Postpartum sex: When you can start and what it’s like

There are no rules and standards when it comes to postpartum sex. In general, women should hold off four to six weeks after giving birth to allow their bodies time to heal. Most women get cleared to have sex again around the six-week mark, though some may be advised to abstain from sexual activity for longer depending on their health and recovery.

For some, six weeks can still feel too soon. The body goes through a lot of significant changes during pregnancy and childbirth, and it can take some time to feel empowered and comfortable in both your body and your new role as a parent.

This is for both vaginal deliveries and C-sections. The vagina is affected no matter how a baby is delivered. Just because a baby was delivered via C-section, does not mean the vagina doesn’t need to heal before having intercourse again.

When can you start having postpartum sex?

Most women can have sex six weeks after having a baby. However, how soon you can start having postpartum sex varies, depending on your medical history and the presence of any birthing complications.

In the four to six weeks after childbirth, women experience lochia, or healing bleeding after birth. Stephanie P. Langsam, MD, an obstetrician-gynecologist at Main Line Health, does not recommend having sex if you're still bleeding after delivery.

Having sex within the first few weeks of delivery comes with a few health risks:

• Getting an infection
• Slowing or impairing healing after birth (especially if you had vaginal stitches that could tear during sex)
• Causing increased bleeding

"If you have sex and it causes bleeding, then you should discuss this with your doctor," says Dr. Langsam.

How soon after delivery can I get pregnant?

According to Dr. Langsam, women can get pregnant before their period returns after childbirth, so it's important to use contraception when having postpartum sex if you aren’t ready to get pregnant again.

Some women choose to go on birth control immediately after giving birth. Others may choose to hold off as their bodies heal during those first six weeks.

Will postpartum sex feel physically different?

Many women find that it takes some time for sex to feel normal again after having a baby due to all the physical changes their body went through during pregnancy and delivery.

Pregnancy and childbirth can also impact sex drive, says Dr. Langsam, pointing to the many changes that come with childbirth, including physical, hormonal and emotional. Other postpartum challenges that can affect desire to have sex include:

• Breastfeeding
• Soreness
• Fatigue
• Hormone fluctuations
• Sleep deprivation

A big challenge of postpartum sex is dryness. The need for lubrication is normal, especially with breastfeeding women. Sometimes your doctor will even prescribe vaginal estrogen to help with the dryness. If you feel that lubricants are not enough and intercourse is painful, talk to your doctor.

Eventually, sex should start to feel normal again. "With time, and as you adjust to your new life as a mom, your sex drive should return to normal," Dr. Langsam says. If it doesn't, talk to your doctor.

Will postpartum sex feel emotionally different?

Chimere G. Holmes, LPC, a psychotherapist with Main Line Health's Women's Emotional Wellness Center, says many women feel intimidated and nervous about having sex soon after having a baby.

"Not everyone feels ready to resume the same level of intimacy following childbirth. What use to be the norm, can now look and feel radically different between couples," Holmes says.

Childbirth comes in all shapes and forms, and recovery from childbirth looks different from person to person. Trust your body and be gentle with yourself. Take it slow as you get re-acclimated to sexual intimacy after birth.

As you recover from childbirth, prioritize self-care:

• Hydrate
• Nourish your body with healthy food
• Get active
• Revisit hobbies/activities that use to invigorate you and lift your spirits
• Try guided meditation
• Speak to a mental health counselor
• Join a women’s new mom’s group for social support

Also get connected with your support system. Together, all of these things can help you feel empowered and comfortable in your new role as a parent.

For those who have a partner, Holmes recommends having open, honest conversations about how you're feeling. These conversations can increase emotional intimacy and connection.

"This new norm can be an invaluable opportunity for reconnection, and intentional conversations. Getting to know your partner in their new role and exploring feelings and needs can ignite a new romantic appreciation and ultimately bring couples closer,” says Holmes.

"I often recommend my postpartum patients and the couples I counsel to invest in specific resources such as: ‘What About Us?: A New Parents Guide to Safeguarding Your Over-Anxious, Over-Extended, Sleep-Deprived Relationship’ by Karn Kleinman as well as the BestSelf Intimacy Deck — a fun deck of cards that produce deeper conversations and intimacy."

Finding intimacy in alternative ways

Having postpartum sex isn't the only way to foster intimacy in a relationship, and as your body heals, Holmes recommends looking to alternative forms of intimacy and connection.

Intellectual intimacy can be nourished by talking deeply and openly about meaningful and emotional topics such as politics, literature or history. There’s also spiritual intimacy, which can be explored through faith, religion and shared values.

By doing activities you and your partner enjoy, you can develop experiential intimacy.

You can build physical intimacy not only through sex, but also through hugging and cuddling, "These activities release oxytocin, a natural, feel-good hormone," added Holmes.

Intellectual intimacy can be nourished by talking deeply and openly about meaningful and emotional topics such as politics, literature or history. There's also spiritual intimacy, which can be explored through faith, religion and shared values.

By doing activities you and your partner enjoy navigating together, you can develop experiential intimacy. "Try to carve out intentional time to do something relevant for you both — if you can find mutual interests that you both can look forward to, that will also strengthen the bond,” Holmes says.

Eventually, the time for sex will come and it will feel right. "It's all about a couple's readiness and being able to take the next step together in a respectful, loving way that is mutually beneficial," says Holmes.

Remember: Take baby steps and look to alternative forms of intimacy if you need more time before immediately trying to have sex after giving birth.

Next steps:

Meet Chimere G. Holmes, LPC
Meet Stephanie P. Langsam, MD
Learn about Obstetrics/Gynecology at Main Line Health
Learn more about Women's Emotional Wellness Center