Every woman bleeds after giving birth. It’s the body’s way of getting rid of mucous, blood, and uterine tissue and recovering from the trauma. Usually it lasts for 4-6 weeks after delivery. For the first few days postpartum, you will experience a heavy flow with bright red blood and blood clots.
After that, lochia flow slows and should become lighter with blood that is pinkish-brown. Until lochia has stopped, your cervix has not closed yet. It’s also a sign that your uterus has not completely healed. This makes you more vulnerable to vaginal and uterine infections.
Sometimes bleeding stops for a few days and then resumes. This is a normal part of the healing process, but it does mean that you still need more time to get back to your normal self.
Doctors advise waiting until lochia has completely stopped before resuming penetrative sex. Most practitioners agree that oral sex after birth and masturbation are completely fine after only a few days of childbirth. When it comes to the intercourse, the best idea is to wait until your six-week postpartum visit, where your doctor will check that you’re on the way to recovery and give you the green light if you are.
Postpartum sex is tricky. There are a lot of factors to consider including physical recovery from childbirth, your emotional state, your sex drive, breast tenderness or soreness, pain, or simply feeling “different” down there. Intercourse after C-section comes with its own challenges, and you may find that it’s taking longer than you expected to feel ready again. There are many postpartum problems that can affect your ability or desire to have sex, and that’s okay.
Maintain open and honest communication with your partner, and let them know how you’re feeling before you start having sex again. If you aren’t ready, you won’t be able to relax during intercourse. You may clamp up, which can lead to injury and bleeding.
Even if you do feel ready and bleeding has stopped early on, jumping back into things too soon — like having sex 3 weeks after giving birth with stitches, for example — would probably be a bad idea. Give your body the time it needs to recover; don’t rush into penetrative sex too soon. Instead, focus on “outercourse” and explore other ways to be intimate with your partner.
Let’s say everything is in place: you feel ready, your partner is ready, your body has healed, and the desire is there. You may still bleed after your first few times having postpartum sex. A little bleeding and discomfort is totally normal. It means that there may be scar tissue in or around the vagina that will soften over time. But it might be a good idea to take things slow at the beginning. The uterus is yet another potential source of bleeding from postpartum sex. Orgasm causes the uterus to contract, which may trigger bleeding if it is not fully healed.
Don’t panic if you see blood after postpartum intercourse. The bleeding will most likely stop shortly after. If the bleeding is heavy or if it has not stopped after a day or two, call your doctor.
Lack of lubrication is a very common postpartum problem. Before and during pregnancy, you may not have experienced this issue at all because your body naturally produced all the lubrication you needed. Now, vaginal dryness may be cramping your style in the bedroom more than you realize.
Vaginal dryness is especially common in women who are breastfeeding because their estrogen levels are lower than usual. Estrogen plays a major role in vaginal lubrication, and so nursing women may need some extra help in that department.
Water-based lubricant can save you from a lot of unnecessary discomfort during postpartum sex. Don’t be afraid to use it liberally, it’s there to ensure that things go smoothly!
If you have stitches from tearing, an episiotomy, or from a C-section, you may be more likely to bleed after your first few times having postpartum sex.
Episiotomy stitches start dissolving after 10-14 days. In most cases, they are healed by the one month mark, but it’s best to consult your doctor before you start having sex again.
Your body has been through so much, you don’t want to delay the healing process any longer. These tips can help you recover as quickly as possible so that you can resume normal (sexual) activity ASAP!
- Don’t wipe! Whatever you do, keep that toilet paper far away from your vagina, perineum, and anus for a good week or two after giving birth. Get yourself a squirt bottle and fill it with room temperature water. Use it to clean after urinating. For a more thorough cleaning after a bowel movement, hop in the shower for a quick (and gentle!) wash.
- Aloe vera and witch hazel are your best friends. Get yourself a package of hemorrhoid pads infused with aloe vera and witch hazel. Place them between yourself and your sanitary pad for instant relief.
- Take a stool softener. The first stool after childbirth may feel uncomfortable. You want the process to be as easy and painless as possible, so talk to your doctor about taking a stool softener and keeping a special diet to prevent constipation and straining in that delicate area.
- Get plenty of iron. Iron helps you to replenish your blood count, which is vital when bleeding for an extended period of time. Eat plenty of iron-rich foods such as dark leafy green vegetables, legumes, and meats.
- Soak in a bathtub. Soak in a lukewarm sitz bath a few times a day for the first week or two after giving birth. The water eases discomfort in that area, but it also keeps it clean so there’s less risk of infection.
A little pain is normal the first few times having postpartum sex. Luckily, there are ways to get around that so you can focus on the excitement of being back together with your partner. These tips will help to keep you comfortable as you resume sexual activity postpartum.
- Follow your doctor’s advice. Sure, there will always be that friend who says 'We just couldn’t wait! Two-week postpartum sex was incredible!' Well, you can be a lot smarter than that. It isn’t worth risking injury or infection. If your doctor says to wait for six weeks, wait for six weeks!
- Get some lube. The importance of vaginal lubrication during sex after childbirth cannot be stressed enough. Water-based lubrication is your best friend when getting back in the sack.
- Take it slow. Things that you may have enjoyed prebirth may no longer do it for you — in fact, they may be downright painful. It may take some time to relearn your body, and even more time for your partner to do so. If something hurts, experiment with different positions to avoid hitting tender spots. Certainly don’t rush penetration, and don’t go at it too roughly at the beginning.
- Be an open book. It’s important for your partner to know exactly what's going on in that head of yours. Whether you’re feeling self conscious, physically uncomfortable, or quite aroused — it’s vital that your partner understand what’s going on.
- Make sure you’re aroused before penetration. Certain hormones are released to trigger lubrication and relaxation of the vaginal muscles. This can make things a lot easier when you decide you’re ready for penetrative sex.
- Wear a bra. Breastfeeding moms may find their breasts are tender and leaky, especially during sex when the same hormones are released as the ones during letdown. Wearing a supportive bra during sex can really help with these issues.
- Do kegel exercises. Kegel exercises are designed to strengthen pelvic floor muscles so that you gain control back over your bladder and anal sphincter. They also help to tighten up vaginal muscles, which can be very helpful in the bedroom.
- Don’t hesitate to say no. You can stop at any point along the way if you’re uncomfortable. Just keep an open line of communication with your partner and let them know if you’re not feeling it, guilt-free. And remember, turning down intercourse does not have to mean turning down all sexual activity.
Keep in mind that there is no ‘normal’ when it comes to pregnancy and childbirth. Each and every delivery is uniquely different, and so are the healing processes that follow.
While you and your partner may be eager to resume intercourse after giving birth, it’s more important to listen closely to your body and to your doctor. If sex still hurts after a year, your doctor may refer you to a specialist.
Don’t panic if you do see blood after having postpartum sex. A little bleeding is normal, but definitely consult your doctor if it is heavy or if it continues for more than one or two days. And remember: even if you get off to a rocky start, things will get better with time. Cut yourself some slack. You did just make a person, after all.
Reviewed by Tahir Mahmood, Chair of the EBCOG Standards of Care and Position statements group.