Can You Have Sex 6 Weeks Postpartum?

Every pregnancy and every stage of parenthood comes with its own set of surprises, no matter how well you prepare. Even if you attend all of the birthing classes and read stacks of books on what to anticipate, pregnancy and new parenthood are full of surprises. It’s safe to say that I was completely unprepared for the weird, at times scary, but always benign grunting noises that came from my little one throughout the night. That first warm shower after giving birth was a pleasant surprise, especially considering how much I had prepared myself for stretch marks and a deflated postpartum belly.) (I’ll never forget bending down to wash my hands and shouting in astonishment and awe when I saw a bloated, stitched-up sight that looked like a balloon animal.)

Pregnancy and parenting are full of surprises, no matter how prepared you are.

The strange, sometimes alarming, but always benign grunting noises that my little one made all night were totally unexpected for me. To my surprise, the first warm shower after giving birth was not as unpleasant as I had anticipated. A swollen, stitched-up sight that reminded me of a balloon animal made me reach down to wash it and yell in shock and amazement.

Also unexpected: postpartum sex issues.

We all know that four to six weeks after childbirth, you can have sex again. The source of this advice may be unknown.

The doctor will examine the cervix, vaginal tears, and/or the C-section incision, check for proper healing of any areas that required stitches, and examine the breasts four to six weeks (but possibly sooner) after delivery. For parents who want more biological children, you usually discuss birth control and pregnancy spacing, according to the March of Dimes.

You may be able to resume intercourse after a four-or six-week checkup. Pregnancy-related infections are caused by bacteria entering the uterus before the cervix fully closes, according to Los Angeles OB/GYN Pari Ghodsi, MD. A C-section may also cause uterine rupture if stitches to repair vaginal tears are not properly placed. So, delaying penetrative sex for this long helps avoid these issues in the future.

The postpartum checkup isn’t always to assess sexual readiness, according to Sofia Jawed-Wessel, Ph.D., an assistant professor at the University of Nebraska-School Omaha’s Department of Health and Kinesiology who studies women’s and couples’ sexual health as they enter motherhood. She explains that it’s a check-up after a person’s body has gone through significant physical and hormonal changes. In the case of a woman who was pregnant but is no longer, it is vital that her medical team monitor her postpartum.

This doesn’t mean you should start having sex again, or that it’ll be normal or even fun.

My six-week appointment after my first child’s birth allowed me to have sex again. Because most people did it at six weeks, I figured it made sense for me and my partner to try it at that time as well. So we did. We would never try again, I thought to myself as I cringed in pain.

To be honest, it may not go well at six weeks (or even later), says Jawed-Wessel, regardless of delivery method.

That the cervix can be sensitive even after normal dilation. Some vaginal tears and abrasions may be healed, but the tear sites are usually still tender or sore, she adds.

This is especially true for women who are breastfeeding, Dr. Ghodsi explains. Dryness can last as long as you breastfeed because of hormonal changes that affect lubrication, she says.

According to Dr. Ghodsi, it’s perfectly normal for some women to be surprised or bothered by the first few times. The lubricant can help scar tissues stretch and make sex more comfortable.

Why did the six-week mark feel so heavy even though I knew that sex was (of course) not required?

This was a common theme among other new moms I spoke with.

Even with lubricant, sex was painful for Rosie. For her, 11 months of painful sex was too long to endure. In the future, if I had the same issues, I would definitely approach recovery differently.

Postpartum sex is influenced by more than just physical pain and discomfort. For example, Jawed-Wessel says new moms may experience fatigue, anxiety about penetration, and general adjustment time. A new routine must be established, and that routine will likely change from month to month as a newborn changes.

I was tired, distracted by postpartum OCD, and spent so much time breastfeeding, rocking, and comforting my baby that additional physical contact wasn’t a priority for me after both of my kids were born.

This isn’t necessarily a bad thing, just a new normal. To adapt to the changes in life, Jawed-Wessel says it takes time. In addition to postpartum anxiety and depression, sex may not be a priority for many women during this time period.

An understanding partner is also critical. Culture and assumptions about how often “normal” couples have sex can add to the pressure to have sex after birth. Pressure can come from a partner who is eager to please, which can be difficult even if they are kind and supportive. To help new mothers, Jawed-Wessel believes partners should be educated on the topic.

The partners of other moms I spoke with were supportive, but not everyone is so lucky. So the six-week mark can be difficult. Asked if she felt pressured by her partner, Mary* said she did. “It was terrible.”

She recounts having “lost” herself trying to be what she was supposed to be due to her husband’s professional struggles. She didn’t want to say no to sex after the baby, but she had a panic attack. She wishes she had known that enthusiastic consent is as important as a doctor’s approval. “This whole time frame guideline and physical go-ahead puts even more pressure on women to be sexual,” Mary says.

It helps to have an ally who can help you and your partner navigate postpartum sex and explain how a mother may feel physically and emotionally even after six weeks—a doctor, nurse, doula, or family member who has been there. “Tell your husband that he does not have the green light for anything, that it is common to have zero sex drive while breastfeeding, and if he has any issues, he can talk to me,” she said. Emily tells SELF her husband had a hard time waiting. Having someone on my side made me cry.

Communication is key between new parents when it comes to, well, everything—including sex.

To avoid misunderstandings, both partners should be honest about their fears, concerns, and desires, says Jennifer Conti, M.D., clinical assistant professor of obstetrics and gynecology at Stanford University.

According to Jawed-Wessel, most new parents want their partner to know they are attracted to and love them. We forget to communicate these thoughts sensitively, without pressure to engage in sexual behaviors, and while validating feelings of disappointment at the same time, she adds.

Not only can couples be intimate, sexual, and affectionate without penetrative sex, says Jawed-Wessel. “If penetration causes pain [or] anxiety, remove it from the table and explore each other’s pleasure in other ways.” Removing the expectation of orgasm may also help couples relax and enjoy touching each other for as long as they feel comfortable, she adds.

Remember that postpartum care isn’t a one-stop shop; reach out to your provider if you have questions or if something doesn’t feel right, even after your checkup.

“Communication across the transition from inpatient to outpatient settings” and improving postpartum care that is currently “fragmented among maternal and pediatric health care providers,” according to an ACOG committee op.

Even with expert advice and decent communication, I can tell you from experience that navigating these waters can be exhausting, fraught, and messy (literally). That’s fine.

Dishes in the sink, a baby crying in the next room, leaking breasts, and a four-minute shower are hardly ingredients for passion. After our second child in 2013, we considered finishing a single episode of our favorite TV show in three bleary-eyed nights a romantic success.

But we made it. Postpartum intimacy is “absolutely something couples can figure out with some old-fashioned vulnerable conversation and better resources,” says Jawed-Wessel.

*Name has been changed.