If you've had a cesarean delivery and are recovering, resuming any activity in the bedroom is probably the last thing on your mind.
Even so, you’re probably wondering when you’ll be able to have sex again and what it will feel like. While some people may think that having a cesarean delivery means you will have less problem resuming sexual activity simple because there isn't as much trauma to the vaginal area, that isn't always the case.
It's still common for women who have had cesarean deliveries to experience sexual struggles, especially in the early postpartum period. Studies have shown that both women with vaginal and C-section births report sexual challenges in the first three months after giving birth.
When can I have sex?
There’s no one-time fits all when it comes to returning to sexual activity after a cesarean delivery, but many women will wait between four and six weeks before resuming intercourse.
Although you may experience slightly less bleeding with a cesarean section, it will still take about six weeks for your cervix to close completely. Some women may feel ready to resume intercourse sooner than others, but you should only have sex again once given the ok by your obstetrician and when you feel comfortable.
Here's what to expect from your cesarean delivery recovery and sex postpartum.
Recovery from a cesarean
Following your cesarean delivery, you’ll be in the hospital for two to four days to recover. You’ll be slowly weaned off medical equipment like pain medications and your urinary catheter.
Even though you didn't deliver your baby vaginally, you’ll still have vaginal bleeding as your uterus contracts back to normal size.
As a nurse, I noticed that a lot of cesarean delivery patients didn't have as much initial vaginal bleeding as those who delivered vaginally. That’s because some of the blood tends to get cleared out during surgery. But you can still expect to bleed for four to six weeks.
A woman's uterus takes about six weeks to return to normal size and for her cervix to close back up. The physical timeline for a woman's body to heal "down there" is pretty much the same, no matter how she gives birth.
The cervix needs to be closed in order for sexual relations to resume safely. You’ll need to avoid sex or putting anything like tampons in the vagina for a few weeks after a cesarean delivery.
While some women may be ready to resume sexual activity sooner, most cesarean delivery patients can have sex after they have been cleared by their doctor at their six week postpartum checkup.
The physical recovery from birth is similar for both vaginal and cesarean deliveries. But the recovery process is going to be very different in the abdominal area for mothers who’ve gone through surgery.
Staples from the incision site will be removed within a week of surgery. The actual incision site itself should be healed by six weeks postpartum. But it’s common for women to feel some discomfort in the incision area. Some women experience numbness or tingling for months after surgery.
This is generally normal, as long as the pain doesn’t increase and isn’t accompanied by other symptoms like a fever.
The area around your incision site might be uncomfortable, so it will be helpful to try sexual positions that don't put any pressure on your abdomen. The first time you have sex, you may be fearful of what it will feel like. Because sex is not just physical, it's also mental, any hesitation or fear you have about having sex again is very real and may have an affect on your sexual experience.
Be sure to talk to your partner, take your time, engage in some non-sexual foreplay, like massage, to help you relax, and use lubrication to get started. Some women experience sexual dysfunction after a cesarean delivery, so if you find sex is abnormally painful, be sure to speak to your doctor.
How to perform Kegels
You might think you can skip the infamous Kegel exercises if you had a cesarean delivery. But you’d be wrong.
Kegels aren't just for your vagina. They’re an exercise for the muscles in your whole pelvic floor. This is affected by pregnancy, no matter how you deliver.
Start performing Kegels as soon as you’d like after birth. You can also start doing Kegels during pregnancy, before you deliver.
To perform a Kegel:
- Squeeze your pelvic floor as if you were stopping urine midstream.
- Hold those muscles for a few seconds.
- Repeat as frequently as you’d like throughout the day. The more, the merrier.
Birth control after birth
Take it from this obstetrics nurse: I’ve taken care of more than one patient returning almost exactly nine months after delivering a baby to have a second.
Pregnancy can happen pretty much immediately, even after you’ve given birth. Don't wait until you've resumed sexual activity to start your preferred birth control method.
There are a lot of options for long-acting birth control. Many of these options are safe for breast-feeding mothers. Talk to your doctor about what method is best for you.
When to see your
Speak to your doctor if you have any increased pain, discharge, or bleeding after a cesarean delivery.
I always tell my patients that as time goes on, they should start to feel better, not worse. If anything starts hurting more, it's a sign that something might be wrong.
Having sex for the first time postpartum might be a little uncomfortable, especially if you’re breast-feeding, your menstrual cycle hasn't returned, or you’re on birth control. All of these could lead to a lowered amount of natural vaginal secretions.
Try lots of foreplay, use lubrication, and take your time. You should also keep an eye on your incision site as you recover.
See your doctor if the incision opens, is painful, or becomes reddened or swollen. These may be signs of an infection.
When it comes to enjoying sex after a cesarean delivery, remember to take your time and pay attention to your body. There's no rush to get back to "normal." You’ll probably need a little time to adjust.
Every woman and every couple is different, so communicate openly with each other. If you encounter any problems along the way, don't be afraid to talk to your doctor about resuming sexual activities. Trust me, they've seen it all. There’s no such thing as an embarrassing question when it comes to women's health.
If you're struggling with your cesarean delivery scar, browse some of the empowering stories at the 4th Trimester Bodies Project. All mothers and bodies are beautiful. Remember, yours has just done something amazing.