Resuming Intimacy After Childbirth FAQ Copyright 1994, Colleen Kay Porter. Use and copying of this information are permitted as long as (1) no fees or compensation are charged for use, copies or access to this information, and (2) this copyright notice is included intact. ============================================================== Information for this FAQ was collected in October 1994. I am including articles from medical journals which I thought were relevant, a few things from my public library, and finally the anonymous summary of the comments I received. ******************* First is one that I would really want to discuss with my practitioner if I was pregnant. Even those of us who don't have episiotomies often need some stitching, and according to this study, the type of suture material can have a significant impact on healing. TI: Episiotomy repair: chromic versus polyglycolic acid suture. AU: Ketcham-KR; Pastorek-JG-2nd; Letellier-RL SO: South-Med-J. 1994 Apr; 87(4): 514-7 LA: ENGLISH AB: The use of an episiotomy for vaginal delivery is a controversial topic in modern obstetrics. If one is done, however, correct technique and appropriate suture material are important. On the LSU Obstetrics Service, the usual midline episiotomy has traditionally been closed with 2-0 chromic suture. Theoretically, the use of a less reactive material, eg, polyglycolic acid (Dexon), may be beneficial in terms of acute postpartum discomfort and healing. As a comparison of healing and patient comfort parameters between 2-0 chromic and 2-0 polyglycolic acid suture used for episiotomy repair after delivery, two consecutive months' worth of parturients at Medical Center of Louisiana/Charity Hospital had episiotomy repair, with either chromic or polyglycolic acid suture, by junior house officers routinely attending delivery. Patients had follow-up during hospital stay, and when examined at 6 weeks for evidence of suture line healing, they were also asked about comfort and resumption of sexual activity. Of 48 patients who had repair with 2-0 chromic suture, 6 were lost to follow-up. Of 44 gravidas who had repair with 2-0 polyglycolic acid suture, 7 were lost to follow-up. At the 6-week postpartum examination, patients with polyglycolic acid sutures had significantly better healing. A noticeable scar was present in 42 of 42 patients with chromic sutures versus 21 of 37 in the polyglycolic acid group, a scar with granulation tissue in 16 of 42 versus 3 of 37, and a gaping scar in 9 of 42 and 0 of 37, respectively. Recovery of function, measured by resumption of sexual activity by 6 weeks, was demonstrated in 1 of 42 patients who had chromic sutures versus 19 of 37 patients who had polyglycolic acid sutures. Episiotomy repair with 2-0 polyglycolic acid (Dexon) offers significant advantages over traditional 2-0 chromic suture, both in terms of wound healing and resumption of normal patient activity, including sexual activity. ************* Next, is the only recent study I have been able to find that examined this topic in a scientific way. TI: Recovery after childbirth: a preliminary prospective study [see comments] AU: Abraham-S; Child-A; Ferry-J; Vizzard-J; Mira-M SO: Med-J-Aust. 1990 Jan 1; 152(1): 9-12 LA: ENGLISH AB: This prospective study examined the time for 93 women to cease to feel discomfort in their perineal areas after the births of their first babies. Sixty-two of the women had experienced a spontaneous delivery that did not require forceps assistance. In 58 patients, an episiotomy was performed. Of the 35 women in whom an episiotomy was not performed, 24 women required sutures and only four women did not suffer any perineal damage. The median time for perineal comfort in general (including walking and sitting) was one month (range, zero to six months); 20% of women took more than two months to achieve general perineal comfort. For comfort during sexual intercourse, the median time was three months (range, one to more than 12 months); 20% of women took longer than six months to achieve comfort during sexual intercourse. Factors that were associated with discomfort for longer than the median time were delivery by forceps; spontaneous vaginal (not perineal) tears; and, in the three to four days after the birth, oedema and the breakdown of muscle or skin sutures. There was no significant difference in these times between patients who did not undergo an episiotomy and those who underwent an episiotomy without a forceps delivery. Let me also include a table from their study which shows, "The reasons that determined when sexual intercourse was commenced" No discomfort/stitches healed 41% Less tired (baby sleeping better) 15% Husband suggested sex 12% No discomfort/less tired and husband suggested sex 7% Postnatal visit (test before) 8% Return of sexual desire 7% Started