C-section is a major abdominal surgery, and most women require time to recover and heal the incision completely. It is recommended to wait for at least four to six weeks to resume sex after C-section delivery. Although C-sections do not involve vaginal trauma, it takes nearly six weeks for the cervix to close after delivery. Many women may also experience vaginal dryness, fatigue, and low sexual desires for a few weeks after delivery.
Some mothers may need more time to resume intimate activities, while others may return in a short time. You may set your timeline after listening to your body and healthcare provider’s advice about resuming sex and other intense physical activities. Read this post to know about safe times for sex after C-section, reasons for painful sex, and tips to have sex after C-section.
When To Have Sex After C-Section?
It is recommended to have vaginal intercourse at least after your six-week postpartum check-up. Rushing into intense activities, including sex, before four weeks postpartum may cause complications, such as infection or bleeding, in some women.
You may also consider the following factors while deciding to resume intercourse after a C-section delivery.
- C-section incision healing rate
- Abdominal pain
- Vaginal bleeding
- Emotional state and mental health
- Overall physical health
- Birth control method
Many people have misconceptions such as it is possible to have sex soon after C-section delivery since it won’t cause trauma to the vagina as in vaginal delivery. However, it may take nearly six weeks for the cervix to close, the uterus to come back to normal size, and the C-section incision wound to heal (1).
Some women may have to wait for more time to return to sexual intercourse after C-section delivery due to the following factors.
- C-section wound incision is still healing
- Severe pain
- Drain is placed after surgery
- Underwent cesarean hysterectomy (the uterus is removed during C-section) due to medical reasons
Once all these issues are cleared, you are medically ready to resume sexual activity, but it does not mean that a woman is ready to resume intercourse at this time. In addition, some mothers can experience low sexual drive (libido) due to mental health issues such as baby blues and postpartum depression.
What Causes Painful Sex After C-Section?
The exact cause of postpartum dyspareunia, that is, painful sex after childbirth remains unclear in many cases. This could occur both in women who underwent C-section delivery and those who had a vaginal delivery. More than 25% of women who underwent C-sections were shown to have postpartum dyspareunia in a study. According to this study, it took up to 5.5 months to recover from the pain, and most felt tenderness up to one year after delivery (2).
The following factors may cause painful sex after C-section delivery (3).
- Low estrogen levels: Hormone levels can fluctuate in the postpartum period. Breastfeeding can lower estrogen levels, which may lead to vaginal dryness and low libido in many women.
- Muscular issues: Many women may feel pain during intercourse since the pelvic floor muscles were under pressure while holding the baby during nine months of pregnancy.
You may seek the consultation of an OB-GYN or other healthcare professionals if you continue to experience pain during sex even after several months of childbirth. Doctors may examine and prescribe estrogen creams for vaginal dryness and refer physical therapists for exercises and manual therapy for muscular problems.
Are There Risks Associated With Sex After C-Section?
Some women resume sexual intercourse before healing from C-section, increasing the risk of bleeding and infection. You may seek doctors’ advice before having sex to know the risks based on individual factors. Strenuous activities, including sex and certain exercises, can also delay incision healing (4).
According to the American College of Obstetricians and Gynecologists, nothing should be placed inside the vagina for a few weeks after cesarean section to prevent infections. It is safe to have sex after the incision is healed, and there is no risk of tearing the incision due to pelvic floor muscle contractions during orgasm.
What Are The Ideal Sex Positions After C-Section?
There are no sex positions that are off-limits after a C-section delivery. However, some women may find it difficult or have irritation of incision in certain positions, such as missionary positions. This can often be felt by mothers who had more than one C-section delivery. Some women may feel comfortable in side-lying positions and women-on-top positions after a C-section. However, it is safe to try any position that doesn’t bother your incision (5).
Every woman and childbirth is different, so the general recommendations cannot fit all. Therefore, you may experiment to find a comfortable position. Women who had emergency C-sections and delivery complications may need more time to heal, potentially limiting the type of sex position they may choose. You may check with your healthcare provider for more individualized recommendations.
Are There Tips To Have Sex After A C-Section?
Sex can be the last thing on many mothers’ minds after childbirth since caring for the newborn takes priority regardless of the mode of delivery. However, most women can naturally have a sex drive as they ovulate and adjust to the baby’s sleep and feeding schedule.
The following tips may help make sex enjoyable after C-section delivery (4).
- Use water-based lubricants or prescribed estrogen creams if you have vaginal dryness.
- Do Kegels and other exercises regularly to strengthen the pelvic floor muscles.
- Try comfortable positions that do not hurt the incision.
- Speak to your partner if you feel something uncomfortable or something good.
- Take a warm bath, have an empty bladder, or have prescribed pain relievers if you have postpartum dyspareunia.
- Apply cold compress with ice or frozen gel wrapped in a clean towel over the vagina if you have burning or pain after intercourse.
You may also consider nonsexual activities, such as cuddling and massages, with your partner to help maintain intimacy without the need for sex. Spending time together without the baby, such as when the baby is asleep or with the caregivers, may help some couples strengthen their bond without sexual activities.
Seek medical care for any concerns or birth control measures. Although some mothers can have natural contraception from exclusive breastfeeding, this is not 100% successful. So, you may consider other options of contraception.
If you are struggling to have an intimate relationship with your partner even after the body recovers from childbirth, check for symptoms of postpartum mental health issues, such as lack of joy and interest in life, mood swings, fatigue, and loss of appetite. You may consult a doctor for it.
Most women may have to wait for six weeks or more to resume normal sexual activity after childbirth. You may share your feelings and concerns with the partner and try sex when you are both physically and mentally ready for it. Never force yourself if you are not ready to do so. Seek medical care if you have any concerns and queries during the postpartum period.
- Going home after a C-section.
- Evaluation and Differential Diagnosis of Dyspareunia.
- When Sex Is Painful.
- Cesarean Birth.
- Sex after a baby: 10 questions to ask yourself.