Sex Postpartum: What to Expect Revisiting Intimacy After Baby

After giving birth, your body, lifestyle, and emotions undergo significant changes. From hormonal fluctuations to sleep deprivation, the postpartum period brings various physical and mental shifts. Having sex for the first time, for example, can bring unexpected feelings, physically and mentally. Therefore, knowing what to expect and preparing for this moment can help ease some anxieties. Here’s what you can expect and some tips for a more comfortable experience.

How Soon Can I Have Sex After Giving Birth?

There’s no set timeline for when a woman should start having sex after childbirth. According to the American Pregnancy Association, experts recommend waiting four to six weeks before resuming sexual activity. This is to ensure your body has had time to heal and recover, especially since you’ll still be bleeding, and your risk of hemorrhage or uterine infection is high during the first two weeks postpartum.

The same rules apply to those who have a c-section, too. OBGYN and sexual health expert Dr. Sadaf Lodhi explains, “Although a C-section doesn’t involve the vagina directly, it’s still possible to experience vaginal discomfort due to hormonal changes and the physical recovery process after childbirth. Hormonal shifts, like decreased estrogen levels, can lead to vaginal dryness and pain, regardless of whether you have had a C-section or not.”

Waiting until your postpartum appointment (approximately six weeks) to get the green light from your healthcare provider may be the safest option. This checkup ensures your body is healing properly and that you’re physically ready to resume sexual activity. However, if you’ve had an episiotomy or vaginal tears, you may need additional time for the stitches to heal.

Will It Hurt?

It’s natural to wonder if sex will hurt after giving birth. Pregnancy, labor, and delivery stretch the pelvic floor muscles, which support vital organs such as the small intestine, uterus, bladder, and rectum. The stretching, combined with any trauma to the pelvic area, can affect how sex feels. Many women experience discomfort during sex postpartum, but there are ways to alleviate this.

Kegel exercises are known to strengthen the pelvic floor muscles, promote healing, and increase blood flow, which can reduce discomfort. And good news is, you can start doing kegels right away, as long as they don’t cause you any pain. Pain can also come from those who have developed scar tissue from vaginal tears or c-section incisions, so take things slow and make sure you feel comfortable.

Vaginal dryness is extremely common after giving birth, especially for breastfeeding mothers. Lactating causes estrogen and progesterone levels to decrease, which can lead to less lubrication. This is just temporary, though. Lodhi explains, “Vaginal dryness often improves after breastfeeding or lactation ends. During lactation, estrogen levels drop, which can cause dryness, but as hormone levels return to normal, so does vaginal moisture.” If you do feel some pain due to dryness, using a water-based lubricant can help make sex more comfortable.

If you notice you’re still having persistent pain after six weeks, it could indicate something more than normal postpartum recovery, like pelvic floor issues, infections, or nerve damage. “I always encourage my patients to listen to their bodies—if something feels off, it’s worth getting checked,” Lodhi says.

Do I Need to Use Birth Control?

Whether or not you need birth control postpartum can depend on factors like breastfeeding, future family plans, and birth control preferences.

Lactational amenorrhea (also known as the breastfeeding birth control method) occurs after giving birth, typically for the first six months, until your body begins ovulating again. Studies have claimed this method to be as effective as hormonal birth control. However, it’s not foolproof. Ovulation can resume earlier than expected, even for those breastfeeding. Therefore, it’s essential to have a backup plan.

If you’re not breastfeeding, ovulation can occur just weeks after childbirth. Therefore, it’s a good idea to consider other forms of birth control. Condoms and spermicides can be used immediately after birth, while other methods, such as cervical caps and diaphragms, are recommended to wait until six weeks after giving birth. Hormonal contraceptives, such as progesterone-only pills, can be taken immediately postpartum.

For breastfeeding women, combined hormonal birth control methods, like pills, should be delayed until four to six weeks after delivery due to the risk of developing deep vein thrombosis (DVT).

