Everything You’ve Ever Wanted to Know About Sex After Birth
If you’re barely surviving on minimal sleep, changing diapers at all hours and waddling around in postpartum underwear, having sex might be the last thing on your mind. And that’s totally fine. At some point in the near or distant future, you will want to have sex again. Still, the thought of doing the deed postpartum might sound terrifying. Is it safe? Will it hurt? Will it feel… different? Ready to get the scoop on sex after birth? Read on for everything you’ve ever wanted to know about postpartum sex, from when you can start having it to what to how to make sure it feels good.
So when can you have sex after birth? There’s no universal or definitive answer. Rather, you’ll want to get the go ahead from your provider at your six-week postpartum appointment. That said, there are some nuances and variables.
Kecia Gaither, MD, director of perinatal services and maternal-fetal medicine at NYC Health + Hospitals/Lincoln in New York City, says that six weeks is the universally accepted standard after a vaginal birth. But women who had c-sections might need to wait eight weeks or more. Additionally, Gaither says that having an episiotomy or other interventions can affect the timing. If you’re still healing, it’s important to not rush back into sex after birth.
“The risks of having sex too soon include contending with unhealed wounds, vaginal dryness, pain, musculoskeletal changes and infection,” Gaither explains.
Medical approval aside, the question of when to have sex again after baby is a personal one. Beyond the physical, there are emotional factors to consider too. You may simply not “feel” ready to have sex again at six or eight weeks postpartum—and that’s okay and normal.
We’re not going to sugarcoat it: Sex after birth may feel different in some way. You might be dealing with uncomfortable physical symptoms, struggling to accept changes to your body or feeling totally touched out by baby and generally disinterested in intimacy.
This is all 100 percent normal, says licensed mental health counselor and certified sex therapist Katie Schubert, PhD, LMHC, owner of Cypress Wellness Center in St. Petersburg, Florida.
“Your body changes tremendously after giving birth, so sex can feel both physically and emotionally different,” she says. “Some women are fine going back to sex-as-usual after their doctor’s approval; other women feel the need to wait longer so their bodies and minds can more fully heal.”
Schubert says your individual anatomy and the way you gave birth (vaginally or via C-section, for example) can help determine what sex physically feels like. Meanwhile, whether or not you’re breastfeeding and how “at home” you feel in your new body can also affect your emotional openness.
“I don’t know any new moms who desire sex the way they did pre-baby, or feel as sexy in their bodies as they did pre-baby,” says Schubert, who adds that it’s important to listen to and trust your body. Give yourself grace; the desire for intimacy will come back, she adds.
You just delivered an entire human being from your body (after growing and carrying them around for nine months). That’s going to result in some changes! For the most part, physical discomforts are entirely normal and to be expected, but it helps to be prepared for what you and your partner may encounter.
Painful sex after birth
Whether you had a vaginal or c-section delivery, you’ll likely experience some postpartum pain and need to heal. Vaginal births a be associated with tearing (which often requires stitches) and sometimes episiotomies, both of which can cause acute and chronic pain with intercourse thanks to initial healing and, later, long-term scarring.
Even if you didn’t have a vaginal birth, you might experience vaginal pain during postpartum sex. Dweck explains that lactation lowers estrogen levels, almost temporarily mimicking the menopause state. This can make the vagina dry and delicate, and less elastic, making you more prone to injury with intercourse.
So what can you do about painful sex after birth? Other than giving yourself plenty of time to heal, Dweck says you can use lubricants or vaginal moisturizers to hydrate the tissue, try a vaginal dilator to increase vaginal elasticity or ask your provider about vaginal estrogen, which may improve some conditions.
Discomfort around c-section incision
Incisional pain from a C-section can make the physical act of intimacy difficult, says Dweck. A 2016 study of postpartum women in Beijing suggested that women who’ve had C-sections generally wait longer to have sex again than women who deliver vaginally, noting that everything from lower sex drive and vaginal dryness to urinary incontinence and painful intercourse affected the timing.
