Sex after childbirth

When can we begin to have sex again?

Whenever you and your partner both feel that it's the right time for you. There is an assumption that you are just waiting for your doctor or midwife to give you the go-ahead at your six week postnatal check. But some suggest that it's a good idea to try making love before the doctor's visit so that you can then discuss any problems you encounter. Some couples do resume their sex life within the first month, and many more resume it between one and three months, but there is a sizeable minority who wait till about the six-month mark, or even a year. There is no norm that you have to aim for.

Why does it take so long?

New mothers feel reluctant or uninterested for a variety of reasons. The most obvious is soreness from an episiotomy and stitches. Even if you haven't had an episiotomy or a tear, the perineal area can feel bruised and sensitive for some time. It makes sense to let the wound heal and the stitches dissolve before you have intercourse.

Tiredness is another overwhelming factor. Looking after a baby 24 hours a day is exhausting physically and emotionally, so when you get into bed you just want to sleep. Your perception of your own body might hold you back -- it may feel so changed by the processes of pregnancy and birth that you need time for it to recover before you feel like you again. Many women report that their libido is low at this time of their lives -- they just don't feel sexy.

What if my partner wants sex before I do?

This situation does sometimes occur and needs love and understanding from both partners to prevent it becoming a problem. First, it is important for you each to talk about your feelings. Your partner might well feel rejected if you don't want sex, so it is up to you to explain the physical discomfort or anxieties that are holding you back.

Perhaps the first priority for you as a couple is to carve out some together time -- many couples complain that there just isn't time in their lives for each other during these early weeks and months with a baby. Words and cuddles can do much to convey affection and emotion, and you will both benefit from this closeness. On the physical side, sex doesn't have to mean full penetration -- the stimulation of touch alone can be highly pleasurable.

Are there any practical tips to help with all these problems?

There are several ways you can help yourselves:

• K-Y jelly or another lubricant can be very helpful if your perineal area is feeling sensitive. It also helps with the vaginal dryness many women experience at this time.
• Full sexual intercourse doesn't have to happen the first time you feel sensuous or aroused. It may be easier to think of just cuddling at first, and gradually getting used to being touched in a sexual way again.
• When you do have intercourse, choose a position that doesn't put too much pressure on wherever you are feeling sensitive.
• If tiredness is your biggest problem, try making love during your baby's nap time, when you are not too exhausted to enjoy it.
• Do your pelvic floor exercises to bring back muscular tone to your vagina, and look out some postnatal exercise classes to help get back into shape and raise your morale.
• Eat well, and drink plenty of fluids. Rest whenever you can. Looking after a new baby is extremely demanding. In order to have any energy left over, you need to be looking after yourself very carefully.

Are there any problems that I should worry about?

If intercourse continues to be painful, despite going carefully and gently about it and taking your time, it is worth talking to your doctor about it. Sometimes the way a tear or an episiotomy is stitched can cause long-term discomfort, which a further surgical procedure can fix. If you have a vaginal discharge that smells unpleasant, you could have an infection that requires medical attention. If you are still losing blood from your vagina after four weeks, or have a sudden increase in blood loss, report this to your doctor.