contraception 5% Stopped bleeding 3% Questionnaire received enquiring about discomfort 2% ************ Next is an editorial that appeared in the same issue as the previous study. TI: Perineal pain after childbirth AU: MacLennan-A SO: SO: Med-J-Aust. 1990 Jan 1; 152(1): 1-2 There was no medline abstract for this one. Basically he calls for more research in this area, commenting, "Fear of the physical consequences of vaginal delivery is quoted as the mahor reason why women in some cultures request elective caesarean sections." He also points to procedures that could help minimize risk factors: birthing chairs, once popular in the 80s, apparently have some correlation with venous engorgement. He calls for the reduction of episiotomy rates. He suggests that since forceps deliveries are such a high risk factor, they be avoided by several procedures. First, not setting an arbitrary time limit on the length of pushing (if mom and baby are doing well). Second, using a type of epidural analgesia that is less likely to require forceps. I don't know if vacuum extractors are used in Australia and if that is one of the advantages? ************** TI: Midwives' journal. Grin and bear it? AU: Hulme-H SO: Nurs-Times. 1993 Feb 10-16; 89(6): 66 Another editorial, no medline extract, my subjective interpretation. Basically, she argues that women are entitled to a lengthy period of abstinence if that's what they want. She claims there is, "a silent majority of new mothers--57% by one count--who, for many months after the birth of their babies, do not want any sexual contact. Friendly cuddles, yes, copulation, no. They are so overwhelmingly involved, physically and emotionally, with their baby that they have little need or inclination for anything else." She says that a lengthy post partum taboo on intercourse is common in other cultures, and suggests, "Maybe this would also give the husband and wife time to know each other better." She suggests that health care professionals treat it seriously, not joke, and outline what to expect. She closes, "Don't talk about 'getting back to normal'; mothers don't go back, they go forwards." Please note: The study she cites with the 57% figure is from a British publication called New Generation. Since I can't find it in our libraries, I'm not sure if it is an obscure but respected academic journal, or a sensational tabloid. Anyone from England who can tell me, I would really appreciate it! **************** Next is some resources from my local public library. I am still looking for more, and would be delighted for some suggestions. (I am amazed at how many of those "improving your relationship thru communication and sex" type books just ignore the impact of childbirth on a couple!!) Title: Sex, love & babies : how babies change your marriage Publisher: Injoy Productions, Pub. Info: Boulder, CO : c1993. 1 videocassette (30 min.) : sd., col. ; Format: [videorecording] ISBN: 096255622X Notes2: A panel discussion with parents about how having children has affected their lives including time management and setting priorites, physical changes, sex before and after the baby, and parenting myths and realities. -------- Author: Kitzinger, Sheila. Title: Woman's experience of sex Publisher: Penguin, Pub. Info: New York, N.Y. : 1985, c1983. 320 p. : ill. ; ISBN: 0140074473 ----- Author: Kahn, Elayne & Rudnitsky, David Title: Parents who stay lovers: How to keep the magic alive from pregnancy onward Publisher: Bob Adams, Pub. info: Holbrook, MA :1992 226 p. ISBN: 1-55850-121-5 ----- Author: Cynthia Copeland Lewis Title: Mother's first year: how to cope with that exhausting, exasperating, exhilirating experience called motherhood Berkley Books New York; 1992 362 p. ISBN: 0-425-13271-4 ------- Author: Brad E. Sachs Title: Things Just Haven't Been the Same: Making the transition from marriage to parenthood William Morrown and Company New York; 1992 ####################### Finally, here are all of your comments. I am so sorry if I failed to cut out something that would identify you; I really tried to delete the baby names and locations and everything. Thanks again to everyone who contributed. *********************** After my first two children I was not given any advice, and didn't think to ask. After normal vaginal delivery (no painkillers, no tears) both times we resumed after 5 days (ie afer I left the hospital). After my third child (10lbs, and no painkillers, no tears!) I was told we should wait till the bleeding stopped, due to the possibilty of infection, but we waited three weeks (bleeding stopped at 9 weeks after a D&C). ******************************** Well, my baby is 10 months now, and we still haven't done it. I am pretty sure it was as long, or longer after the first one. I don't have a high libido (as you can see), so its a miracle we have