Sex after childbirth and contraception

After giving birth, sex is probably not at the top of your to-do list. Between maternity pads, sleepless nights, and a changing body, it’s completely normal for intimacy to take a back seat for a while. Still, at some point, many couples start wondering: When can we have sex again? And: What about contraception? This article helps you make informed and safe choices.

What’s normal?

Every birth — and every body — heals at its own pace. Some people feel ready for sex again after six weeks, while for others it takes months. Everything is fine as long as both of you feel comfortable.

Here’s what you should know:

• Wait to have sex as long as you’re still bleeding.
  The blood comes from the wound where the placenta was attached to the uterus. As long as there is bleeding, there’s a risk of infection after intercourse.
• Allow any scar tissue to heal properly.
  The skin around a scar can feel tight or firm. Wait until you’re truly aroused, and use lubricant to reduce discomfort. Over time, the tissue will become softer and more flexible.
  This also applies after a cesarean section: wait until the incision is no longer painful, usually between 6 and 12 weeks. Take your time, experiment with different positions, and rediscover what feels good together.
• Lubricant is your friend
  Many couples find sex after childbirth a bit tense. Talk openly about what you need and what feels good. Because of tension or hormonal changes (especially while breastfeeding), it may take longer for natural lubrication to occur. Take your time, and consider using lubricant to make it more comfortable.
• Don’t forget contraception
  It’s wise to use contraception from the moment you start having sex again if you don’t want to get pregnant. Giving birth or breastfeeding does not protect against pregnancy — you can become pregnant even before your first period returns!

Contraception: sooner than you think

A common myth is that you can’t get pregnant until your first period after giving birth. But your first ovulation happens before your first period. So yes — you can get pregnant before menstruation starts again. That’s why it’s important to use contraception as soon as you resume sexual activity, unless you want to conceive again right away.

What are your options?

There are many contraceptive methods. What suits you best depends on factors such as:

• Whether you want (more) children in the future
• Whether you are breastfeeding
• Your previous experience with contraception
• What your health insurance covers

A few commonly used options include:

• Condoms
• The contraceptive pill (some types are suitable while breastfeeding)
• The IUD (hormonal or copper coil)
• The contraceptive injection
• Diaphragm
• Sterilization

During your postnatal check-up, we’ll take time to discuss this topic in detail and help you find what works best for you. 
Want to read more? Visit the www.acog.org postpartum birth control.