Sex after pregnancy might be the last thing on your mind. Understand what to expect and how to renew intimacy with your partner.

By Mayo Clinic Staff

Sex after pregnancy happens. Honestly. First, however, vaginal soreness and sheer exhaustion are likely to take a toll. Whether you're in the mood or sexual intimacy is the last thing on your mind, here's what you need to know about sex after pregnancy.

Whether you give birth vaginally or by C-section, your body will need time to heal. Consider waiting to have sex until your health care provider gives you the green light — often four to six weeks after childbirth. This allows time for the cervix to close, postpartum bleeding to stop, and any tears or repaired lacerations to heal.

The other important timeline is your own. Some women feel ready to resume sex within a few weeks of giving birth, while others need a few months — or even longer. Factors such as fatigue, stress and fear of pain all can take a toll on your sex drive.

Hormonal changes might leave your vagina dry and tender, especially if you're breast-feeding. You might experience some pain during sex if you're healing from an episiotomy or perineal tears, especially extensive tears.

To help ease any discomfort during sex, take it slow. Start with cuddling, kissing or massage. Gradually build the intensity of stimulation. If vaginal dryness is a problem, use a lubricating cream or gel. Try different positions to take pressure off any sore areas and control penetration. You might also discuss alternatives to vaginal intercourse, such as oral or manual stimulation, until healing is complete. Tell your partner what feels good — and what doesn't.

You might also take pain-relieving steps beforehand, such as emptying your bladder, taking a warm bath or taking an over-the-counter pain reliever. If you experience burning afterward, apply ice wrapped in a small towel to the area.

It's also important to focus on the moment. Keep your mind on yourself and your partner — not the diapers, laundry and other household chores.

If sex continues to be painful, consult your health care provider about possible treatment options.

After childbirth, decreased muscle tone in the vagina might reduce pleasurable friction during sex — which can influence arousal. This is usually temporary.

To tone your pelvic floor muscles, try Kegel exercises. Simply tighten your pelvic muscles as if you're stopping your stream of urine. Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions. Once you've got the hang of it, do at least three sets of about 10 Kegel exercises a day.

Sex after pregnancy requires a reliable method of birth control — even if you're breast-feeding.  To reduce the risk of pregnancy complications and other health problems, limited research suggests waiting at least 18 to 24 months before attempting your next pregnancy.

Your health care provider will recommend thinking about your desire to have more children and pregnancy spacing before you deliver your baby. Your options immediately after delivery include progestin-only contraceptives, such as the contraceptive injection Depo-Provera or the minipill.

You might also consider a longer lasting contraceptive, such as the copper or hormonal intrauterine device (IUD). Your health care provider can help you choose the right time for placement.

Birth control methods that contain both estrogen and progestin — such as combined birth control pills — pose an increased risk of blood clots shortly after delivery. For otherwise healthy women, it's OK to begin using combined birth control pills and other types of combined hormonal birth control six weeks after childbirth. Although birth control methods that contain both estrogen and progestin have long been thought to decrease the milk supply for women who are breast-feeding, recent research suggests this is not true.

Talk to your health care provider during your postpartum visit about the different birth control options and the appropriate time to start contraception.

Caring for a newborn is exhausting. If you're too tired to have sex at bedtime, say so. This doesn't mean your sex life has to end, however. Consider making love early in the morning, while your baby naps, or while your baby spends a few hours with a trusted friend or loved one.

That's OK. There's more to an intimate relationship than sex, especially when you're adjusting to life with a new baby. If you're not feeling sexy or you're afraid sex will hurt, share your concerns with your partner.

Until you're ready to have sex, maintain intimacy in other ways. Spend time together without the baby, even if it's just a few minutes in the morning and after the baby goes to sleep at night. Share short phone calls or send text messages throughout the day. Look for other ways to express affection. Rekindle the spark that brought you together in the first place.

If communicating with your partner doesn't help, be alert for signs and symptoms of postpartum depression — such as intense irritability and anger, overwhelming fatigue, lack of joy in life, and difficulty bonding with the baby. If you think you might be experiencing postpartum depression, contact your health care provider. Prompt treatment can speed recovery.

Most sexual concerns associated with pregnancy or childbirth resolve within a year. In the meantime, concentrate on ways to promote your physical and mental health. For example:

  • Set reasonable expectations as you adjust to parenthood.
  • Eat a healthy diet, including plenty of fluids.
  • Include physical activity in your daily routine.
  • Rest as much as you can.
  • Ask your partner, loved ones and friends for help.
  • Join a support group for new moms.

Remember, taking good care of yourself can go a long way toward keeping passion alive.

July 02, 2015