children at all. ************************************ For your first question, they told me that they recommended not to resume sex before 15 days after delivery (I had an episiotomy), and that it would be painful before that time. No advice about having sex before or after the check-up, which in my case was at 4 weeks. (No sex before) Easing discomfort: No advice. (I am not pretty sure of that, I can't really remember, but anyway I never used any advice) These recommandations were far from the reality which was close to 3 months before I could handle sex again, and much more to get to a normal frame again. Here in France they tend to say in feminine and family magazines that many women have sex again soon after delivery (2 or 3 weeks) but my personal opinion about it is that these cases are NOT the most frequent cases. ************************************* With our first we waited 4 weeks. Our OB said to wait 6 weeks. He was a vaginal delivery, episiotomy, breast-fed. I felt a ridge in my wife's vagina when we made love - it was somewhat painful for both of us, and much lubricating jelly (KY) was necessary. After that we waited until after 6 weeks. The ridge was much less noticeable. After about 7-8 weeks things were back to normal. I'm pretty sure it was due to the episiotomy. With our second we waited just under 4 weeks. She was c-section, breast-fed. Except for dryness (we've become accustomed to using KY) there were no problems. We were careful not to strain her stitches. A comfortable position for us both during and just after pregnancy was rear-entry, with her lying _flat_ on her stomach. ********************************** My doctor suggested waiting until my 6-week checkup. I didn't have a problem with that. I was too sore and too tired anyway. How long after the checkup was proportion to how long my episiotomy was :-). I was more sore for a longer time after my first baby than after my second baby. ******************************** I'm writing because I don't know whether anyone else will have made my point, which is that I needed medical help to get started again. Between childbirth (by c-section) and breastfeeding, I had basically no estrogen left at all, with resultant "vaginal atrophy", most painful. My OB gave me a sample-size tube of estrogen cream with warnings to use it sparingly, since vaginally-applied estrogen can go through into the milk. (Fortunately, sufficiently small quantities of estrogens are not harmful to the baby, even if it's a boy.) After using the cream very sparingly for a week or so, it was possible to attempt intercourse with plenty of added lubricant. After that, for the duration of breastfeeding, it was very much a case of "use it or lose it", as they say to menopausal women....frequent sex prevented problems, but a gap of more than a week necessarily led to major irritation that seemed like and often led to a yeast infection. It was never bad enough to require the estrogen cream again, however. ***************************** Have you gotten many responses from moms who delivered by C-section? Rather different factors at work than with vaginal deliveries, I would think. Both my children were born surgically. I received the standard 6 weeks advice with both. After the first, I had cervicitis and a Class I pap smear but the doctor didn't say anything about not resuming relations. My second birth was a transport from a homebirth, and the on-call OB was the one who thought midwives should be burned at the stake. So any contact with him was polite, but rather gelid. So after he pulled out the staples (none too gently) he tells me & my husband, and I quote, "No whoopee for six weeks." It's pretty hard to roll on the floor laughing after you've just had surgery. In the discharge report, this is reported, "Patient has been instructed on vaginal abstinence for six weeks". It's my funniest memory of that birth. We waited 12 weeks after my daughter's birth, mostly because she would not sleep anywhere but right next to me until then. It was five months after my son was born, because of pretty bad postpartum depression. I have heard a friend say that intercourse hurt her after her cesarean births, but I have no idea why that would be - it wasn't my experience. ************************************* Okay, my experience: I was told to wait until the bleeding stopped. That is supposed to be between 2-3 weeks. I had 3 tiny stitches from a very small tear (no episiotomy); my delivery had been very fast, intense, but uncomplicated. Helps when your delivering a 6 lb., 10 oz., *23"* baby! Long and lean, built for being born! Anyway, I had no pain with the experince at 3 weeks after the birth; we both had a hard time waiting. I called the OB after 2 weeks when there was still a little bleeding, asking, hey, how long is this going to go