Remember that a C-section is literally abdominal surgery, so you’ll need to give your incision plenty of time to heal before expecting to be pain-free. In some cases, you may need to try different sexual positions to find one that doesn’t cause discomfort around your incision. Taniqua Miller, MD, an Atlanta-based ob-gyn and founder of Revival Telemedicine for Menopause Care, says having sex on your side can take some of the pressure off your abdomen.
Continued postpartum bleeding
Postpartum bleeding, or lochia, usually ends after about six weeks, but some women still experience it for up to eight weeks, per Cleveland Clinic. Miller says as long as you’ve moved into the phase where your lochia is yellowish or looks more like light spotting, it’s safe to have sex. You can prepare for it by laying down an old towel or blanket wherever you’re having sex and keeping some wipes handy to clean up after.
If the lochia persists past eight weeks postpartum, smells bad, or continues getting heavier, or if you’re only bleeding during sex, let your provider know.
Sore and swollen breasts
If you thought your breasts were sore and swollen during pregnancy, just wait until they’re engorged with breast milk and your nipples are raw from feeding baby around the clock. New moms are often understandably hesitant about jumping back into sex when their breasts are so sensitive, and many also worry about breast milk leakage during intercourse.
Over time, your breasts should start to feel less sore and be less likely to leak milk; meanwhile, make sure you’re communicating with your partner if you want your breasts to be off-limits during sex, and consider wearing a bra with nursing pads tucked inside if you’re concerned about leaking.
Low sex drive
Your healing body and emotional state can affect your sex drive after birth. Miller says the mental bandwidth it takes to have a newborn combined with sleep deprivation and plummeting levels of estrogen, progesterone and serotonin in the weeks after birth can leave new moms completely uninterested in sex. Plus, you might be feeling self-conscious about your body changes, which can also dampen the mood. While spending time together as a couple not having sex—just being loving, romantic and affectionate—can help your sex drive ramp up again, it’s important to remember that a lower sex drive postpartum is normal (and that pressuring yourself or feeling guilty is counterproductive, since stress contributes to low libido in both men and women).
In the meantime, Miller suggests doing things to boost oxytocin, like getting outside on a nice day, and asking for help so you can catch up on sleep or maybe sneak out for a quick date.
While postpartum sex can be complicated, there are ways to reconnect with your partner in the bedroom little by little, and get back to feeling confident and comfortable during intimacy.
Set realistic expectations
Dweck says new moms have a lot to consider when it comes to having sex: vaginal bleeding, excess baby weight, fatigue, anxiety about baby (the list goes on). Just knowing that sex is going to be different for a little while can make it easier to imagine actually having it. It won’t be perfect, and your first attempts might not go smoothly, but that’s okay.
Go slow
Schubert says you shouldn’t rush any part of intimacy. Your body will heal, and you’ll know when you’re ready. If you’re not mentally or physically there yet, it’s okay to keep waiting.
Expand your definition of intimacy
Dweck suggests finding ways to be intimate with your partner without necessarily going all the way: cuddling, kissing and engaging in other non-penetrative activities can help you and your partner feel physically close even when you’re not literally having sex.
Use lubricants
As Dweck mentioned, sex can be painful no matter how you gave birth because of lactation (but doubly so if you had a vaginal delivery). You may need to use lubricants or moisturizers for a while to make sex more comfortable.
Change up your positions
Schubert says it’s helpful to find a position that feels physically and emotionally comfortable, which may mean getting into new or different positions than before. It can help to be on top of your partner, she says, so you feel more in control of the movements and the degree of penetration.
Communicate with your partner
“Communicate with your partner about your needs and desires,” advises Schubert. “Communication is truly the most important thing to do postpartum on all fronts.”
We know: getting pregnant again is literally the last thing on your mind right now, but you have to think about it anyway. It’s possible for pregnancy to occur soon after delivery, says Dweck, and in some cases it can happen even before you’ve had your first postpartum period.
