After having a baby - sex and contraception

Choosing when to start to have sex and use contraception after birth can depend on, when you delivered your baby, your birth experience, how you’re recovering, and whether you’re breastfeeding.

Why is this important?

Giving birth and becoming a parent is physically and emotionally tiring. It’s important to look after your own health as well as that of your new baby in the first few months.

What does this mean for me

Your hormones change dramatically in the first few days after giving birth.

It is up to you when you start having sex again after you've given birth. A number of things may affect your decision.

immediately after the baby is born, your vagina will feel swollen and painful, and you will have quite a lot of bleeding for a few days after giving birth. If sex hurts, it won’t be pleasurable. Take your time. If you still experience pain two months or so after the birth, talk to your GP or local sexual and reproductive health service
you might feel vaginal soreness from an episiotomy, stitches or bruising after the birth. This may take several weeks to heal
if you’ve had a caesarean section, you will be given advice on how to help your body recover in the weeks after the operation. You will need to wait at least six weeks before having sex, and then you should take it slowly and find a position that is comfortable

you might want to explore with your own fingers first to reassure yourself that it won’t hurt
the first couple of times you have sex, you may want to use a lubrication because hormone changes can make your vagina feel drier than usual. You can also ask your health visitor to check your vagina, especially if you feel you are not healing correctly. It’s hard to know what you should feel like, so if in doubt, always ask
pelvic floor exercises help to tone the vaginal and pelvic floor muscles. This will help to prevent incontinence (urine leaking) and can help your vagina feel firmer and make sex feel better. You should do these throughout your pregnancy as well as after the baby is born.

Talking to your partner

If you are in a relationship remember everyone can find the adjustment to parenthood difficult. Many people worry about what’s right for their partner - they're unsure what to do and they may feel worried about hurting you. It can help to keep talking and sharing how you’re feeling. Sometimes it’s hard to find time to be together when you have a new baby.

Speak with your health visitor or GP if you or your partner have any concerns about sex after childbirth.

How long you should wait before using contraception?

	Breastfeeding (lactational amenorrhoea) If you are fully breastfeeding (your baby is taking no additional food or fluids and you are breastfeeding at least every 4 hours in the day and 6 hours at night), your baby is less than six months old and your periods have not returned, then breastfeeding is over 98% effective as a contraceptive. Male condoms and female condoms
	Progestogen only pill, implant and injection Progestogen only methods of contraception can be used from three weeks (21 days) after birth. There is no evidence to suggest that they affect your milk supply. Some women experience troublesome bleeding with the injection in the early post-birth period, so you might prefer to wait six weeks before having an injection. Irregular bleeding is a common side effect of any progestogen only method. Combined pill, ring and patch These methods are only suitable if you are not breastfeeding, as they may affect your milk supply. If you are breastfeeding, you are usually advised to wait until your baby is six months old.
	Non-hormonal coil (IUD) and hormonal coil (IUS) Coils should be fitted at least four weeks (28 days) after birth.
	Diaphragm If you used a diaphragm before becoming pregnant, see your GP or contraception (family planning) clinic to ensure it still fits correctly. This is because childbirth (and other factors such as weight loss or gain) can mean you need a different size.

Questions?

What are pelvic floor exercises?

Sometimes called Kegel exercises. You can do pelvic floor exercises anywhere and at any time, either sitting or standing up:

squeeze and draw in your anus at the same time, and close up and draw your vagina upwards
do it quickly, tightening and releasing the muscles immediately. Then do it slowly, holding the contractions for as long as you can (but not more than 10 seconds) before you relax
repeat each exercise 10 times, four to six times a day
you may find it helps to imagine you’re stopping a bowel movement, holding in a tampon or stopping yourself urinating.