on? ;-) Personally, the stories about people waiting 6+ etc. weeks really made *me* wonder! I can't say I ever had the diminished sex drive so many people describe as common after their baby is born. ************************************ Here's our story. In the pre-natal class sponsored by the hospital, the nurse said no sex until after the post-partum exam, usually at six weeks. My doctor never said anything specific about it. My husband couldn't wait and kept asking when we could do it, within days after the baby was born. I only had a small tear which healed very quickly. (My husband and I put baby in the stroller and walked--about a 20 minute walk--to campus, visited various people there, and walked back, five days after she was born.) We decided to try resuming intercourse about three weeks post-partum, with the agreement that we'd stop if anything was wrong or if it was painful, we'd stop. We were fairly tentative, but everything went fine. The only thing was that my vaginal area has gotten all its sense of feel back yet. When we went back to the doctor's for the post-partum checkup (which was mistakenly scheduled by the nurse for 4 weeks instead of 6 weeks after), everything checked out fine for me. The doctor asked if we've resumed sexual intercourse. We said we had and had no trouble, and she said "that's good" or something else equally unmemorable. So it really wasn't a big deal for us. My mother, on the other hand, bled for a couple of months after her first child was born, and after the bleeding finally stopped, my parents resumed intercourse, and it was painful for my mom for a long time. In fact, she said she never felt completely comfortable until a couple of years ago, almost ten years after menopause, and more than 25 years since my older brother was born. *************************************** We didn't get any advice apart from `whenever you want to, but remember it might take quite a while before either or both of you feel like it' which I thought was very good advice. I think laying down guidelines on such things makes some people feel it's a bit of a competition and they're abnormal if they don't conform exactly! Anyway, I couldn't even sit down for 4 weeks let alone do anything more erotic! I can't remember exactly when the first attempt was but probably around 4-5 weeks. It got progressively less uncomfortable over the months but even after a year things are not completely back to `normal'. Things that help are: - almond oil - sleep - time - not feeling pressured (e.g. by books that tell you when you ought to be doing it by!) One thing we had not realised is that lactating seriously depletes your libido, as well as sometimes making intercourse more difficult for various physical reasons. I wish we'd been told that before. It IS a factor in deciding when to stop breastfeeding as well. ********************************* IAs I recall, the OB's advice was "As soon as you feel up to it after the 6-week visit." Our child was born almost a year ago and we are still waiting for her to feel up to it. She tore badly during delivery and also is still breastfeeding. The few attempts we have made have caused her a significant amount of pain. Unfortunately for me, she doesn't seem motivated to do anything about this problem and it's beginning to drive me crazy. Let's just say I'll be looking forward to you posting any good advice you receive on how to reduce discomfort. ********************************* Group midwife practice. When I came in for the checkup the day after giving birth, I was told to wait until the lucia ended. (6 weeks). Sex was somewhat painful at first, but got better quickly. Note: I did have an epistiostomy...(sp) **************************** I don't remember any recommendations from health providers or when we resumed sex after childbirth. I did have some problems after my first delivery due to scar tissue from my episiotomy. Since I moved shortly after my child was born, I didn't really have an opportunity to discuss it with a health provider until quite a few months after the delivery. In between, I found out (from a newpaper article) about ultrasound therapy for breaking up scar tissue and asked my GP if I was a good candidate for this. I was able to have ultrasound treatment to break up the scar tissue (about 8 15 minute sessions) on the NHS (England) which worked. I think it's worth publicising this option for treating painful post-partum intercourse. [EDITOR'S NOTE: I have some references on this, so e-mail me if you are interested in more information] ****************************** My physician, who is chairman of the Ob/GYN Dept at the medical college here, said to wait until my postpartum checkup (about 8 weeks after birth). It was at least 3 months, however, until I even attempted anything, and another 6 weeks until it was