Making love after birth

Your question is very appropriate because many women are anxious to resume an active sex life after giving birth and are afraid to ask their care providers about this issue.

You may be surprised to learn that the restrictions regarding resumption of sexual intercourse after birth are largely a result of "folk wisdom." There are no research-based studies that show an ideal waiting time. Women should be given the freedom to chose when they wish to resume sex after birth.

It is observed that it takes approximately six weeks for the uterus to return to "normal" size after vaginal birth. So, early "authorities" felt that the proscription against intercourse should coincide with this landmark.

What we actually see in practice, however, is that some women are emotionally and physically ready for intercourse much earlier. Williams Obstetrics, a respected text, states: "following an uncomplicated delivery, a six-week abstinence from intercourse makes little sense. It can be safely resumed in as little as three weeks or when comfort can be maintained".

From your description, it sounds as if you may be ready for intercourse far earlier than some other women. If you have had no tearing or episiotomy, and your lochia (bleeding) has changed from red to pink and is scant in amount, it is probably fine for you to resume sexual relations as soon as two weeks postpartum. I would advise this additional week to assure the healing and closure of the cervix.

You will want to protect yourself from another pregnancy by using a contraceptive method.

You should not resume sexual relations if you have any fever, malodorous discharge or red bleeding.

For some women, it takes much longer than six weeks until they are ready to make love. Advice should be provided to women based on individual variations.

A review entitled "Sexuality during Pregnancy and the Year Postpartum" was published in The Journal of Family Practice (1998) by J. Byrd et al. 47(4), 305-8. It reported that "there is little agreement in the findings of research on the resumption of sexual activity following childbirth". They state that "at five to seven weeks postpartum, only 50 percent of women had resumed intercourse." Numerous reasons have been suggested for the delay in resumption of vaginal intercourse after childbirth. The principal ones are: pain related to an episiotomy; vaginal bleeding or discharge; fatigue and discomfort related to inadequate lubrication of the vagina, due to low levels of estrogen in the postpartum period.

Women who have had a lengthy labor following a high risk pregnancy or women who have had a birth assisted by a vacuum extraction, forceps or cesarean, may not wish, nor perhaps should they, resume intercourse until 8 to 12 weeks postpartum, or perhaps even longer. Women who suffer extensive perineal tearing, or those with a large episiotomy or mediolateral episiotomy, may not be "comfortable" for several months after the birth.