Women's Health

Your guide to the ins and outs of postpartum sex

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Being pregnant is different for everyone. While some women or people with uteruses may love having sex while pregnant, it may be nine long months of reduced sexual activity for others.

While a couple might be keen to get back into it shortly after they've welcomed their new baby into the world, it's recommended that you should generally avoid postpartum sex in the four to six weeks following a vaginal or caesarean delivery.

After giving birth, your body enters a healing phase. Having sex too soon, for example, within the first two weeks, could be dangerous and increase the risk of postpartum haemorrhage or uterine infection.

How long after birth can you have sex?

Many factors will determine whether or not someone may be ready to resume sexual activity after giving birth, including pain levels, fatigue, stress, sex drive, fear of sex, vaginal dryness, and postpartum depression.

The risk of complication from postpartum sex is highest within the first two weeks after birth, and waiting those extra weeks will allow the body to heal.

Most doctors recommend you wait at least six weeks before getting intimate with your partner again.

Still, you may need to wait longer if you have a perineal tear or episiotomy — a surgical cut to widen the vaginal canal.

If you have previously suffered with dyspareunia, the medical term for painful sex, you are more likely to experience it after birth as well, according to research.

Once you have reached the six to eight-week mark, you should be able to return to your usual sexual activity.

But remember, everyone is different, and these timeframes are simply a guide. You may feel like you need to wait a little longer but chat to your doctor if you're worried.

Anxiety can also create discomfort, creating a vicious cycle where you worry about pain, which brings about the issue you were worried about, almost like a self-fulfilling prophecy.

After giving birth, your body's hormones need to readjust to your pre-pregnancy state, and this change can affect your sex drive and sexual response.

As a result, it may take time for you to be entirely comfortable with sex after birth.

Be open with your partner during this time because it's likely their desire is much higher than yours.

Create open communication about how you're feeling, especially now that you've added a new baby into the equation.

Take things slowly, maybe with oral sex or mutual masturbation rather than penetrative sex.

Remember there are different ways to enjoy sex and feel sexy with your partner.

How soon can you have an orgasm after giving birth?

It's unlikely for most women that you'll experience an orgasm the first time you have sex after birth.

For some women, it can take weeks of postpartum sex before they experience an orgasm, even if they used to climax regularly before birth.

It's important during this time to communicate with your partner and tell them if you feel strange, sore or nervous.

Keep lubricant handy, as there will be a decrease in oestrogen after childbirth, reducing vaginal lubrication.

NORMAL's Water-Based Lube and Silicon-Based Lube are great options for postpartum sex as they are formulated without parabens and are extremely gentle on the skin, while also reducing friction during sex.

What happens if you have sex before six weeks postpartum?

After childbirth, your body will be trying to heal itself and having sex too early, especially within the first two weeks, increases your risk of postpartum haemorrhage or infection.

After delivery, the risk of having a complication is highest in those first two weeks, and waiting will allow your body time to heal.

Some women may be ready to have sex before the six-week timeline with some researchers believing six weeks became the standard because it usually coincides with a postpartum checkup.

Another way of feeling out when you might be ready is to wait until you're no longer bleeding, as this means your uterus and the uterine lining is likely healed.

If you feel ready around the four-week mark, check with your doctor beforehand and remember to start slow.

Does sex feel different after giving birth?

While you might be eager to have sex, it's important to note that it might not feel the same for the first few months after giving birth.

Researchers have found nearly nine in 10 women will experience pain the first time they have sex after childbirth, with almost 25 per cent still reporting painful sex 18 months later.

The study also found that women who gave birth via caesarean or vaginally with vacuum extraction were twice as likely to experience painful sex at 18 months postpartum compared with women who had vaginal deliveries.

As there are lower circulating oestrogen levels in the postpartum period, many women will likely experience vaginal dryness, which may continue past the six-week timeframe if you're breastfeeding.

To relieve the symptoms of vaginal dryness, a lubricant may be helpful.

Postpartum sex may also feel different as you have reduced vaginal muscle tone and limited capacity for stretching, but don't worry, as this is often temporary.

Several other factors can contribute to how sex feels for a woman postpartum, including genetics, the baby's size, whether you've had previous births and the use of Kegel exercises.

Kegel exercises can help strengthen the vaginal area following delivery. These can be performed pretty much anywhere.

To find your pelvic floor muscles, stop the flow of urine the next time you visit the bathroom. The point where you feel it straining are the pelvic floor muscles.

To perform a Kegel, relax your body, then try to stop an imaginary stream of urine mid-flow.

Next, squeeze your pelvic muscles and hold for five to 10 seconds. Rest for five to 10 seconds and repeat ten times. You can do this three times a day.

When you and your partner engage in sexual intercourse postpartum, you may experience bleeding due to dry tissue. This can increase your risk of infection.

Postcoital bleeding is estimated to affect up to nine per cent of menstruating women, with vaginal dryness the most common cause.

When the skin is dry, it's much more vulnerable to damage, with mucus-producing tissues in the vagina especially vulnerable.