somewhat comfortable. I did some research and found that for many women a 6 to 12 month wait was normal due to physical pain, hormonal imbalance, or emotional burnout. The 6 week waiting period only take into account the time it takes for the uterus to return to normal, and does not consider the previously mentioned factors. ******************************** I was told wait 6 weeks. Whether to do it before or after the 6 week checkup was never specified. >Any tips on easing discomfort? Lubricant. Since I was nursing, I was dry. >In my own case, recommendations ranged from 3 weeks to 6 weeks. We started again at 6 weeks, but didn't do much the first 6 months really. In fact, it wasn't until after the baby weaned himself at 8 months that I started feeling normal again. ********************************* He wanted to see me 4 weeks after birth, and told me to wait until after that. He saw me again at 8 weeks, and we did have sex the night before so that we could determine if there were any problems. (There were :-( He gave me estrogen cream, which I didn't use, because I wasn't comfortable with possible side effects, and I was nursing. I found man on top more comfortable than woman on top. From behind was absolutely impossible for almost 6 months. I think that the degree of tear/episiotomy might make a big difference as well. I had both, and the tear healed more quickly than the episiotomy. (I also had some blood problems which slowed healing) I don't think my husband had any discomfort at all :-) Actually, though, he was very apprehensive because he didn't want to hurt me. ***************************************** I was told to wait until my 6 week check-up before considering having sex. At around 4 weeks, I thought maybe I was ready, but when we tried it, it was painful, so we stopped. At the time, I was worried that alarms would go off somewhere if we attempted penetration, or that my OB/GYN (who was a really nice woman) would be able to "tell" and would yell at me. This is not relevant, but I know lots of people who are afraid of their doctors. ************************************** Throughout the time I was nursing, vaginal dryness was a problem. What helped me was to schedule sex. I know, it's supposed to be this spontaneous thing. But if I knew my husband was coming home for lunch, I could make sure to drink a lot of water, plan to nurse the baby right before, and think about it all morning and get ready mentally. Then, after my periods started (even thought I never gave the baby a bottle!) I found that the lubrication was better around the time I ovulated, so I tried to schedule a nice date for that time of the month. Also , I wasn't as tired if we met for lunch or arranged for a sitter for an hour and a half in the early evening. ************************************* Well, my doctor (a woman OB) schedules the checkup at 8 weeks, not six, and explicitly says it is fine to have sex before then, but that is when she refits birthcontrol devices, etc. Personally, I had a big mediolateral episiotomy each time, and 3 weeks is just BEYOND MY IMAGINATION. I was still in pain sitting at three weeks! Both times we started again at about 8 weeks and both times it was really painful (not the incision, though, the pain was more internal--my friend says it hurts after c-sections too!). I was brestfeeding both times and was tired and had ZERO desire. COuld have waited a lot longer! My husband and his brother are eleven month apart in age. That means my mother in law was PREGNANT eight weeks after delivery! OUCH! *********************************** I don't seem to recall my midwives giving me a specific time as to when my husband and I could start making love again, other than waiting until after the lochia stopped (2-3 weeks for most women) and when I felt ready. After my c-section this was exactly two weeks after birth (my perineum didn't hurt, obviously, but I remember that my uterine scar was still a bit sore for the first few minutes) and after a vaginal birth (with a moderate tear that was stitched and didn't hurt at all after 3 or 4 days after birth) it was 2.5-3 weeks. he female superior position was recommended in books and it worked well for me because I could control penetration if I felt any discomfort. ***************************************** Neither time did my doctor(s) give me any recomendation. I read in one of my books that if you don't wait 6 weeks you should use condoms to prevent infection of the placental site. After my first we did not wait 6 weeks, we used condoms, no problem. After my second sex was impossible for months. I told my doctor who basically said "time and KY" and was not prepared to consider it further. This was espcially annoying since KY was not helping one speck. This was undoubtedly hormonal since my periods were suppressed this