After my second child was born (which was an AWESOME impowering painless birth), I wanted to have sex within HOURS. I mean *really* wanted to have sex. I didn't, actually, I didn't even mention it to DH because I thought he would have decided I was crazy. I also thought that I had to wait the 6 weeks or whatever that you're "supposed" to wait. Is this really necessary?

THE RESPONSES:

• I have read that it is suggested you wait until you stop bleeding because of risk of infection. I don't think it is necessary, but I sure as hell didn't want to!! My child's birth was wonderful, not tramatic in any way, no tearing, but we tried at 6 weeks and it still hurt. At 8 weeks I seemed totally healed.

• Do you think that episiotomies make it even harder? I do and I read in the new Mothering mag that it's probably true. I SWEAR I have NEVER experienced anything so painful as sex after childbirth. I tore with my son's birth though so perhaps it was that I tore. I actually cried the first time we had sex at about 6 weeks after and that is the part of this birth I'm dreading the most. LOL. I'm hopeful it won't be as bad this time.

• Oh yes! Episiotomies often cut through the muscle where a tear would just tear through more superficial tissue. Besides tears heal better than an episiotomy which is a blunt cut. I had a 2nd degree tear and we tried sex 5 weeks later. Used a ton of lube and while it was a bit uncomfortable, I would never say that it actually was painful. I know everyone is different though.

• I'm not sure. I had a cut the first time and a third degree tear the second. Sex after the first child was easy. Sex after the second was painful. Had to use a lot of lubrication because of the breastfeeding. First bowel movement after the first child was horrendous. Easier with second. Kind of funny how they were reversed.

• I had a lot of pain with post-partum sex too. I tore both times (in the same spot, 2nd degree), and sex hurt after the first birth for more than 8 months. It got better when I got my period back -- something my midwife says is not uncommon. After the second it felt better more quickly but it still hurt for 3 months or so. (Still no period this time, though.) But the second time I used comfrey ice packs to help my tear heal, and I felt that it healed up much faster. The birth was not at all traumatic this time, either--home waterbirth.

• I definitely think so! With my first birth I had a tear all the way through to my anus and an episiotomy as well so I am not sure which was to blame but I cried for months because sex hurt so bad. Actually, when we conceived 9 or so months later we laughed because at least we successfully had intercourse. It was really that bad. With my second birth I tore pretty bad but had no episiotmy and sex was PAINLESS after just a couple weeks. Sutures and all, no pain in healing after her birth!

• Despite the conflicting evidence, maybe in your case you should consider perineal massage.

• What is conflicting? You mean before and during birth? We have already talked to my MW about doing that and DH is going to learn from her how to do it for me.

• Before -- some people say it doesn't really help, but from my perspective the actual act of relaxing into it and the deep tissue work - emotionally - did help me.

• How interesting. I felt like it totally helped me also, plus it gave dh a job.

• I am convinced it helped me too the second time.

• I looked this up in the midwife archives. They quote a study that shows that 76% of women who did perineal massage had perineal injury/tearing during childbirth, as compared to 85% of women who did not do the perineal massage. So it does make a difference statistically but it appears to be small. Apparently there is also some controversy among midwives as to whether or not perineal massage actually *increases* the amount of perineal injuries. You can read the whole thing at: http://www.gentlebirth.org/archives/perinealProtection.html. We were going to do it but never got around to it, so I guess we'll see what degree of tearing I have. My midwife does do perineal massage during labor and birth though.

• Was this study in perineal massage during the second stage or before labor? From what i read, the controversy has been about the "moses manouver" ie perenial massage when the head is crowning - it might increase the risk of tears. But I always read that regular perenial massage in the last months is like magic in preventing tears. I'm also wondering whether there was a differnce in the severity of tears between the perenial massage group and the non-perenial massage group.

• I had an episiotomy both times and sex was fine at 6 weeks after both children. The MW's at the birthing center I am going to this time NEVER do epi's so now I am wondering if that is such a good thing. I mean, I have scar tissue now from the two cuts-- and that tears easier and tends not to stretch. Hum????

