Postpartum Intercourse: Pain and Bleeding After C-Section

Postpartum sexual intercourse

Dear Doctor, I had a cesarean section on August 28, and my lochia continued until October 11, when it almost stopped.
On October 12, my husband and I attempted intercourse, and it was very painful.
Afterwards, I experienced slight bleeding, and the next day I had some bleeding and mild abdominal discomfort.
Is this normal?

Elly, 20~29 year old female. Ask Date: 2015/10/13

Dr. Lin Wenbin reply Obstetrics and Gynecology

When starting to engage in sexual intercourse, it is important to take it slowly, as the position and structure of the reproductive organs may have changed.
Whether this is normal can only be determined through a clinical examination.

Reply Date: 2015/10/13

More Info

After a cesarean section (C-section), it is not uncommon for women to experience pain and bleeding during the postpartum period, especially when resuming sexual intercourse. Your experience of pain and light bleeding following intercourse is something that many women encounter, but it is essential to understand the underlying reasons and when to seek medical advice.

Firstly, after a C-section, the body undergoes significant changes as it heals from surgery and adjusts to the postpartum state. The uterus, which has been stretched during pregnancy, needs time to contract back to its pre-pregnancy size. This process can take several weeks, and during this time, you may experience lochia, which is the vaginal discharge that consists of blood, mucus, and uterine tissue. It is normal for lochia to last several weeks, and it can change in color and consistency over time.

In your case, since you had your C-section on August 28 and experienced lochia until October 11, it is reasonable to expect some residual bleeding after engaging in sexual intercourse on October 12. The pain you felt could be attributed to several factors:
1. Healing Process: The incision from the C-section and the surrounding tissues are still healing. Engaging in intercourse can put pressure on these areas, leading to discomfort or pain.

2. Uterine Contractions: After intercourse, the uterus may contract, which can cause cramping or a feeling of heaviness in the abdomen. This is a normal response as the uterus continues to shrink.

3. Hormonal Changes: Postpartum hormonal fluctuations can affect vaginal lubrication and elasticity, potentially leading to discomfort during intercourse. If you are experiencing dryness, this can contribute to pain.

4. Infection or Complications: While some bleeding and discomfort can be normal, it is crucial to monitor for signs of infection or complications. Symptoms such as fever, foul-smelling discharge, or severe pain should prompt immediate medical attention.

Given that you experienced light bleeding and abdominal discomfort after intercourse, it is advisable to take a few precautions:
- Rest and Recovery: Allow your body more time to heal before resuming sexual activity. It is generally recommended to wait at least six weeks after a C-section before having intercourse, but this can vary based on individual recovery.

- Consult Your Healthcare Provider: If the pain persists, or if you notice an increase in bleeding, it is essential to consult your healthcare provider. They can assess whether your symptoms are within the normal range or if further evaluation is needed.

- Consider Lubrication: If vaginal dryness is an issue, using a water-based lubricant can help reduce discomfort during intercourse.

In conclusion, while some pain and light bleeding after resuming sexual intercourse post-C-section can be normal, it is essential to listen to your body and seek medical advice if you have concerns. Your healthcare provider can provide personalized guidance based on your recovery and overall health. Remember, every woman's postpartum journey is unique, and prioritizing your well-being is crucial during this time.

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