So, you’ve recently given birth – congratulations! Are you ready to rekindle that spark that 9+ months ago resulted in your new baby (or babies).  You may be wondering what forms of contraception to use in this post-baby world of yours? Did you know that the latest recommendation is to wait 18 – 24 months before getting pregnant again? This time allows your body and hormones time to recover and balance out.  Did you know that waiting also reduces the risk of premature birth?

When can we start having sex again after baby?

First, it’s important that you get the medical “all clear” to have sex again. Whether you had a surgical or vaginal birth, your body needs time to heal.

  • It can take 3 or more weeks for your post-birth bleeding (lochia) to cease
  • Your uterus needs time to shrink back to its pre-birth size and for the blood vessels where your baby’s placenta was attached to scab over
  • any stitches in your perineum or caesarean staples/stitches need to heal and all sutures should be dissolved or been removed

Your body needs to heal internally before having oral and penetrative sex to avoid infection.

Will Sex Be Painful after birth?

Sex may be uncomfortable or painful your first couple of times.  Remember, if you are breastfeeding you may have a low libido and extra vaginal dryness due to hormonal changes. Take it slow and use a natural, chemical–free lubricant. If using condoms, avoid oil based lubricants like coconut oil because they can weaken the condom causing it to be less effective. Stick to water-based lubes.

If you continue to have discomfort or pain during sex months after giving birth, consider contacting your healthcare provider. They can examine you to make sure that your perineum has healed properly after a tear or episiotomy or confirm that you do not have pelvic organ prolapse of the uterus, bladder or rectum. You may also consider seeing a Physiotherapist that specializes in pelvic floor therapy. A pelvic floor physiotherapist would thoroughly assess for scar tissue, pelvic organ prolapse, diastasis recti, muscle tension, weakness and more. They would then work with you to create a postpartum recovery plan. Typically your healing requires more than just doing Kegels!

It is possible to become pregnant as early as 3 weeks postpartum. The type of contraception you use should be considered carefully.

Hormonal Contraception

It is not unusual for us to hear from our clients that at their 6 week post-birth appointment with their OB/GYN or family doctor that they have received a prescription for the pill, “mini”-pill or injection, or that it has been recommended to them to use a progesterone-releasing IUD to prevent pregnancy. This is fine, except caution should be used if you are breastfeeding! 

T​he hormones in these contraceptive methods may actually lower milk supply for some women! Your OB/GYN may not be aware of this as breastfeeding is not within their specialty. ​

Hormonal contraceptives are not recommended for breastfeeding persons before 6 weeks postpartum. Baby’s liver may be too immature at this point to process the contraceptive medications.

​Nonhormonal methods such as barrier methods (such as condoms, sponge, cervical cap, etc.) or the copper intrauterine device (IUD) are better choices to use while breastfeeding. If you are not breastfeeding you have all the choices you had pre-pregnancy at your disposal. 

Is breastfeeding a type of birth control?

Breastfeeding can be 98% effective in avoiding pregnancy.  This is called the Lactational Amenorrhoea Method (LAM). It is important to know that LAM is only effective for the first 6 months before baby has started solid foods and only if you are exclusively breastfeeding on demand – never missing a feed or giving a bottle. If you miss a feed, give a bottle, give a pacifier or start scheduling baby’s feeds, then this form of birth control loses its effectiveness in the same way as missing an oral contraceptive pill.  You could ovulate and not know it (as most women do not get their periods while breastfeeding and ovulation occurs two weeks before your first period).  More information on breastfeeding as birth control: https://kellymom.com/ages/older-infant/fertility/

Natural Family Planning Methods (Fertility Awareness)

If you are breastfeeding exclusively on demand, fertility awareness methods like the calendar rhythm method can be challenging because you are unlikely to start your period before 6 months postpartum. You cannot rely on a regular cycle to track. However, together with breastfeeding (LAM), tracking cervical mucus and position, as well as basal body temperature, other natural family planning methods can be highly effective when followed correctly. We highly recommend that you work with your healthcare provider to help you learn to track your fertility. Fertility Apps are still very new and their accuracy has yet to be determined. Whether you are feeding from your body or bottle feeding it is important to be aware that all Natural Family Planning Methods have a higher chance of unplanned pregnancy than other contraceptive methods.

Sterilization

Tubal ligation “getting your tubes tied” for women/persons with a uterus and vasectomy “getting snipped” for men/persons with a penis are surgical procedures that are suppose to eliminate any chance of getting pregnant again (95-99% effective). If you and your partner know you are done having children and don’t want to worry about contraception this may be the option for you. There are risks to each procedure but your health care provider can help you understand the risks and the benefits of each. 

Postpartum Romance

Once you’ve healed from birth, chosen your lube, researched and picked your contraceptive method, you can shift the focus to romance again. 

Romance can sometimes be the most challenging part about sex after baby!

While your partner may be rearing to go, you can’t remember the last time you showered, slept for more than a 2 or 3 hour stretch, or changed out of your pajamas. If you are breastfeeding, it may be difficult to psychologically switch from “baby on boob” mode to “partner on boob” mode – food boobs to sex boobs. It is also quite possible that you are dealing with new post-baby body image issues. Explain to your partner that they may need to court you with flowers, home-cooked meals (or favourite take-out), mood lighting, etc.

Sex after baby tip #1:
Give yourself time to fall in love with your postpartum body!

Sex after baby tip # 2:
Buy new lingerie that fits your new postpartum body and helps you feel more comfortable (and sexy) in your new skin!

Sex after baby tip #3:
Communicate with your partner. You call the shots, the tempo, the speed – you are in the drivers seat. And if you have to stop, that’s ok!

The most important thing for couples to know is that this rekindling will take time, patience and some planning. You now have a newborn demanding most of your time, attention and nurturing.  Be sure to have extra love, grace, patience and understanding for each other – this goes a long way, and will return to you tenfold in the bedroom!


Sarah Baker is a the co-owner of Lifetime of Love Doula Services. She has been supporting families for almost a decade as a birth doula, postpartum & infant care doula and childbirth educator.  She is mom to three boys, twins and a singleton.

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