• Hmmm, I still think I would tear any day over going through another episiotomy, but that's just my experience.

• A tear will heal more easily than a cut.

• That's great to hear. I was *happy* I would not have to go through another epi--- I never heard before this thread that there could even be ANYTHING positive about one compared to tearing (well, except for those rare humongo tears, I guess).

• The thing is most humungo tears are caused by either an episiotomy or the injection of numbing agents into the tissue.

• You know, you may be onto something here. I guess I never thought about this before but when I had the episiotomy with my first birth it was a 3rd degree epi but I also had a...get this....FOURTH DEGREE tear. Yes, open from vagina to anus. Nice huh. So, if you really think about it, they couldn't really have cut me AFTER that tear, cause there was nothing left to cut! And now that I remember back further I will BET they cut me FIRST because they did think I was having a huge baby because I was over 42 weeks (induction, yes, sigh) and here my babe was only 7 and a half pounds. Fuckers. Now I am pissed again. But thanks for reminding me cause I need to know these things...

• I think it's not so much the risk of infection as the risk of a vaginal embolism. Because all the vessels of the vagina are so open, you run a higher risk of pumping an air bubble into the vagina which can actually kill you. This isn't just a scary story - it happened twice in the last couple of years at the major maternity hospital where my SIL practises.

• So does this preclude all forms of sex or just intercourse?

• I think oral sex (cunnilingus) is out for the same reason - you could blow air into the vagina. Masturbation would obviously be OK and there's no way I can see that giving a BJ would risk anything. Matter of fact, I think orgasms from masturbation would probably be a good thing because surely they'd increase the tissue shedding from the uterus.

• Post-partum sex was DREADFUL for me after my first. (I had an episiotomy.) I hurt so badly I couldn't have sex for several months after the birth. All together, I went almost two years without painless sex. After my second, I had gentle intercourse after 7 days PP (no tear or epis). The third, I had a lot of perineal massage, and again was unscathed (not even a skidmark). I had sex two weeks later after that one, with no pain. The epis was the most painful part of my entire first birth. I actually BELIEVED that it was a necessary medical procedure that every womyn had to go through to give birth. Yikes, the ignorance!

• {{{HUGS}}} I know exactly what you mean. It STILL hurst me though not from my second. I can tell it is still from the first because of the location of the pain - right along the lines of the scar tissue on the floor of my vagina. I am so glad you are healing - it does get better over time, huh?

• I didn't wait either! With my baby #2 I couldn't wait either, I was going crazy by the time she was 2 weeks old, crunching ice and tapping my nails and everything. Finally I called the midwife and asked her exactly WHY they have that rule, what it means and do I really have to wait. When she was done laughing at me, she said it was to give the uterus time to get back to normal (Don't contractions do that!). The 6 week thing is simply because that's when your next checkup is and the Doctor wants you to see THEM first, in case you're too stupid to think about birth control and you happen to be interested in it. Also, you can tell if your body is ready by the change in your.... discharge! They don't want anything unsterile being introducedto your body until it's healed. If there's any placenta left behind you could hemmorage and die! (It's a long shot!) After baby #2 which was also VERY empowering, I ended up only waiting 2 weeks and 2 days. This time (baby #3) It was less than 2 weeks. I can't imagine waiting 6 full weeks.

• My midwife checked me for tears after I had my second and said I might want to wait a little while because I did have a few "skidmarks" to which she added, "Of course, it is completely up to you!" A week later at my postpartum check she said "Your skidmarks are fully healed so you can have sex whenever you want, but some womyn prefer to stop bleeding first." I will admit I was truly shocked!! I believed the books and doctors prior to this. Dh and I counted down the days to the magic 6 weeks from delivery day when I had my first. I was DYING to have sex yet I didn't because I "wasn't allowed." With my second I don't even remember the first time but I know it was within 10 days of delivery. I think as with anything else you need to listen to your body, it is the only "EXPERT" you need.

• According to my midwife, the cervical os (opening) closes to infection at 3 weeks postpartum, and the cervix returns to its non-pregnant state by 4 weeks pp.