Because childbirth causes vaginal tissues to stretch and tear, they're even more susceptible to injury.

If you find sex painful after birth, Kin's Sitz Bath can relieve tender and sensitive skin both during and after pregnancy.

The Sitz Bath uses a special blend of Epsom Salt, mineral-rich dead sea salt, witch hazel and essential oils to help relieve pregnancy aches, itchy stretched skin, haemorrhoids or a torn perineum.

The best part? You don't even need a bathtub to relieve your pain because Kin's Sitz Bath can be placed on a toilet seat, turning it into a spa for your sensitive bits.

Thankfully, any sexual issues you may face after childbirth are usually not long-term and shouldn't have an impact on your sexual desire, activity or satisfaction later in life.

The Sitz Tub hugs your toilet and turns it into a spa for your sensitive bits.

How long after birth can you have anal sex?

Like vaginal intercourse, anal sex isn't recommended within the first four to six weeks after birth.

If you've had an episiotomy or vaginal laceration repair, you'll need to wait until they're properly healed before attempting any kind of intercourse.

Anal sex can also disrupt stitches and stop the body's healing process so it's best to wait until your body is feeling up to it.

Many women will have haemorrhoids following delivery, so anal penetration can be painful or even lead to heavy bleeding.

You may want to wait until a doctor has examined you before engaging in any kind of intercourse to be safe.

Does breastfeeding affect sex?

Breastfeeding can reduce a person's sex drive, and due to hormonal changes, there can be several unusual and inconvenient symptoms.

For example, during sex, your breasts may leak milk due to the hormonal response to orgasm. To reduce the risk of leaking breast milk, try pumping before sex.

Researchers have found that women who breastfeed are more likely to delay sexual activity following the birth of their baby than those who don't breastfeed.

This is due to your oestrogen levels falling after birth, leaving two other hormones, prolactin and oxytocin, to increase.

These hormones have different impacts on the body and can affect your sex drive differently.

For example, an increase in prolactin and oxytocin could provide you with enough emotional and physical intimacy during breastfeeding, so you don't feel the need to have sex or seek affection from your partner.

But the opposite can also be true, with the increase in hormones leading to increased sexual desire.

Either way, it's important to note that this is a normal part of your postpartum journey and sex life.

Your desire may rise and fall, but eventually, you'll reach a point where your libido is at the same point it was pre-pregnancy.

What if my post-baby body image affects my sex life?

Having a baby can significantly impact your body image and sex life. Along with fatigue and emotional stressors, body image issues can strongly influence whether you feel ready or not for sex.

According to one study, a change in body image plays a huge role in influencing how women perceive their sexual health and satisfaction during sex.

Having a negative self-image resulted in women feeling less intimate and less confident about returning to sexual activity.

On the other hand, positive self-image improved sexual health, including satisfaction with postpartum sex.

When to start birth control postpartum

You can fall pregnant just three weeks after giving birth, so it's essential to be using birth control after delivery to prevent unintended pregnancy too soon after.

If you're interested in immediate contraception, you have a few different birth control options including barrier contraceptives such as condoms or progestin-only contraceptives such as Depo-Provera or the mini-pill.

You can also discuss with your doctor if you'd prefer to use an IUD or a fitted barrier method such as a diaphragm, or if you'd like to use combination birth control methods, such as those containing oestrogen and progesterone, like the pill.

How soon can you get pregnant again after giving birth?

As mentioned above, you can fall pregnant just three weeks after delivering a baby.

If you're considering having another child, one thing you may be thinking about is how close in age you'd like your children to be.

However, some research has shown that how you space your pregnancies can affect both the mother and baby.

If you get pregnant within six months after having your previous child, you could be at risk of premature birth, low birth weight, placental abruption — where the placenta partially or completely peels away from the inner wall of the uterus before deliver, anemia, and more.

The study has suggested that closely spaced pregnancies may be associated with a higher chance of autism in second-born children, which is highest in pregnancies less than 12 months apart.

But in the same way that pregnancies being too close together can impact the mother and child, pregnancies that are too spaced out can also pose risks.

Research suggests there is an increased risk of preeclampsia in women who have long intervals between pregnancies.

It's unknown why this is, but it's possible pregnancy improves the uterine capacity to promote foetal growth and support.

The best interval between pregnancies is believed to be between 18 and 24 months, but less than five years.

These timings do not apply to those who have had miscarriages. If you feel ready and healthy, you don't need to wait to conceive again after a miscarriage.

References

https://www.medicalnewstoday.com/articles/308480

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https://www.pennmedicine.org/updates/blogs/womens-health/2015/august/sex-after-birth-what-to-do-when-it-just-doesnt-feel-the-same

https://www.webmd.com/sex-relationships/features/after-babys-born

https://www.webmd.com/sex-relationships/news/20190214/is-there-a-right-time-for-sex-after-childbirth

https://www.babycenter.com/baby/postpartum-health/how-long-should-we-wait-before-having-anal-sex-after-childbi_11812

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