If you think your love life won't be affected by the arrival of your little bundle of joy, think again. Not only will having a baby affect the way you interact with each other (and most likely send one or both of you for regular trips on the emotional roller coaster of parenthood), there are also physical realities that affect your sex life.
To find out what to expect medically in the postpartum months, we talked to Dr. Kate Abello, an obstetrician/gynecologist practicing at Mercy Medical Center in Baltimore, Md.
Q: How long after having a baby should you wait to have sex?
A: It depends on the degree of laceration [to the vagina]. If there are no tears, then we usually say two weeks. If there is a first- or second-degree tear, then we say to wait three weeks and for worse tears, we say four to six weeks. For someone who had a C-section, I'd say three to four weeks.
Q: What is the reason for waiting?
A: Just to allow the uterus and the vagina to heal. You don't want to worsen any tears and you want to avoid infection.
Q: Are women usually ready for sex two weeks after giving birth?
A: Some people are ready. Most people are not. I would say a lot of people try to wait more than six weeks, too, just because they are so tired or so sore.
Q: Does breastfeeding affect a woman's ability or desire to have sex?
A: Yes, it definitely makes the vagina drier, so they need to use a lubricant. A lot of women don't realize that. Also, because they have so much contact with the baby, they don't need as much contact with their partner. Plus, your breasts are probably sore, so you don't want anyone to touch them.
Q: What type of birth control can women take if they're breastfeeding?
A: Anything that doesn't have estrogen in it. So there is the mini-pill. There is the Depo-Provera shot or an IUD or any kind of barrier method such as a condom or diaphragm. I don't recommend one over the other - whatever they are most comfortable using is fine.
Q: Can you get pregnant while breastfeeding?
A: You definitely can. In theory, if you are exclusively breastfeeding, i.e. on demand, not pumping, not on any schedule and not using any formula, you should not ovulate. That's probably pretty safe for three or four months. But we do recommend that women get on birth control even if they are breastfeeding, just to be on the safe side.
Q: Have you had patients who got pregnant while breastfeeding?
A: Occasionally. Honestly, we don't have that many people who breastfeed exclusively. Most people supplement a little bit or pump.
Q: When is it safe to get pregnant again?
A: I recommend waiting nine months and continuing to take your vitamins during that time. It's the same whether you gave birth vaginally or had a C-section.
Q: Can you continue to breastfeed while you're pregnant?
A: You can continue to breastfeed but it's very important to take vitamins because it's a real strain on your body. And you need to eat healthy and get a lot of liquids. Usually what happens is that after time, the breastmilk will change and the baby will wean himself. But that's not usually until at least halfway through the pregnancy.
Dr. Kate Abello is an obstetrician/gynecologist practicing at Theresa Hoffman and Associates, Mercy Medical Center, Baltimore, Md.