You've given birth to your beautiful newborn and now you're trying to navigate a new schedule with big demands while trying to recover. Sex is probably the last thing on your mind for those first few weeks. Eventually, you or your partner will want to test the waters. Your doctor or midwife should have sent you home with an estimated timeline and guidelines to follow to increase your rate of recovery and decrease your risk of infection or injury. Each mother's body will heal differently, depending on how the birth went, hormone levels and previous births as well as her health before and during pregnancy. Once you're ready to dive under the sheets again, be prepared to have it feel different at first. Bottom line: it shouldn't hurt, and if it does, you can do something about it.
Keep those legs crossed until the time is right. Approximately 45 percent of women report pain with sex after birth. Most doctors will recommend waiting four to six weeks before attempting to have intercourse. Some couples wait three to six months before they're ready. The reasoning behind this is due to a few things:
- Wait until the bleeding stops. This postpartum bleeding is called lochia. It's the result of the uterus breaking down and shedding the lining that once held your baby. It occurs while the body develops a big scab over the location where the placenta was attached, and then sheds that once the underlying tissue is healed. Once the bright red bleeding stops, the healing has reached a good point where most "open" areas are now concealed and protected with new tissue. If you attempt to have sex or insert anything, including tampons, before this all heals up, you can easily contract an infection.
- Rebuild your strength. Not so much talking about endurance, because let's be real — sex marathons are going to have to wait. The strength you need to focus on is the pelvic floor and vaginal tissue. "After childbirth, many women are left with tears (lacerations) in the pelvic floor and or inside the vagina," writes Marianne Ryan in her recently published book Body Bod. "These areas often require stitches and form into scars as they heal." Try perineal massages or a trigger point massage with your finger or S-shaped wand found here. Click here to discover how to strengthen your lady parts during and after pregnancy.
- Respect the pain. If you do try having sex and it's painful, listen to that pain and stop. Postpartum pain with sex is common, but it's temporary. "Pain is a clear indicator that she needs to communicate with her partner she is not ready for that particular activity," says Nicole Prause, sexual psychophysiologist, PhD. "If she tries to push past pain and continues to experience pain, she may develop a rational fear of even trying that activity in the future or develop a sexual dysfunction."
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When you're ready to go for it, here's what you can expect: Once you're physically healed, cleared by the doc, more rested, feeling good about yourself and wanting to be intimate with your partner, go for it. You'll need a few things to help you out and you'll need to be aware of some red flags.
- Lubrication. Even though you're not pregnant anymore, hormones still rule your postpartum life. They can dry you up, making a painful friction out of sex. Get a gentle, scent-free lube for sensitive skin to start. Try Astro Glide or Just Like Me.
- 24/7 dryness. Vaginal dryness can be pretty uncomfortable, especially if you are nursing. OB-GYN Alyssa Dweck, MD, recommends a hormone-free vaginal moisturizer like Replens for three to five days.
- New positions. The favorite positions you had before baby may not be the best for you right now. "I suggest a woman tell her partner that sex is now a grand experiment," says Prause, "where she may try a position and suddenly find a new pain point, or not like feeling her partner's hand on her belly now ... try activities, allow them to fail, and redirect without getting upset."
- Scar tissue. If you've tried the S-wand and the self massages, you can also use your partner as a form of physical therapy. Having intercourse can actually help ease the rigid scar tissue in the vaginal lining. Check with your medical provider before going this route. Otherwise, your OB-GYN may provide you with estrogen cream or an injection at the site of the worst pain to break up the scar tissue.
- General discomfort. "In general, after a vaginal delivery, one would expect pain in the perineal area that improves daily and is easily managed with ibuprofen, Tylenol or at times a narcotic," says Dweck. "Incisional pain from a C-section is more notable and may require narcotics for a week or two depending on pain threshold." Worsening pain or pain not relieved by medication is cause for concern.
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Sex drive, body image and other factors. After you've had a baby, you might not feel great about your body. It will take time to get it back to a place that makes you feel sexy. "Libido is complicated in women and being newly postpartum is surely factor which can diminish sex drive," Dweck says.
Instead of trying to press the issue or avoid it, communicate it. "Couples are establishing a new normal," Prause, sexual psychophysiologist, says. "Generally, a partner also may be very conflicted, worried about hurting the woman as well as satisfying their sexual desires. 'No' is important, but so is 'yes' in trying to discover what the new normal is."