Sex and contraception

Shortly after giving birth you may feel like you’ll never want to have sex again. But at some point, you probably will, so it’s good to be prepared for how you might be feeling physically and emotionally – and to consider what form of contraception you may want to use.

It’s OK to wait

Physically, there’s no real reason why you shouldn’t have sex as soon as your vaginal discharge (lochia) has cleared up (usually after about 4 weeks), and any cut or tear in your perineum has healed. Before that, there’s a risk of infection.

In practice, many couples wait longer than that. Either of you may feel too tired for sex. The new mum may feel a bit bruised from the birth (physically and emotionally) and may want to wait a while. There’s no right or wrong – it’s up to you when you feel ready – different people want to resume their sex life at different points.

Keep talking

This can be a tough time for relationships. Try to spend some time together (to remind yourselves why you like each other) and, most importantly, keep talking to each other about how you feel. Couples should make it clear that they’re not rejecting each other.

Taking your time

Remember there are other ways of being close that don’t involve penetrative sex. And cuddling is almost always welcome. When you do feel the time is right, don’t be surprised if it feels a bit strange and different. Your muscles can take several months to get back to normal. Remember too that you’ll both probably be a bit nervous, so use some lubrication and don’t rush it.

Sometimes you can feel too ‘dry’ for sex after childbirth and vaginal dryness caused by low oestrogen levels during breastfeeding can make sexual intercourse uncomfortable. A water-based lubricant such as KY Jelly can help and won’t damage condoms or diaphragms. Don’t us oil-based lubricants such as Vaseline as they can damage these forms of contraception. If sex actually hurts, talk to your GP, as you may have an infection.

Using contraception

You should start using your chosen method of contraception within four weeks of the birth if you don’t want to become pregnant again. Health professionals bring up the issue now so that you can think about it before it becomes more pressing. It may be that the method of contraception you used before you became pregnant may not be the most suitable one now.

The pill

If you’re breastfeeding, it’s recommended that you avoid the combined pill (types with both oestrogen and progesterone) as the oestrogen will reduce the amount of milk you produce. The mini-pill (progesterone only) is thought to be more suitable, but can have side-effects. You also need to be a lot stricter about making sure you take it at the same time every day. However, there is a new type of progesterone only pill which has a
12-hour missed pill window.

Family planning experts may be able to suggest other methods, such as progesterone implants or an injection, which mean you don’t have to remember to take the pill every day.

The diaphram, cap or IUD

If you use a diaphragm or cap, you need to get it checked to make sure it still fits as the size and shape of the cervix can change during birth. Some women decide to use IUD (intrauterine device) contraception which is inserted in the womb. Usually this can’t be fitted until 2 to 3 months after the birth, so other methods would have to be used in the meantime.

Condoms

The condom is the simplest choice of contraception for many women and can be used with other forms of birth control. Condoms are available free from family planning clinics and many GP surgeries.