How soon can I have sex after giving birth?

>> Thursday, January 6, 2011

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Dear KnowYourV,  

"I know the standard rules for returning to vaginal intercourse after vaginal birth, but what is the real 411? How soon can we have sex or how long should we wait, really?" 

Well, Janet, so many women want to know the "real" answer to this question because the standard rules always seem so vague. What's really frustrating is grandma & auntie say one thing, I say another & the nurse says something else when you are discharged from the hospital. The truth is that no one can tell you when it is going to be alright, because it is different with each baby.

The basic post-partum rule, whether someone has had a c-section or vaginal birth, is that all women are given the standard “pelvic rest”, meaning nothing vaginally for at least 2 weeks. This means do not: use tampons, have vaginal intercourse, douche, or take tub baths (as fluid may get into the vagina). Bleeding after birth can be heavy for about 2 weeks (and sometimes last up to 4 weeks) and the uterus takes about 4-6 wks to go back to pre-pregnancy size. It can take up to 2 weeks for the cervix to close again. If the cervix is open, it's easy to get an infection after delivery. Of course, this is usually not a problem as most women aren't concerned about jumping right back into sex. In fact, the opposite is true, and I've had some patients who have been so afraid that they waited 3-4 months afterwards.

I think what most of you really want to know is, when is it really ok, and when is it better to wait.
Honestly, if you have an uncomplicated vaginal birth or c-section, with no tears or episiotomies, then 2 weeks is the minimum time to allow your body to heal. As for bathing and tampons, those are usually OK to use after about 4-5 days.

We never recommend douching, as it is known to cause infections and create more harm than good. However, using the WaterWorks feminine cleansing system, as we've mentioned before, is considered safe, and it can be used to cleanse the vagina around four weeks after delivery. It is nothing like douching in that it uses only plain tap water and a medical grade stainless steel nozzle, with no harmful chemicals. It also uses a gentle downward sprinkling action to rinse the vagina, instead of a forceful outward blast like traditional douches which can force infection upward into the vagina.

The other very important thing to keep in mind is that, if you did have an episiotomy or vaginal tear, it is best to wait at least 4-6 weeks to allow maximum healing of the tissues. When you do have sex for the first time after delivery, be sure to use lots of lubrication. It may feel tender where you tore, but that is normal. It is best to continue as much as you can tolerate, because the more it is stretched, the more elasticity that will return.

Just remember, everybody is different, and every delivery is different. So if this is not your first child don't expect the after-effects to be the same as the last one. Also, trust yourself and your own intuition. If you feel something might be wrong, make an appointment with your doctor, sooner than your post-partum visit.
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