time around and had not been after my first, even though both were exclusively breastfed. To give an example, after my periods did come back I couldn't use tampons, it was physically impossible. After a few cycles things got better, but my doctor never did get concerned at all. Oh, both births were C sections so I didn't have episiotomies to worry about, though I did have 6-8" incisions in my lower abdomen :-). **************************** My first childbirth was a difficult forceps delivery. At my 6-week post-partum, I was still bleeding a little (so she couldn't do a pap smear test). The doctor asked if I had tried sex again and I said no. I was in no hurry. I think we first tried at 7 weeks, and then waited at least another week before doing it again. My doctor's current post-partum instructions are that you can have sex any time after you stop bleeding. ************************************ I was told to wait until after my 6 week check. At that check we discussed birth control and I was refitted for my diaphragm. Go slow! :-) Breathing exercises. I had a pretty good-sized episiotomy, which I'm sure contributed to the discomfort. It took until 4-5 months post to really get comfortable again, but we weren't having sex too frequently at that point, so that probably only means 4-5 acts of inter- course. I have heard that it's OK after the lochia stops, although in my case that brought me almost up to the 6 week mark, anyway. I'm sure they the OB's that say 6 weeks are trying to make sure that any slim chance of infection are gone. **************************************** My midwife said that waiting six weeks is common (to give the woman's body time to recover), but that it was fine to try sooner if I felt up to it. It was too short of a time for me. We tried at 6 weeks, but it hurt too much. It was more like 10 weeks for me. My midwife did not explicitly state a preference (before or after), but the impression that I got from her was that I should probably wait until after the 6-week checkup. Even at 10 weeks, it hurt for me. It felt like I had a "strawberry burn" along the whole length of my vaginal canal, even though we were using lubricant. I talked to my midwife about it and she said that we needed to use more lubricant. So, we really slathered it on/in/around, everywhere. This did work. The pain went away. ************************************* My OB's recommended waiting 6 weeks. We usually waited between 3 and 5. ************************************** After the birth of both of my children, my doctor said to wait six weeks (when my follow-up visit was scheduled). My first was a vaginal delivery and six weeks seemed long enough mentally but resumption of sex was quite painful. Going very slowly was the only thing that helped. My second was a C-section and waiting six weeks didn't seem necessary. Of course the second time around there was nopain associated with resuming sex so I was a little more eager to resume. ********************************************* My doctor told me a month after childbirth was ok. It was still VERY painful at that time. She did tell us to wait until after the checkup. The only reccomedation she made was KY Jelly. Not all that helpful really. ******************************************* For both of my births my health-care provider indicated that a "normal" period of waiting would be 6 weeks. She did not require that I wait until my 6 week appt if I was ready. Was it good advise for me? I had a difficult time resuming sex with both children. With the 1st I had a minor epsiotomy. Sex hurt for me for about the first 6 months after having the baby. Lubricants, etc had no effect on making it better. I think for normal births with minimal or no epsiotomy that it's probably a pretty good general recommendation. Actually, having sex BEFORE the 6 week appt and discussing it is a great idea. I didn't try sex with either child until after the 6 week doctor appt and so didn't discuss the associated problems with my doctor. It might have made a difference for me. With the 2nd child I nursed. You may have seen the previous misc.kids thread about the lack sexual interest for some mothers while nursing. That was definately me. I nursed my 2nd until he was 10 months. During that time I had zero interest in sex. 2 weeks after stopping nursing my normal interest in sex returned. This is apparently common in some nursing woman. One woman posted that there are things you could do about that (medically). I saw the posting about this approx 1 month after I stopped nursing, I didn't think to talk with my health-care provided about it. I just thought I was tired and uninterested rather than it being tied to nursing and hormones. ************************************ With #1, my midwife reccommended waiting until after the six week check-up. I suspect