Sex after pregnancy: Let your body set the pace

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

After the baby is born, how soon can I have sex?

Whether you give birth vaginally or by C-section, your body will need time to heal. Many doctors recommend waiting six weeks before resuming intercourse. This allows time for the cervix to close, postpartum bleeding to stop, and any tears or repaired lacerations to heal.

But the other important timeline is your own. Some women feel ready to resume sex within a few weeks of giving birth. Others need more time. Factors such as fatigue, postpartum blues and changes in body image may take a toll on your sex drive.

Will it hurt?

Your vagina may be dry and tender, especially if you're breast-feeding. To ease any discomfort, 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. Tell your partner what feels good — and what doesn't.

If sex continues to be painful, consult your doctor. A low-dose estrogen cream applied to the vagina often helps. Rarely, complications of healing may require additional treatment.

Will it feel different?

After several vaginal deliveries, decreased muscle tone in the vagina may reduce pleasurable friction during sex — which can influence arousal. To tone your pelvic floor muscles, remember to do your Kegel exercises. Simply tighten your pelvic muscles as if you're stopping your stream of urine. Try it for five seconds at a time, four or five times in a row. Repeat throughout the day.

What about birth control?

Unless you're hoping to become pregnant right away, sex after pregnancy requires a reliable method of birth control — even if you're breast-feeding. Barrier methods such as condoms and spermicides can be useful. If you prefer hormonal birth control, it's important to select a method that doesn't interfere with breast-feeding. Your postpartum checkup is a great time to ask your doctor about the options.

What if I'm too tired to have sex?

Caring for a newborn can be exhausting. If you're too tired to have sex at bedtime, say so. But that doesn't mean your sex life is over. You may prefer making love early in the morning or during your baby's nap. Feed your baby first to extend the time you and your partner have together.

What if I'm not interested in sex?

That's OK. There's more to a sexual relationship than intercourse — 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 throughout the day or occasional soaks in the tub. Look for other ways to express affection.

If communicating with your partner doesn't help, be alert for signs and symptoms of postpartum depression. If your mood is consistently low, you find little joy in life or you have trouble summoning the energy to start a new day, contact your doctor promptly.

What can I do to boost my sex drive?

Go easy on yourself. Set reasonable expectations as you adjust to parenthood. Appreciate the changes in your body. Eat healthy foods, and drink plenty of fluids. Exercise regularly. Rest as much as you can. Spend some time alone. Taking good care of yourself can go a long way toward keeping passion alive.

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