Doctors typically advise that couples wait 4-6 weeks after giving birth before having sex again. This gives the cervix and uterus adequate time to heal. During this time the lining of the uterus is highly susceptible to infection, particularly where the placenta was attached. Inserting tampons or participating in intercourse could spread bacteria that increase this risk. The lochia (normal discharge and bleeding after giving birth) flow from the uterus lining lasts 2-8 weeks. Generally, when you no longer see bright red lochia, everything has healed.
Around 4-6 weeks after delivery a woman will have a postpartum exam to see how her body is healing and discuss future plans for contraception. During this time her doctor will determine if it is safe to resume intercourse. If a woman is told to abstain from sex this does not mean she cannot participate in other intimate acts.
While waiting for intercourse, participating in different types of intimate contact can help to share pleasure during the period when it may not be safe to have sex. “Outercourse” such as masturbation or oral sex can be resumed a few days following delivery. Just avoid contact with the vagina if the woman has experienced a vaginal tear or episiotomy. Also restrict oral contact to strictly external areas to avoid spreading bacteria. Those that wish to maintain intimacy without sexual means can hold hands, share a massage, hug, kiss or participate in other forms of physical contact.
Also avoid using a tampon to stop the lochia flow. No items should be inserted into the vagina until your doctor tells you it is safe as this increases your risk of infection.
Women are not fertile immediately following a birth, particularly when nursing, but doctors cannot predict how long this period of infertility will last. A woman may not experience menstruation for months, but her body will still release an egg before her first period. For those that are not breastfeeding this will occur around 45 days following delivery, but some experience it sooner. Ovulation will occur around two weeks before the first menstrual period. It is important to use birth control during this time if you do not want another pregnancy. Your health care practitioner will likely discuss this subject at your postpartum check and provide you with any necessary resources to resume contraception.
Your vagina may be tender after birth thus it is normal to feel painful during intercourse. Start by taking things slow and building stimulations up to determine your comfort level. Adjust your position to avoid areas that are sore. If you find you are experiencing dryness, lubricating gels or creams can be helpful. Be very clear with your partner about your needs and what is uncomfortable so you can find intimate actions that work. If sex continues to be painful, talk to your doctor about treatment options that may help.
Your vagina will have decreased muscle tone following birth which can reduce pleasurable friction. This is typically a temporary problem. Kegel exercises can help return the tone of the pelvic muscles following birth. These can be performed by tightening the pelvic muscles, similar to the sensation of stopping the flow of urine. Try holding this position for several seconds, 4-5 times in a row and continue to build up the length and amount of repetitions over time.
Caring for a new baby is very tiring, so tell your partner if you do not have enough energy for sex. This does not mean you can no longer have an active sex life. Simply seek out times when it will be pleasurable for both parties to engage in intercourse such as first thing in the morning or while your child is napping. You can also have a trusted loved one or friend babysit for a few hours to give you some time to be intimate with your spouse.
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