Sex After Birth: When It's OK, Why It Can Hurt, and What Helps

There is no single date when sex after birth becomes OK. The NHS says there are no rules about when to start again, while US sources such as Cleveland Clinic and MedlinePlus commonly suggest waiting around six weeks. What matters most is whether the bleeding has stopped, whether stitches or a C-section wound have healed, and whether you feel ready.

How long after birth can you have sex?

The sources word this differently, so it helps to see them side by side:

• NHS: there are no rules about when to start having sex again. You will probably feel sore as well as tired, so don't rush into it.
• Cleveland Clinic: providers will likely recommend waiting two to six weeks. After a tear or heavy bruising, the advice is usually six weeks. After a tear-free vaginal birth with no complications, some providers say as soon as two weeks.
• MedlinePlus: you can start sexual activity around 6 weeks after a vaginal delivery, if the discharge (lochia) has stopped.
• RCOG, after a third- or fourth-degree tear: once your stitches have healed and bleeding has stopped, you can have sex again when it feels right for you.

The reason for waiting is healing, not a rule for its own sake. Cleveland Clinic explains that your cervix takes time to return to its pre-pregnancy state, and that bacteria can get into the uterus more easily in this time, so it advises keeping things out of the vagina for a few weeks.

After a C-section delivery

A caesarean does not mean you can skip the wait. Cleveland Clinic says your doctor will likely suggest at least six weeks after a C-section so the incision can heal, and that if you were dilated before the birth, the uterus may still be more prone to infection. MedlinePlus says sex can begin any time after 6 weeks following a C-section.

Why does sex hurt after birth?

Pain during sex after birth is common. In the MAMMI study of 832 first-time mothers in Ireland, 37.5% had pain during sex six months after the birth. The main reasons the sources give:

• Healing tissue and scars. Cleveland Clinic says scar tissue from a tear is often less stretchy than the tissue around it, and that it often softens as it heals. Stitches need time to dissolve and the tissue needs time to become strong enough.
• Vaginal dryness. The NHS says hormonal changes after birth can make your vagina feel drier than usual.
• Breastfeeding. Cleveland Clinic explains that estrogen levels drop while you breastfeed, which can make the vaginal tissue thin and dry. In the same study, 43% of women reported a lack of vaginal lubrication at six months. Cleveland Clinic says this tends to improve in the weeks after you stop breastfeeding or your periods return.

Cleveland Clinic draws a clear line: some discomfort during the first few attempts can be expected, but pain during sex is not OK. The RCOG says sex may be uncomfortable and feel different at first, but the discomfort should not persist.

What helps make sex more comfortable

• Use a lubricant. The NHS suggests a personal lubricant from a pharmacy to begin with, and MedlinePlus advises using a lubricant and practising gentle sex.
• Go slowly. The NHS suggests taking it gently, and exploring with your own fingers first to reassure yourself that it won't hurt.
• Say if it hurts. The NHS says if penetration hurts, say so, because pretending everything is fine can make sex start to feel unpleasant.
• Try what feels comfortable. Cleveland Clinic says some things will work and some won't, so talk about what is working, especially the first few times. If you are leaking milk, it suggests wearing a bra.
• Remember closeness does not have to mean penetration. The NHS says you can still give each other pleasure without it.

Does sex feel different after birth?

It can, at first. The RCOG says sex may feel different, and Cleveland Clinic says sex may not be what you remember right away, but with time and patience you will find a new normal. Pelvic floor exercises may also help: the NHS says they strengthen the muscles around your bladder, vagina and bottom and can make sex better too. It suggests building up to 10 repeats of each exercise at least 3 times a day, breathing normally.

Not in the mood? That is common

Low interest in sex after a baby is very common. In the MAMMI study, 46.3% of first-time mothers reported a loss of interest in sex six months after birth. Cleveland Clinic points out that caring for a newborn day and night is exhausting, that sex being at the bottom of the list is not unusual, and that desire generally does increase again with time. The NHS says it might be some time before you want to have sex, and you can be loving and close in other ways until then.

Cleveland Clinic also notes that being cleared by your provider does not mean you have to feel ready. It also says that many women have the baby blues after birth, which can bring crying, anxiety and sadness for no clear reason. If you or your partner have worries, the NHS suggests talking about them together, and with your health visitor or GP if you need more help.

Can you get pregnant before your first period?

Yes. The NHS says you can get pregnant 3 weeks after the birth, including if you are breastfeeding and your periods haven't started again. Cleveland Clinic explains why: you ovulate before you get your period. If you are not breastfeeding, it says the first ovulation is likely to be around 39 days after the birth.

That is why the NHS says to use contraception every time you have sex after giving birth unless you want to get pregnant again, and Cleveland Clinic suggests having a plan in place before you leave hospital. Some methods can be started straight after the birth and others are usually started a few weeks later, and whether you are breastfeeding affects which suit you. Your midwife, GP or a sexual health clinic can talk you through the options. Breastfeeding alone is not something to rely on without advice: Cleveland Clinic says it shouldn't be counted on exclusively, and the NHS lists conditions, such as the baby being under six months and exclusively breastfed, that must all apply.

When to call your midwife or doctor

• Sex is still painful at your postnatal check (NHS), or stays uncomfortable after a few tries (Cleveland Clinic). Cleveland Clinic says your provider can discuss medication and lubrication options, and that some people benefit from physical therapy that strengthens the pelvic floor.
• Pain during sex after a third- or fourth-degree tear (RCOG lists this as a reason to see your healthcare professional).
• Bleeding from a tear, a smell, or pain that is increasing (RCOG).
• Signs of infection, such as a fever over 100°F (37.8°C) or a foul-smelling vaginal discharge (MedlinePlus).
• Vaginal bleeding heavier than one pad an hour, or clots bigger than a golf ball (MedlinePlus).
• Any new difficulty controlling your bowels or wind after a tear (RCOG).

It can feel awkward to bring up, but the NHS, RCOG and Cleveland Clinic all say painful sex after birth is something to talk to a professional about rather than put up with.

MatraBloom cannot tell you when you are ready, but its daily check-in, its recovery timeline by week and birth type, and guided pelvic floor work gated by week can help you keep a record of how healing is going to bring to your postnatal check.

Read how stitches heal after a tear or episiotomy

Frequently asked questions

Recovery at your own pace

MatraBloom's daily check-in and recovery timeline by week and birth type can help you keep track of how healing is going, including pelvic floor work, so you have notes to bring to your postnatal check.

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