this is because she was very conservative, and at the time we were in school (M.I.T.) and she was used to having to be very assertive with her medical opinions. With the second child, my midwife reccommended 2 - 4 weeks. We waited three. Our choice for birth control are condoms because I am breastfeeding. Before intercourse, I always nurse the baby. (Let-down can be painful, and, well, a mood spoiler, during a particularlynice moment!) Also, because nursing dries you out, K-Y jelly is is very helpful. And ofcourse, we went very slow. Because my stiches were in a different place than last time, we had to really take our time to find the position that was most comfortable. We did a lot of touching before hand, which was not only nice, but also helped create a nice numbing effect. ************************************** When we had our first child three years ago, I got a few different answers to this question. My OB never gave me any definite information, mainly because I never asked. (I did NOT want to have to wait 6 weeks, and I figured if he didn't say anything on his own, it was probably up to me to decide.) Our Lamaze instructor told us that we could resume sex whenever we felt comfortable with it, and she also recommended that it be *before* the six-week checkup so that any problems could be cleared up then. The nurses in the hospital (who I assume had the doctor's blessing) also told us that we could resume sex when I felt up to it. As it turned out, we had sex about three or four weeks after the birth, when my episiotomy was healed enough that it wasn't too uncomfortable for me. We did have problems with dryness and a bruised cervix, which I mentioned to the doctor at my six-week checkup. Since he didn't scold me for trying again so early, I assume it didn't bother him. He did tell me just to give things a little more time, and that things would get better on their own. (He's very non-interventionist.) ************************************* I don't think they were very firm about the six weeks, but at the 6-week check-up she was told that she needed more time to heal, and my opinion was the same. >Any tips on easing discomfort? Astroglide! That's the best lubricant there is. :-) ***************************************** We were told by the doctor to try _before_ I went back for the 6 week checkup. i I think we waited about 4 weeks, until the lochia had gone away. I had a big episiotomy, but it was fine. > >Any tips on easing discomfort? KY Jelly, and be gentle! ***************************** The first time he said 6 weeks, the second time he gave no restrictions (the same doctor) First time - 21 days. Second time -- 10 days. No problems. My doctor doesn't do 6-week checkups (very low interventions, etc.) *************************************************** My nurse practitioner said to wait 6 weeks. We waited 3 months. However, our apartment manager's son and his wife must not have "waited" for anything. She had her third baby when her second baby was only 9 months old. *************************************************** My OB advised us to wait until after the 6-week check-up (at which time I was fitted for a diaphragm, BTW). Oh, and I was such a zombie that I don't think I would have even *contemplated* having sex before that 6-week mark anyway :-). **************************************************** Only one kid so far. At two weeks post-partum, my midwife said sex was fine if we felt like it. I don't know whether it matters but there was no episotomy or tearing and she did not do any kind of exam prior to saying this. At later follow-ups, she did ask if we'd tried sex and whether there were problems. (A nice thing about my midwife -- lots of follow-up in those first six weeks which was interested in both me and the baby.) As far as discomfort, the midwife recommended a lubricant (mostly because of the likely dryness side effect from breastfeeding) but we didn't need it. Slow, gentle, easy. An understanding partner. Let mom set the pace. Have the baby in bed with you or very close. (At least for me, the baby starting to fuss would immediately halt my pleasure. Much easier to have the baby nearby and pause a bit to nurse or cuddle and then continue having fun with baby's dad.) ********************************************** With my first child (3.5 hours pushing), the recommendation was "when the lochia has stopped and you feel like it". I had lochia for 7 weeks (very stressful postpartum) and a sore bottom for 6 months. I think we resumed somewhere around 8 weeks and sex was painful for at least 6 months. With #2, same recommendation. I actually felt ready 3 days postpartum, but I think we waited about 2 weeks (the lochia lasted for 10 days that time). No pain at all. My midwife stressed that desire and ability varied a lot from woman to woman and that I