Generally, you should refrain from intercourse until after the bleeding has stopped for a few days and you feel more comfortable. This time is needed to allow for tissue healing and to prevent infection. It may take longer depending on your own recovery and if you have had stitches, a caesarean, or a tubal ligation. (A tubal ligation is a form of sterilization in which a small segment of the fallopian tubes is surgically blocked to prevent future pregnancies.) Check with your health care provider for his/her recommendations.

Remember to use some form of contraception if you are not planning another pregnancy right away.

Physical Changes
If you are breastfeeding, it is common for the vagina to be drier and extra lubrication such as KY Jelly™ or Astro-Glide™ (available at many local pharmacies) may be needed. Initially, even if you are bottle-feeding, lubrication and some discomfort may be a problem.

As a new mother, your body will function differently after giving birth. If nursing, your breasts may be tender, full and may leak at any time. As stated above, the vagina does not lubricate upon arousal as readily as before, which may make the first attempts at intercourse somewhat uncomfortable.

Emotional Adjustments
Adjusting to a new baby can leave new parents drained and interest in sex can vary with the amount of rest you get. Especially in the first few months, there may be little energy left for sex. Consider making love in the morning or in the afternoon when the baby is fed and napping. Do not be surprised if your first attempts are interrupted by the baby!

A baby affects all realms of a couple's life. There is frequently little or no time together. Both of you suffer from a loss of sleep and face a new challenge in your early efforts to understand how to meet your child's needs. The attempt at being super parent and partner may leave you both exhausted and subject to postpartum depression. Try to have patience with each other and yourselves. Open communication is perhaps the single most important factor in a satisfying life together, of which sex is only one part.

Considerations
• Some discomfort is normal the first few times you have intercourse.

• Gentle foreplay and the introduction of lubrication before intercourse may be helpful.

• If there is pain during intercourse, find other ways of satisfying your partner until later.

• If you have had an episiotomy, check your perineum with a hand mirror as soon as possible; your imagination is usually worse than the reality.

• At the time, it is hard to believe these sexual changes are temporary, but as you become more comfortable as parents, you will become more comfortable as partners.

• Check with your health care provider for any special recommendations.

Contraception
Breastfeeding is not a reliable method of contraception. Even though you may not have a period, you may ovulate. Since the time of first ovulation after childbirth varies from woman to woman, it is important to use contraception as soon as sexual intercourse is resumed. A full discussion of birth control will be provided by your health care provider at your six to eight week postpartum visit, so come to this visit prepared with your questions and concerns.

Common Methods of Birth Control

Cervical Cap
A cervical cap is a thimble-shaped rubber cap which covers thecervix like a mini-diaphragm. It can be worn for up to 48 hours. Spermicidal jelly is used only initially, at insertion. One disadvantage is that the cervical cap may be difficult to insert and remove.

Male Condom
A male condom is a thin sheath which is worn by the male partner. The condom collects the semen and prevents it from entering the vagina. The risk of pregnancy is less if the woman also uses a contraceptive cream, jelly or foam.

A latex condom is the only form of contraception effective against sexually transmitted diseases included HIV (AIDS virus).

Female Condom
The female condom is a soft, loose-fitting sheath with two flexible rings which can be inserted as many as eight hours before intercourse. As with the male condom, spermicidal cream, jelly or foam should be used to increase the effectiveness.

Depo Provera
Depo Provera is a hormone (progestin) which is given as an injection to inhibit ovulation. Protection is provided for three months. Ask your health care provider regarding use during breastfeeding and possible side effects.

Diaphragm
A diaphragm is a strong, flexible rubber shield which fits over the cervix. It is only effective if lubricated with a contraceptive jelly or cream. You will need to be re-fitted at your postpartum check-up, as well as at any time you experience a weight loss or gain of 10 or more pounds.

Intrauterine Device (IUD)
An IUD is a small flexible piece of plastic which is inserted into the uterus by a physician. After insertion, the IUD is left in place for up to 10 years. The doctor can remove the IUD if pregnancy is desired. It is believed that the IUD prevents the egg from implanting in the uterus.

Oral Contraceptives
The most effective method of birth control (besides sterilization) is the contraceptive pill. It contains synthetic hormones similar to those produced by a woman's body each month. These hormones prevent the monthly release of the woman's egg. Some forms of oral contraceptives are not recommended for use during breastfeeding whereas others are considered appropriate. Some women notice their milk supply decreases when they take birth control pills. The type of pill and dosage is determined by your health care provider.

Be sure to talk with your health care provider before resuming any oral contraceptives. If you are breastfeeding, they may not be recommended.

Oral contraceptives are used sometimes as “morning after pills.” Consult your health care provider for more specific information.

Norplant™
Norplant is a set of matchstick-sized hormonal implants which are placed in the woman's forearm. Protection is provided for approximately five years. Ask your health care provider for specific information regarding insertion, removal and side effects.

Spermicidal Foams, Creams and Jellies
The chemical found in vaginal foams, creams and jellies kills sperm and prevents it from entering the uterus. These products can be purchased without a prescription.

NOTE: When inserting the applicator of spermicide, take care to insert it as deeply as possible into the vagina so that the cervix is completely covered with the foam, jelly or cream.

Sterilization
Sterilization is a permanent method of birth control. For a man, a vasectomy is performed — the tubes that transport sperm from the testes are surgically blocked. This procedure is usually done in the doctor's office. For a woman, tubal ligation is performed — the fallopian tubes are surgically blocked to prevent the egg and sperm from meeting. This procedure is performed in an operating room. Contact your health care provider for more information about these procedures.