use lubricant

As Pisal explains, ‘breastfeeding may lead to vaginal dryness and discomfort during sex’. The best way to combat this and ensure any sex you have is pleasurable and less likely to result in pain or injury, is to use a good quality lubricant.

If lubricant isn’t quite sufficient, Lee suggests using a local vaginal estrogen in the form of a pessary (Vagifem) or a cream (Ovestin). She explains, 'These products contain natural oestrogens. Only tiny amounts are absorbed through the vaginal epithelium (skin) into the bloodstream. As a result, they are believed to be safe in terms of breast milk/breastfeeding. You do need to discuss this option with your doctor and be sure to use the correct, low dose, product.’

Kathrin Ziegler Getty Images

Is anal sex safe?



Anal sex is an option, if that’s something you’re comfortable with and want to try. However, Lee says to be wary if you’ve had a third or fourth degree tear that has been stitched up. Ensure this is fully healed before attempting anal penetration.

‘Haemorrhoids are a frequent problem in pregnancy,’ she adds. ‘Anal sex will require a lot of lubrication, and especially with haemorrhoids, may be associated with bleeding. Having anal sex may also increase your risk of infection.’

Postpartum sexual dysfunction (PPSD)

Lee says it’s very common for women to experience sexual problems, which are known as postpartum sexual dysfunction (PPSD) after childbirth. This can include sexual desire disorders, arousal disorders, issues with orgasm, and painful sex.

‘Women are often embarrassed to discuss sex and sexual function with their doctors, midwives, and health visitors. They also feel a societal pressure to get back to normal and want to please their partners,’ she says. ‘All this adds up to hidden anxiety about how and when to resume their healthy sex life.’

Loss of libido or sex drive

There are multiple reasons that people may experience a loss of libido post childbirth, and it’s really normal. ‘There are big hormonal changes that happen during pregnancy, and after childbirth which can impact how we feel, but also our sense of selves and wellbeing which can have a knock on impact on our sex lives,’ Moyle explains. ‘Desire, the want to be sexual, sits in the context of the rest of our lives and so can be impacted by our thinking, and if we are feeling anxious, perhaps about sex being painful, feeling nervous about having intercourse again, or feeling a lack of body confidence, or fear of what our partners may think about our post-natal bodies then we can get stuck in our heads instead of being in our bodies which can negatively impact desire.’

She also mentions common factors such as lack of sleep, exhaustion and a complete change of lifestyle as major contributors to not feeling sexual desire.



If you don’t want to have sex yet

Remember if you’re not feeling up to it, that’s absolutely normal. You should never feel pressured into having sex, even if you’re worried how that will impact your partner. Telling your partner this can feel daunting, but the best way to deal with any mismatched feelings about sex is to communicate. ‘Be open with your partner, and start the conversation with a positive. If you jump into the conversation with a phrase like, “I just know you want to have sex again”, they may respond defensively as they feel they are being criticised or attacked; and when we have a new baby the lack of sleep can play havoc with the sensitivity of our emotions anyway,’ says psychosexual therapist and sex expert for LELO , Kate Moyle.

‘Always start with a positive and a reassurance, say that you are not ready for intercourse yet, and be honest about why so that your partner can understand and help you when you get to it. They may also be nervous about re-initiating things so ask them how they feel about it too. Focus on what you can do, and make some time for yourselves as a couple to have some physical intimacy so that you both don't feel that the distance between you is growing.’



Last medically reviewed: 12-06-2020

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