Sex, contraception and your postnatal check: what to ask your doctor

"So, have you thought about contraception?" It can feel like a strange question when you are sitting in the doctor's surgery with a six-week-old baby, a sore body and very little interest in anything except sleep. Yet it is one of the most useful conversations you can have after birth. This Q&A covers what many mums wonder about but feel shy asking. It is general information, not medical advice, so please talk it through with your own midwife, doctor or clinic.

When can we have sex again after birth?

There is no fixed date. Many couples wait until bleeding has stopped and any tear, stitches or caesarean wound has healed, and until the mum feels physically and emotionally ready. For some that is a few weeks, for others many months. Both are normal. If you are unsure whether you have healed, ask at your postnatal check.

Why does it feel so different?

Several things can affect sex after birth:

• Dryness. Hormone changes, especially while breastfeeding, can make the vagina drier. A water-based lubricant can help.
• Tenderness. Scar tissue from a tear or episiotomy can feel tight at first.
• Tiredness and touch overload. After a day of holding, feeding and soothing a baby, many mums feel "touched out".
• Body confidence. Feeling unsure about your changed body is very common.
• Fear. After a difficult birth, some women feel anxious about pain or another pregnancy.

Go slowly. Kissing, cuddling and closeness without pressure are good places to start again. If sex is painful, keeps hurting, or you notice bleeding, tell your doctor. Ongoing pain is not something you have to put up with, and it can often be helped, sometimes with a referral to a pelvic health physiotherapist.

Can I get pregnant before my period comes back?

Yes. You can ovulate before your first period after birth, so it is possible to become pregnant again before you realise your fertility has returned. This surprises many couples.

Is breastfeeding a reliable contraceptive?

Breastfeeding can delay the return of fertility for some women, but on its own it is not a reliable method for everyone. It is only considered effective under specific conditions, which change as your baby grows and starts sleeping longer or eating solids. If you are relying on breastfeeding, ask your doctor or clinic to explain exactly when it can and cannot be trusted.

What options are there?

There are many types of contraception, including hormonal and non-hormonal methods, short-acting and long-acting options, and natural family planning. Some are suitable while breastfeeding and some are better avoided in the early weeks. Your doctor or clinic can explain which options fit your health, your birth, how you are feeding your baby and your plans for the future.

What if our faith shapes our choices?

Christians hold a range of convictions about family planning. That is a conversation for you and your husband or partner, and perhaps a trusted church leader, rather than for a blog. What matters is that you are honest with your doctor about your values, so they can give you information that fits. A good clinician will respect your convictions and still make sure you have the facts.

Questions to take to your appointment

1. Have I healed well enough for sex?
2. When could I become fertile again, given how I am feeding my baby?
3. Which contraception options suit me now, and which should I avoid while breastfeeding?
4. What should I do if sex is painful or I have bleeding afterwards?
5. Is there a recommended gap before another pregnancy, given my birth?

Write them in your phone and show the screen if saying them out loud feels awkward. Doctors and nurses have these conversations every day.

Talking with your husband or partner

Many couples find it hard to talk about sex after a baby. Try to be honest and kind: "I love you and I want to be close. My body still feels sore, and I am nervous. Can we take it slowly?" It helps when both of you remember that intimacy is wider than sex. Holding hands, praying together, a long hug and a shared joke all keep you connected.

Paul's description of love is a good guide here: "Charity suffereth long, and is kind; charity envieth not; charity vaunteth not itself, is not puffed up" (1 Corinthians 13:4). Patience and kindness, on both sides, make room for healing.

If you feel pressured, frightened or unsafe in your relationship, please speak to your doctor, midwife or health visitor. You have the right to say no, and help is available.

A prayer for closeness

Lord, You designed love and intimacy. Help us be patient and kind with each other as my body heals. Give us honest words, wise decisions and a closeness that grows deeper in this new season. Amen.