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5
Minutes read

Let's Talk Sex!

The Modern Midwife’s guide to postpartum sex and birth control.

Author Marie Louise
Categories   Pregnancy

Postpartum, the mere mention of the word ‘sex’ might make you want to run for the hills (if you could!) and it’s a perfectly normal reaction. We’re talking postpartum here – you’ve just given birth and it could well be that you feel as if you could not ask any more of your body. It stands to reason then that most women don’t feel like having sex too soon in the postpartum period. But some do – I read a story recently about a mum who had sex in her birth room, so everyone is different.

You might be wondering if there is a ‘time frame’ here. The abstinence period recommended by health professionals is two weeks until any wounds are healed. There is a risk of bleeding and infection in that window, and you want to give any wounds a good chance at healing properly. Apart from that, your body has been through huge changes and possible trauma (mental and physical) and needs to rest, recharge and heal.

There will be some partners who are fully on the same page as you, possibly even anticipating that the likelihood of sex any time soon is a no-no. It may be something your partner is pondering over but not wanting to bring it up, or maybe they’re wondering whether they should go for it and make a move.

"Your body has been through huge changes and possible trauma (mental and physical) and needs to rest, recharge and heal."

There’s plenty of scope here for misunderstandings. For example, your partner may want to feel close to you and will still need the physical contact they had with you before. It might be that they just want to be loving rather than intimate. But a lot of mums have told me that during the postnatal period, they don’t feel particularly ‘loving’ towards their partner. Others are really up for cuddles, hugs and gentle physical contact, but not sex.

It can take a while to want sex, but it’s such an individual thing. You could have had the best sex life ever right up to before your started labour. It’s not unheard of for women to encourage the onset of labour (when full term or overdue) by having sex. Post birth, you’re likely to find it’s dropped right down your list of priorities. Your partner will need to understand that this isn’t personal, you haven’t gone off them and you still love them. They may need reassurance and it will help to explain how you are feeling and that your body needs to heal.

It’s incredible how much your body changes during pregnancy and birth. Many women who have a vaginal birth experience some kind of trauma in the form of tearing or an episiotomy. The trauma can be anything from minimal to extensive, in which case there will be sutures and a wound to contend with.

"It can take a while to want sex, but it’s such an individual thing."

If you had a C-section, there’s the abdominal wound to deal with, as well as allowing the rest of your reproductive anatomy to start to get back to normal. Throw in a few haemorrhoids and your lower body could well feel very underwhelmed at the idea of intercourse.

At around 6-8 weeks, you’ll be due for a check-up with your GP. This is a good time to bring up any concerns, for example if intercourse is painful. It’s an ideal opportunity to talk about contraception too. There will be many women who have still not felt ready to start having intercourse for several months. It’s very much a personal choice and not something to rush back into or to be coerced into. It’s your body, your choice.

Postnatal Contraception

Whether you’ve resumed being sexually active or not, bear in mind that you can become pregnant from as early as three weeks after birth (even if you are breastfeeding). If you have a hospital birth, contraception is something you can discuss with your midwife before you leave hospital.

There are several options, but not all contraception methods are suitable for all women. If you have health concerns, these will need to be flagged up. For example, if you have high blood pressure (hypertension), this could exclude some forms of contraception. The choices of contraception are:

"Whether you’ve resumed being sexually active or not, bear in mind that you can become pregnant from as early as three weeks after birth (even if you are breastfeeding)."

Immediately Postpartum

Starting with the most effective choices:

  • A contraceptive injection or implant, which are both 99% effective
  • Progesterone-only pill, which is 99% effective if taken correctly
  • Male condom, which is 98% effective if used correctly
  • Female condom, which is 95% effective if used correctly
  • Intrauterine Device (IUD) or Intrauterine System (IUS), both more than 99% effective

3 Weeks Postpartum

If you’ve been checked for medical risks (such as blood clots) and you are not breastfeeding, you have the following choices:

  • Vaginal ring, which is more than 99% effective if taken correctly
  • Combined pill, which is more than 99% effective if taken correctly
  • Contraceptive patch, which is more than 99% effective if used correctly

If you do have health risks or are breastfeeding, it’s best to delay using these forms of contraception.

If you already used a cap or diaphragm before becoming pregnant, check with your GP or Contraception Clinic that it still fits correctly, as changes in your anatomy during pregnancy and birth could affect this.

Author Marie Louise
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The Modern Midwife

Marie Louise is an experienced Midwife, PTLLS adult educator and hypno-birthing teacher from the UK. She has travelled extensively to learn about midwifery in different cultures and has also practised in Australia. She runs ‘Modern Midwives Meetups’ which provide a safe space for midwives to share best practice and hear from experts in the maternity field. Marie Louise is a sought after expert and has most recently been invited to Parliament to discuss maternal mental health and maternity discrimination. She's also a communications partner for Child.Org, an equal opportunities charity for children and advises Cocoon Family Health, a perinatal mental health charity based in London.

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