Sex and Birth Control After Childbirth

When can I have sex again?

This is a common concern for new parents. The number of weeks you should wait before having sex varies depending on your specific circumstance. If you had an episiotomy, you should wait at least 3 to 4 weeks before having sex so it can heal. If you had a Cesarean section you should wait at least 4 weeks so your incisions can heal. Because it takes approximately 6 weeks for your uterus to return to normal after you give birth, many providers recommend waiting a full 6 weeks. Your hormone levels may take even longer to return to normal, especially if you are breast-feeding.

Remember that even if your healthcare provider tells you that you can have sex again after a certain number of weeks, it does not mean that you will feel like having sex or that it will not hurt at all after that period of time. Recovery time varies from woman to woman. It takes time to completely heal and feel like having sex again. Changes in your hormone levels after delivery and while breast-feeding often lower your sexual desire. Your partner may be concerned if a set time has passed and you still do not feel ready. He may be especially anxious considering sex during your pregnancy may have been awkward and less frequent. Assure him that this feeling will go away eventually and your sex life will return to normal.

How will sex be different after birth?

Even if you want to get back to your normal sexual activities as soon as possible, you may have some problems at first.

• You may still have some pain while having sex for weeks or months afterward, even after your incisions or tears have healed.
• Your vagina may be drier than normal, especially if you are breast-feeding.
• You may feel too busy, anxious, and tired while you adjust to the new baby, especially if it is your first baby. You may also be afraid of getting pregnant again.
• You may have post partum blues or depression that lessens your desire to have sex.

While you are waiting for your body to return to normal, use these tips to help make sex more enjoyable.

• Use a lubricant, such as K-Y, until your hormone levels are back to normal and your vagina lubricates itself.
• Talk to your partner about how you feel and tell him what hurts you so he can be gentle, especially if you have had an episiotomy.
• If you are breast-feeding, you may find that you have milk let-down during sex. Breast-feeding your baby before having sex may help.
• Try to have longer periods of foreplay and use a sexual position that puts less pressure on your stomach and sore areas. If you are on top, you may have better control over movements that cause pain.

Sex after birth does have its benefits. The hormones that are released during sex will help your uterus return to its normal shape.

What methods of birth control can I use?

If you start having sex before your postpartum check-up, it is a good idea to use some form of birth control, such as a condom, until you and your healthcare provider can discuss all your options.

If you are breast-feeding, you should not use combination birth control pills (containing both estrogen and progesterone), a vaginal ring, or monthly shots (Lunelle). Ask your healthcare provider about choices for birth control methods if you plan to breast-feed. (Breast-feeding by itself is not considered a completely reliable method of birth control.) Birth control methods that can be used when you are breast-feeding include:

• condoms (male or female)
• spermicide creams
• cap
• diaphragm
• IUD
• progestin-only birth control pills, which you can begin 3 to 4 weeks after the birth of your baby
• shots of progesterone (Depo-Provera) given every 90 days, starting 6 weeks after delivery.

If you do not plan to have children again and are looking for a more permanent form of birth control, male sterilization (vasectomy) or female sterilization (tying of the tubes) are two other choices available to you.

If you plan to have children again very soon, you may want to avoid using the hormone methods of birth control (pills or shots). That way you will not have to wait for your body to readjust to your normal hormone level and menstrual cycle. This makes it easier for you to get pregnant when you are ready.