Though the chances of getting pregnant in the first four to six weeks postpartum aren’t massive, they do exist: One study suggests as many as 44 percent of women could become pregnant in that timeframe by ovulating before their first postpartum menstruation.
Women who are exclusively breastfeeding are particularly vulnerable, says Dweck, since exclusive breastfeeding can make it harder to observe the ovulation cues, like thick, stretchy discharge and sore breasts.
Basically, you could get pregnant again with a newborn in the house, and that’s not just a totally overwhelming and stressful scenario—it’s also not entirely ideal for your physical health and well-being.
The American College of Obstetrics and Gynecology (ACOG) strongly advises women to avoid getting pregnant again until at least six months after birth, though the recommended amount of time between pregnancies is actually 18 months. When pregnancies occur too close together, the risks for preterm birth, low birth weight for babies and pregnancy and birth complications for moms increase.
One of the reasons experts recommend waiting until after your six week postpartum appointment to resume having sex is so you can make a plan to avoid getting pregnant again before it’s considered safe.
Pregnancy prevention is an extremely personal decision, but it’s a conversation worth having with your provider. Whatever birth control or prevention method you were using before getting pregnant may no longer be a good fit for you. It may not fit into your new lifestyle, be safe for breastfeeding or be compatible with your plans for future pregnancies. If you’re not sure which method of birth control is right for you postpartum, your provider can help you choose.
Frequently Asked Questions
When is it safe to orgasm after giving birth?
According to Dweck, there aren’t any limitations on when you can have an orgasm after birth; it’s safe at any point postpartum. But there may be limitations in how you actually achieve an orgasm. “Most women are advised to avoid anything being inserted in the vagina for six weeks after delivery, and sometimes longer based on individual circumstance,” she explains.
She adds that it’s safe to orgasm with external stimulation, either of the clitoris or vulva or the nipples. But keep in mind that vaginal stitches from tears or episiotomies can affect healing, and might make external stimulation uncomfortable for a while.
After giving birth, when can I receive oral sex?
Penetrative sex isn’t recommended for several weeks after giving birth, but Miller says other forms of intercourse are generally safe as long as they don’t interfere with your healing process (i.e. if you had vaginal stitches, you should avoid inserting anything in your vagina and take extra caution around your sutures).
Can you masturbate after giving birth?
Yes, the rules here are the same as they are for having an orgasm and receiving oral sex: It’s okay as long as you’re comfortable with it and it’s not interfering with your healing.
Can your G-spot move after birth?
Dweck says the G-spot (a somewhat elusive female erogenous zone) is generally located in the anterior vagina, about an inch inside the vaginal canal, but its existence as an actual anatomically-distinct structure is controversial (many believe it’s actually an extension of the clitoris, she explains). Wherever it may or may not be located, Dweck says it wouldn’t move in any noticeable way after birth—though the vaginal walls could relax postpartum and affect its position somewhat.
Postpartum sex is often complicated by both physical and emotional changes, and this is entirely normal. Knowing that sex will feel different for a while can make the changes easier to cope with. Know that there’s nothing wrong with you if sex is painful, if you don’t feel like your most attractive self or if your sex drive has dropped down to zero.
While there are some ways to ease back into enjoying sex after birth, the best solution is to give yourself the time and space to heal, mentally and physically. Don’t rush, listen to your body, communicate with your partner, and take things slow.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.
Kecia Gaither, MD, is an ob-gyn, maternal-fetal medicine specialist and the director of perinatal services and maternal-fetal medicine at NYC Health + Hospitals/Lincoln in New York City. She earned her medical degree from SUNY Health Science Center in Syracuse.
Taniqua Miller, MD, is an Atlanta-based ob-gyn and founder of Revival Telemedicine for Menopause Care. She is trained in psychology at Yale University and earned her medical degree from Harvard Medical school before completing her residency training in Obstetrics & Gynecology at the University of Virginia in Charlottesville
Katie Schubert, PhD, LMHC, is the owner of Cypress Wellness Center in St. Petersburg, Florida.
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