Postpartum Sex

    After delivery many obstetricians usually tell their patients "nothing in the vagina for six weeks." Or they just say "no sex until the 6-week postpartum visit."

    Couples often get little or no explanations of what they can or cannot do, and are left to their own imagination as to what's allowed and what isn't.



    What obstetricians usually mean by "no sex" is that it's recommended to avoid penetration into the vagina (and also rectum) such as not inserting a penis, fingers, dildo, vibrator, or other things.

    Other doctors may specify only four or even two weeks or when the lochia (postpartum discharge from the vagina) stops, whichever is later. 

    Why No Sex Postpartum?
    There are several reasons for the recommendation for delaying postpartum intercourse:

    • Allowing the woman's genital tissues to heal, especially if there was an episiotomy or tearing
    • Allowing a cesarean skin or uterine scar to heal
    • Avoiding infection to the genitals and the uterus

    However, in most cases these risks don't necessarily require weeks of abstinence from intercourse, and there is little scientific proof to require abstinence for exactly 6 weeks after delivery.

    The postpartum visit has been traditionally at six weeks, though there are really no firm rules if 4 weeks or 8 or even 10 weeks are better.

    The reason for the "six week no sex rule" is more for the obstetrician's convenience than the new mom's medical needs. 

    Six weeks is usually when the uterus should have returned to its pre-pregnancy size. This is the last of the major physical postpartum changes (again, from the obstetrician's perspective).

    But a woman doesn't really need her uterus return to its pre-pregnancy size for intercourse, and obstetricians put everything into the 6-week postpartum re-check, including "permission" to have intercourse at six weeks.

    Does a women really have to wait 6 weeks after delivery to resume sex? Can you do it earlier? Though many women's desire for sex is lower after delivery, there are many other who want to resume sex right after delivery.

    Some feel that perineal and abdominal healing has not progressed enough to make intercourse pleasurable. Other just don't feel "up to it" postpartum for many reasons including hormonal and other body changes.

    Some studies have shown that the average woman resumes sex after 6 weeks, with amedian time of 3 months, other studies found that 1 in 5 first time mothers took 6 months to feel physically comfortable during sex, and still  another study found that over 50%  of women were still having less frequent sex at 12 months after childbirth.

    Women who breastfeed sometimes also comment that by the end of the day they are pretty well done with being touched.

    Fear of Pain
    Many women do not desire sex after childbirth because of pain, or fear of pain, during intercourse. The time it takes for a woman's desire to return to previous levels depends largely on her birthing experience.

    Women who deliver with the assistance of forceps tend to take longer to feel comfortable during sex. The same goes for women who experience internal vaginal tears.

    Women with swelling after childbirth and/or any breakdown of the perineum (the external region between the vulva and the anus that is made up of skin and muscle) also tend to take longer to feel comfortable during sex.

    Surprisingly, whether a woman has an episiotomy doesn't seem to make a difference. If a woman experiences pain or fears pain she might try oral sex, manual sex, or being on top during sex, which can help her steer her partner away from sore spots. In any case, she can guide the penis into her vagina gently.

    Also make sure to use a lot of lubricant, as this will combat pain due to vaginal dryness. 

    Fatigue
    As any new mother knows, the first weeks and months after childbirth are exhausting. Fatigue is one of the most common reasons for low sexual desire. Between recovering from childbirth, hardly sleeping, and the demands of breastfeeding, sex often falls to the wayside.

    Childbirth requires huge adjustments on the part of both parents and sex can be difficult to fit into an already packed schedule and into the changing roles of the individual parents and the partnership itself. For most women, decreased libido is only a temporary change that requires time to return to normal.

    The Bottom Line
    New mothers may find that it takes them a while to get back into the groove when it comes to sex. This can be related to a number of factors, including the disrupted sleep and exhaustion that comes with being a new parent, the precipitous fall of hormone levels after pregnancy, the physical discomfort that is common after childbirth, postpartum depression, and feelings of unattractiveness due to the physical changes that accompany pregnancy. Many, if not all, of these problems will improve with time. As these problems disappear, your sex life will probably improve.