Your Guide to Sex After a C-Section

Recovering from a C-section and having a new baby at home isn't easy. Having sex may be the last thing on your mind—and that's totally normal. But as your recovery progresses, you may start to wonder when it's safe to engage in sexual activity. Experts weigh in on what you need to about sex after a C-section, when when you can have it, and how it might feel.

C-Section Recovery and How That Impacts Sex

Typically, you will stay in the hospital up to four days after a C-section and recovery will continue for several weeks postpartum.

Like vaginal deliveries, you can expect vaginal bleeding for four to six weeks, and sometimes longer. And it takes about six weeks for the uterus to return to its normal size and for the cervix to close. Typically, sexual activity can safely begin again after the cervix closes. This happens around six weeks, around the same time your incision should heal. This is also the time one can expect their six-week postpartum checkup, which is an ideal time to discuss any concerns with your health care provider, including about sex.

Keep in mind, it’s not unusual to feel discomfort around the incision site for a while longer than six weeks. Numbness, tingling, burning, and sensitivity in the incision area are also possible. Every healing experience is different so it’s important to speak with your health care provider about any concerns you have.

When Can I Start Having Sex After a C-Section?

"After delivery, it's recommended to wait six weeks before resuming vaginal intercourse," says Pamela Promecene, MD, professor and obstetrician with McGovern Medical School at UTHealth/UT Physicians in Houston. Again, this timeline gives your C-section incision time to heal and your cervix time to close and return to normal.

If you had complications during or after delivery, though, you may have to wait for up to eight or 10 weeks for penetrative sex after a C-section. It's important to let all of the tissue heal to prevent further damage. Check with your practitioner before restarting sexual activity so they can advise you on the best course of action.

Resuming sex before you're healed can lead to infection and other complications.

Does Sex Feel the Same After a C-Section?

Once your health care provider gives you the green light to have sex after C-section recovery, your first time could feel different. It may also be painful. A study published in the International Journal of Obstetrics and Gynecology found that C-section delivery is associated with persistent pain during or after sex, a condition known as dyspareunia. The study of more than 1,200 first-time moms found those who had an emergency C-section, vacuum extraction, or elective C-section had double the risk of pain during or after penetrative vaginal sex at 18 months postpartum than those who had vaginal births.

Another study in the British Medical Journal found people who had C-sections reported other sexual challenges post-surgery, including problems with vaginal lubrication, low sexual desire, pain in the vagina, and difficulty reaching orgasm. It is worth noting that most studies on sexual response and changes after both vaginal and C-section births have been done on cisgender birthing people, so future studies will also need to investigate specific challenges to those with other gender and sexual identities and relationships.

Will a C-Section Affect My Sex Drive?

Having a C-section should not affect your sex drive any more than a vaginal delivery, even though many new parents in general don't feel like making love again right when the six weeks are up (and that's totally normal). For one thing, you're probably exhausted from your newborn's round-the-clock schedule. And if you're nursing or pumping, the hormones you release while breastfeeding have also been known to temporarily lower libido, too. Lactation may also result in vaginal dryness and discomfort with sex.

In general, pregnancy, labor, and delivery can certainly impact your sex drive, so don't be afraid to talk to your partner and your health care provider if you do experience any changes that you are concerned about.

What About Anal Sex After a C-Section?

You might think you can work around these guidelines by having anal sex after a C-section, but in actuality, the six-week timeframe might still hold up. That's because the movements of anal sex could still aggravate your incision and pose a risk for infection. As always, check with your health care provider for advice about your specific situation.

Can I Have Non-Penetrative Sex After a C-Section?

External clitoral stimulation may be safer to perform before the common six-week clearance mark, since it's external stimulation only, but most providers do recommend waiting until you've been medically cleared for sexual activity in general, just to be on the safe side. And keep in mind that orgasms can trigger postpartum uterine cramps, which might feel uncomfortable post-birth and especially if you're breastfeeding.

Tips for Better Sex After a C-Section

If you've been cleared for sex and are feeling up to it, these tips may help:

• Use a lubricant. Estrogen levels decrease after delivery, whether vaginally or via C-section. This can impact the vagina by causing thinning, dryness, and inflammation. Lubrication can help to provide relief. You can try a water-based one, which is less likely to cause irritation. Or opt for a silicone-based lubricant with minimal ingredients, which tend to be longer lasting and slicker if needed. You may also want to speak with your health care provider about using a vaginal estrogen cream which can help reduce uncomfortable vaginal symptoms postpartum. 
• Find sex positions that work. After a C-section, you may feel discomfort by your incision area. Experiment with sex positions that feel comfortable and don’t cause any issues for you or your incision. 
• Talk with your partner. It’s important to have open conversations with a partner if you have one. Let them know what feels good and what doesn’t.
• Go easy on yourself. Things may feel different the first time having sex after a C-section, and maybe even for while. You may also not have the same sex drive. It’s all normal. Focus on how you’re feeling and don’t rush into what doesn’t feel right until you’re ready.

Additional reporting by Robin Elise Weiss, PhD, MPH.