Articles

Key takeaways

• There are no set rules for when to have sex after birth.
• Wait until you feel physically and emotionally ready.
• Open communication with your partner is important.
• Contraception is important, even if you are breastfeeding.

When is it safe to have sex again?

There are no set rules about when you can start having sex again after giving birth. Everyone recovers differently. It depends on when you feel physically and emotionally ready.

You may have vaginal bleeding (lochia) for several weeks after birth. This happens after both a vaginal and caesarean birth. Many people choose to wait until the bleeding has stopped and any wounds have healed. This may improve comfort.

You may feel very tired and emotional during the weeks after birth. Do not feel pressured to have sex before you are ready. If you do attempt to have sex and anything hurts, stop.

After a vaginal birth

After a vaginal birth, your vagina and the surrounding area may feel sore. If you had stitches after tearing or a cut made to widen the vaginal opening (an episiotomy), discomfort during sex is common in the first months. Hormonal changes after birth can also make your vagina feel drier than usual, which can cause discomfort.

After a caesarean section

If you had a caesarean section, you can start having sex as soon as you feel physically and emotionally ready. This will be different for everyone. It may take up to 6 weeks or longer while your body heals.

Common physical and emotional challenges to intimacy

After giving birth, you will go through many physical and emotional changes, which can make sex less of a priority or more challenging.

Physical challenges

• Bleeding– Vaginal bleeding (lochia) can last for up to 6 weeks.
• Soreness – Your vagina and surrounding area may be sore, especially if you had stitches for a tear or an episiotomy.
• Vaginal dryness – Hormonal changes after birth can make your vagina feel drier than usual, especially if you are breastfeeding.
• Tiredness – Sleepless nights with a newborn can lead to extreme tiredness.
• Other symptoms – Incontinence or piles (haemorrhoids) may also affect your comfort and desire for intimacy.

Emotional challenges

It is normal to go off sex for a while after having a baby. You are recovering and caring for a newborn. You may feel intensely focused on your new role as a parent.

• Low libido – Tiredness, hormonal changes and adjusting to life with a newborn can all affect your interest in sex.
• Mood changes – Changing hormones and the demands of caring for a newborn may contribute to the "baby blues”. You may feel tearful, emotional, or irritable.
• Feelings of depression – Constant sadness, loss of interest, or hopelessness that lasts for more than 2 weeks may be a sign of postnatal depression (PND). Speak to your midwife, health visitor, or GP if these feelings last longer than two weeks.
• Body image – Your body will look different after giving birth, which can affect how you feel about yourself.
• Privacy concerns – Some new parents find having sex in the same room as their newborn off-putting.

Easing back in and reconnecting with your partner

When you are ready to consider intimacy again, take it gently and do not rush. If sex is painful, it will not be pleasurable.

Tips for intimacy

• Communicate openly – Talk with your partner about any worries and how you feel about having sex.
• Start slowly – There are many ways to be close without penetration. You can try kissing, massaging, and other forms of intimate touch.
• Use lubricant – Hormonal changes can cause vaginal dryness. A water-based lubricant can help make sex more comfortable.
• Explore gently – You might want to explore your own body first. This can help reassure you that sex will not hurt.
• Make time to relax – You are more likely to feel intimate when you are both relaxed.
• Speak up – If penetration hurts, say so. Continuing despite pain can make sex feel unpleasant.

Contraception after having a baby

You can get pregnant as little as 3 weeks after giving birth, even if you are breastfeeding and your periods have not returned. It is therefore important to use contraception if you do not want another pregnancy.

Breastfeeding as contraception

Some people use breastfeeding as a method of contraception. This is called the lactational amenorrhoea method (LAM). It can offer some protection if all of the following conditions are met:

• Your baby feeds frequently, with no gaps longer than about 4 hours in the day and 6 hours overnight
• You are exclusively breastfeeding – This means your baby receives only breast milk, and no formula or solid foods. This can include expressed breast milk.
• Your baby is under six months old.
• Your periods have not returned.

Contraception choices

Choosing contraception after birth depends on various factors. These include your breastfeeding status and how long it has been since delivery.

• Immediately after birth (within 48 hours) – You can usually have a hormonal or non-hormonal coil (IUD/IUS) fitted. You can also start some other methods right away, even if you are breastfeeding. These include condoms, the implant, injection, and progestogen-only pill.
• From 3 weeks after birth – You can start the combined hormonal contraception such as the pill, vaginal ring, or patch. This is if you are not breastfeeding and have a low risk of blood clots (DVT). If you are breastfeeding, it's generally advised to wait until at least 6 weeks after birth for these methods. This is because of concerns about blood clot risk and possible effects on milk supply.
• At 4 weeks after birth – You can usually have an IUD or IUS fitted if it was not fitted immediately after birth.
• Around 6 weeks after birth – You can usually start using a diaphragm or cap. If you used one before pregnancy, see a GP or contraception clinic to ensure it still fits correctly, as your body shape may have changed.