should do what felt comfortable for me. > Any tips on easing discomfort? Lots of foreplay. ;-) ******************************************************* I wasn't going to reply, but what the heck. I saw so many posts on how painless sex was after childbirth and how soon people managed it that I wanted to contribute something opposite: My doctor adivsed me to wait 6 weeks, until after my postnatal checkup. Due to fatigue and just a plain hectic schedule, we didn't try until 9 weeks. It was agony! It hurt like h*ll and I began to bleed. Fortunately it stopped fairly soon, but it was scary. Sex is still uncomfortable for me (almost 1.5 years later). I had an episiotomy and a vacuum extraction when my baby was born, and it just feels like that area is not as flexible as it was before birth. I mentioned this to my doctor at my annual exam, and he just shrugged and told me to use some lubrication. I tried to tell him this wasn't the problem, but he never listened to me during my pregnancy, so why should he listen to me after? Needless to say, I will choose a new doctor. It's a pity his partner doesn't have a practice separate from him, because he was really a nice guy. ******************************************************* We were told that it would be okay when major bleeding stopped (about 6 weeks). ******************************************************* It's varied, noone said anything to me with my first, 14 years ago, so Iwaited for my 6 week checkup, assuming this was the thing to do. 10 years ago, with my second,the doctor said "go for it", anytime, but I probably wouldn't feel like it for a couple of weeks. This is the same advice I was given for the last 2 (3 and 6 months) though I wasn't interested for a couple of months withthe last one, severe stitching. They preferred I tried prior to the checkup so they could tick the checkbox as all working :-) All recommended using a lubricant, and gave me lengthy contraception advice. ******************************* My OB recommended waiting two weeks after my oldest was born. We waited two weeks and then made love on the floor of the front hall. With the second, the nurse-midwife recommended waiting two weeks and waited one week. With the third, we didn't ask. We waited three days. >Did your doctor or midwife want you to wait until after they did the 6-week >checkup, or did they prefer that you have sex BEFORE the check-up so that >they could handle any problems you discovered? I figured my preferences in this department were more important than theirs , and after our first, we were both convinced that I wouldn't break. I recall that we took it rather slow and easy. Six weeks? Really? I don't think that I'd have followed a recommendation like that, even the first time. ************************************ The nurses that taught our childbirth class told us to wait 6-8 weeks. They also hinted broadly that some couples don't wait that long. They said to be very gentle, use lubrication and a condom. In addition to the very real, though unlikely, possibility of getting pregnant again, there is a risk of infection. ************************************** My husband I were told to wait 6 weeks after the birth before we had sex again, of course after my two week checkup and all was well -- we didn't wait any longer. A funny thing that happened was that some of my stitches from the episiotomy fel l out onto the bed that night and my husband and I couldn't figure out for a lit tle while what in the heck they were...it was funny, but I guess that you had to be there! ******************************************** I was never told anything, neither in Switzerland nor in Canada (where I had a midwife.) I read somewhere in a book to wait for 6 weeks, but this was too long for me to wait. In this book it also said that you couldn't conceive during six weeks after giving birth. ******************************************** We also received the recommendation for waiting 6 weeks, caveated somewhat with a "when you feel ready". As I recall, with both of ours, we just kinda resumed when my wife felt ready, which was in the about 3 week range. While we're both on the "enthusiastic" side (very), with the epesiotomy to heal, she needed a little more time physically than she wanted emotionally. And taking it easy at first is definitely recommended. ******************************************* I remember being told 6 weeks, sooner if I wanted to, with my first one. I'm awfully glad we didn't wait, because no-one had told me that it might be _extremely_ uncomfortable, which it was. I appeared at my six-week check afraid I had somehow been ruined for life! The doc suggested gentle sex and digital stretching, and yes, I did recover. It's one of those things I make sure to tell first-time moms I know, because I really wish someone had told me!