Sexuality and Contraception After Birth

The strain of childbirth is over. You're in the postpartum period and your body is recovering. The birth injuries are healing and your hormones are adjusting. Nothing is the same anymore. This also applies to sexuality. The baby needs almost all your attention. It needs food, closeness and attention. In this situation, lust and intimacy can easily fall by the wayside. This is perfectly normal. However, most couples eventually find their way back to a fulfilling sex life. There is no one right way to do this. There is also no medical recommendation. The only requirement is that your wounds have healed and you both feel like having sex. What matters is how you feel, whether it takes weeks or months. Talk to your partner about this if you have fears or concerns or are unsure. This is the best way to prevent problems and misunderstandings.

Four weeks after birth, the post-birth vaginal discharge (known as lochia) becomes weaker, the injuries heal, and the vagina feels less sore and irritated. After about six weeks, the lochia stops and most of the scars have healed. Your body did an incredible job during pregnancy and birth. Give your body time to recover. If you have no birth injuries and you and your partner feel like having sex, it is possible to have sex again before the lochia comes to an end. If you are sensitive and careful, there will probably be no pain even with penetration. If there is, address it directly and say what you'd like instead. Your vagina is a little dilated after giving birth. It will tighten up in the weeks after though. Postnatal exercises can help you with that. If you're breastfeeding, your vagina will probably be a little less moist during sex than it was before you got pregnant. The reason for this is the hormone that is released during breastfeeding. Often extensive foreplay and lubricant help. Instead of penetrative intercourse, masturbation or manual or oral sex can be pleasurable alternatives during this time. See what you feel like and try it out with your partner.

Stress, fatigue, physical discomfort and constant proximity to the baby do not tend to promote the desire for sex. This is normal. Don't put any pressure on yourself. Your body, hormones, mood, and relationship have all changed as a result of childbirth. Some people only feel like having sex again a year after giving birth, others after just a few weeks. Both are perfectly fine. Talk to your partner about your thoughts, fears and desires. Spontaneity is harder with a baby, of course. But if you feel like it, consciously make time for each other, whether it's cuddling, talking, or having sex. Your partner may also be insecure and worried that you might be in pain during sex. It's best if you both say what you think, how you feel, and that you listen carefully to each other. This way you can understand each other better and respond to each other's needs. Honesty and humor can help rediscover your sexuality.

During regular breastfeeding, the body releases a hormone that suppresses ovulation. However, you should definitely not rely on it and think that you can't get pregnant now. This is because the amount of the hormone already decreases about four hours after breastfeeding. This makes ovulation possible again. Therefore, many people use contraception again soon after giving birth. A contraceptive pill containing oestrogen is not recommended during breastfeeding because it reduces milk production. A mini pill without oestrogen is more suitable. If you want to use an IUD, you can only do so once your uterus has completely shrunk. You can therefore have it inserted six weeks after birth at the earliest. The same applies to hormonal implants, three-month injections, diaphragms and cervical caps. Natural methods of contraception involving temperature measurement and calendar tracking are even more unreliable than usual in the time right after giving birth. Menstrual cycles are usually irregular for quite a while after childbirth. Many couples therefore use condoms for contraception in the first period after childbirth. It is best to get advice from your gynaecologist and then decide on a suitable contraceptive method.

As with all topics relating to pregnancy, birth and the time after, you can contact the Early Help Network (Netzwerk Frühe Hilfen) with questions about contraception and sexuality. Some of the pregnancy counselling centres in the network can also give you advice on problems in your partnership. Some of these agencies even offer financial assistance for the cost of contraceptives. The consultation is usually free of charge. If you receive Unemployment Benefit II (Arbeitslosengeld II), you can apply to the Jobcenter to have the costs of contraceptives covered. The prerequisite for reimbursement is that they have been prescribed by your gynaecologist. If you are under 22 years old, statutory health insurance will reimburse you for the cost of contraception. Here too it is best to get detailed advice from your gynaecologist beforehand.