Sex and Birth Control After Childbirth

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KEY POINTS

• The number of weeks you should wait before having sex depends on your specific circumstance. Many healthcare providers recommend waiting 6 weeks.
• You can get pregnant before your periods start again after delivery. 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 choices.

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When can I have sex again?

This is a common concern for new parents. The number of weeks you should wait before having sex depends on your specific circumstance. If you had an episiotomy, you should wait at least 3 to 4 weeks before having sex so the cut can heal. If you had a C-section, you should wait at least 4 weeks so the cuts on your belly can heal. Because it takes about 6 weeks for your uterus to go back to normal after you give birth, many healthcare providers recommend waiting 6 weeks.

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 heal and feel like having sex again. Changes in your hormone levels after delivery and while breast-feeding may make you less interested in sex. Your partner may be concerned if a set time has passed and you still do not feel ready. Your partner may be especially anxious because sex during your pregnancy may have been awkward and less frequent. Assure your partner that after a while your feeling will change and your sex life will return to normal.

How will sex be different after childbirth?

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

• You may still have some pain when you have sex for weeks or months, even after your cuts 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 want to be careful that you don’t get pregnant again.
• You may have postpartum blues or depression that lessens your desire to have sex.

While you are waiting for your body to go back to normal, these tips can help make sex more enjoyable.

• Use a lubricant, such as K-Y jelly until your hormone levels are back to normal and your vagina is not as dry.
• Talk to your partner about how you feel and tell him what hurts you, so your partner 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 go back to its normal shape.

What methods of birth control can I use?

You can get pregnant before your periods start again after delivery. If you start having sex before your postpartum checkup, 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 choices.

Ask your healthcare provider about choices for birth control methods if you plan to breast-feed. (Although it may stop you from having periods for a while, breast-feeding by itself is not considered a reliable method of birth control.) Birth control methods that can be used when you are breast-feeding include:

• Condoms (male or female)
• Spermicide
• Diaphragm
• IUD
• Birth control pills
• Shots of progesterone (Depo-Provera) given every 90 days

If you do not plan to have children again and are looking for a more permanent form of birth control, 2 other choices available to you are:

• Male sterilization (vasectomy)
• Female sterilization (tying of the tubes) or fallopian tube inserts

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.