Sex after pregnancy – the female body

Why can it take so long to get your sex drive back after pregnancy? It can depend on both emotional and physical factors. 

You're holding your little bundle in your arms and the clock is reset to zero. Now is the start of a brand new adventure filled with joy, challenges and togetherness. But the woman's body has also been through an adventure during pregnancy and needs time to heal and regain its balance.
Also read about sex and libido after pregnancy.

Carrying and giving birth to a baby is a feat of strength
During the whole pregnancy, the woman's body is fully occupied with carrying and finally giving birth to the baby. After labour and delivery, the body needs time to heal, and it extra important for the woman to take care of herself. Her pelvic area is swollen, her breasts are tender and she is having afterpains. Giving birth is a real feat of strength.  
Read here about healing after giving birth.

Hormones affect sex drive
For the first few months after giving birth, a woman's body is awash with hormones that affect her sex drive. For the first few days after childbirth, she has a lot of endorphins - the body's own morphine - in her body. Not only that, but she'll also have a residual effect of the oxytocin hormone, which is produced during childbirth. Soon these hormones will subside and the body will reset and start producing milk for the baby. These are big physical changes and she may be very sensitive and in need of support at this time. It's very likely she won't be in the mood for sex.

Resuming sex
After about six months, the hormones will subside to their normal level and things can return to normal. Well, almost. The new little family member may be quite a drain on your sleep and time. 

The woman's body also changes during pregnancy and labour. Some women feel insecure about themselves and their partner's expectations.

Postpartum bleeding, healing and condoms
Postpartum bleeding is caused by placenta tissue being expelled from the womb after pregnancy. It is like a wound that gradually heals. Postpartum bleeding can last from a few weeks up to eight weeks after giving birth. It's fine to have sex before the bleeding stops if you both want to, but use a condom to reduce the risk of infection.

It may hurt to have sex
Many women have one or several tears stitched in their pelvic region. In some cases, the scar tissue can be so hard and sore that sex is initially painful. It can prevent some women from having sex at all. When the woman has had self absorbing stitches, the knots can remain in place and chafe for a while. The discomfort will disappear eventually. If things don't feel right, ask the midwife at your maternity clinic for an examination.
The mother can help the healing process by doing Kegel exercises and massaging the area with unperfumed baby oil.

It can be hard to relax when you first start having sex again. This can be a reason why it hurts. Give it time. Worrying about waking the baby can also cause tension. Doing a lot of Kegel exercises can also make it difficult to relax, so don't go overboard with them.

Vaginal dryness during breastfeeding – use lubricant
Your vagina may become dry and fragile while you are breastfeeding. This problem is caused by hormones and will pass after you stop breastfeeding. It can usually be solved by using lubricant. If this is not enough, ask your midwife for advice. Pharmacies sell oestrogen creams and suppositories over the counter. These products are useful while breastfeeding.

Breastfeeding and contraception
If you are not breastfeeding, your periods can return as early as after four to six weeks. A woman's periods may return while she is breastfeeding. However, it is also common for the woman to have irregular or no periods while breastfeeding. This varies a lot and is completely individual.

Bear in mind that you can get pregnant again very soon after giving birth Because ovulation happens before menstruation, it is not easy to tell when you become fertile again. It is advisable to initially use a condom to protect against pregnancy and infections.

While breastfeeding is not a surefire way to avoid getting pregnant, under certain conditions is it a fairly reliable form of contraception. This is known as the lactation amenorrhoea method (LAM).
LAM is about 98 percent reliable as a contraceptive method provided the following criteria are met:
• you are breastfeeding full time with no more than a four-hour break during the day and a six-hour break during the night.
• the baby is less than six months old and your periods have not returned.

Ask your midwife for more information.