Here are all of the birth control options to choose from after pregnancy and when it’s safe to start taking them:

• Condoms, Spermicide, IUD: Immediately after birth
• Cervical Cap, Diaphragm, Sponge: Six weeks after birth
• Combined Hormone Pills, Ring, Patch: Breastfeeding: Four to six weeks after birth/Not Breastfeeding: Three weeks after birth
• Progesterone-Only Pills, Injection: Immediately after giving birth
• Tubal ligation: Within 24 hours after giving birth

Dr. Lodhi recommends “using progestin-only birth control (the mini-pill, IUD, or injection) while breastfeeding, as it’s considered safe and won’t affect milk supply.” She continues, “Combined hormonal methods (those with estrogen) can reduce milk production, so I prefer to avoid them in the early months.” To be safe, it’s best to consult with your doctor to discuss the best option for you and your baby.

Physical and Hormonal Changes After Birth

Postpartum changes are not just physical but hormonal and emotional as well. HUM’s two-step Womb Service supplement is OBGYN-formulated with 23 nutrients to help take you from the pre- to post-pregnancy stages. It’s important to continue taking prenatal vitamins for at least three months after giving birth to give your body time to readjust after giving birth. After delivery, you may experience some of these common symptoms:

Physical Symptoms:

• Vaginal discharge and bleeding (lochia)
• Vaginal dryness, especially for breastfeeding moms
• Vaginal tears or soreness from an episiotomy
• Breast soreness or engorgement
• Back pain

Hormonal/Emotional Symptoms:

• Low libido due to hormonal shifts
• Increased stress hormones (cortisol)
• Decreased dopamine production, leading to lower sexual desire
• Sleep deprivation, which can make intimacy feel like a low-priority

Additionally, mood fluctuations are common, but overwhelming feelings of sadness, detachment, and anxiety may be signs of postpartum depression. If you find yourself feeling overwhelmed or have troubling thoughts, reaching out to your healthcare provider for support is crucial.

How to Make Postpartum Sex More Comfortable

Getting back into the groove of intimacy can take time. Here are some tips to help make sex more comfortable after childbirth:

1. Take Pain Relievers: Over-the-counter medications like acetaminophen and ibuprofen can help ease any discomfort before sex.
2. Use Lubricant: Vaginal dryness is common postpartum, so using a water-based lubricant can help with the dryness, relieving or minimizing any pain, and it won’t cause an imbalance in your pH levels. (Here are the best types of lubricants to try.) Lodhi says estrogen cream can also help with lubrication. Taking things slow with extra foreplay can be the key to helping natural lubrication occur, resulting in a more comfortable experience.
3. Explore Alternative Options: If vaginal penetration is too painful, consider other forms of intimacy like oral sex, manual stimulation, or extended foreplay.
4. Focus on Non-Sexual Self-Care: After having a baby, the lack of sleep, unbalanced hormones, and the overall experience of having just given birth don’t typically leave you feeling confident and in the mood for intimacy. Try pampering yourself by taking a warm bath with some candles, having a glass of wine, or getting a massage to help rejuvenate your confidence. 
5. Experiment with Positions: Try new positions that might reduce pressure on your pelvic area and make sex more enjoyable. Lodhi recommends trying side-lying or spooning positions as it can reduce pressure on the abdomen and pelvic floor. She also suggests “trying woman-on-top, as it allows you to control depth and speed, making things more comfortable for you.”
6. Time It Right: If you find yourself exhausted at the end of the day, the last thing you want to do is have sex. Instead, find a time of day when you have the most energy and plan sex around then.
7. Communicate with Your Partner: Having sex isn’t just about being physical. Being open and communicative with your partner is vital to rebuilding intimacy postpartum. If you’re still feeling soreness in some areas or are feeling self-conscious about your body post-baby, let your partner know. The connection of communication can help your sex life (and overall relationship) in the long run.

Your first time having sex postpartum will almost always feel different than before, and that’s completely normal. Your body has undergone significant changes, and giving yourself grace as you navigate this new phase is essential. Healing takes time, and with open communication, patience, and the right tools (like kegel exercises and lubricant), you and your partner can rekindle intimacy and approach postpartum sex in a way that feels comfortable and fulfilling for everyone.