Sexual and reproductive health after having a baby
On this page:
When will my period start again after having a baby?
Can I use breastfeeding or chestfeeding as a form of contraception?
Will formula feeding help my cycle ‘go back to normal’ quicker?
Can I use tampons after giving birth?
What will my first period after birth be like?
What kind of contraception should I use after pregnancy?
Can I start any type of contraception straight away?
Will contraception affect my breastmilk?
Can I use emergency contraception after having a baby?
What if I don’t want any more children?
What if I want to get pregnant again?
When will my period start again after having a baby?
It will be different for everyone, so it’s hard to be exact about when your period may start again.
If you bottle feed your baby (including expressed milk) or combine bottle feeding and breastfeeding, you might start your period again about 5 to 6 weeks after giving birth.
If you fully breastfeed or chestfeed during the day and at night without any bottle feeding or using dummies your period may not start again until after you stop breastfeeding, or begin giving your baby solid foods and formula. This is because the hormone that causes your body to make breastmilk can stop your body making the hormone that controls your periods.
You may be able to get pregnant as little as 3 weeks after the birth of your baby, even if you are breastfeeding and your periods haven't started again yet.
Can I use breastfeeding or chestfeeding as a form of contraception?
Because breastfeeding can temporarily stop ovulation and periods, it can reduce your chances of getting pregnant (fertility). Because of this, some women and birthing people use it as a form of natural contraception. This is known as the Lactational Amenorrhoea Method (LAM).
It's important to start using another form of contraception if
- your baby is more than 6 months old
- you give them anything else apart from breast milk, such as a dummy, formula or solid foods
- your periods start again (even light spotting counts)
- you stop night feeding
- you start to breastfeed less often
- there are longer intervals between feeds, both during the day and at night.
Experts don’t know how expressing breastmilk affects LAM, but it may make it less effective.
NHS has more information about natural family planning.
Will formula feeding help my cycle ‘go back to normal’ quicker?
This is possible, but there are many things that can impact your menstrual cycle. This includes things like stress or having a medical condition such as polycystic ovary syndrome (PCOS).
The World Health Organization (WHO) recommends that all babies are exclusively breastfed for the first 6 months of life. At 6 months, WHO recommends that breastfeeding can continue alongside solid foods until up to 2 years of age or for as long as you and baby want to.
There are benefits to breastfeeding. But there are many reasons why women and birthing people decide not to breastfeed or to stop breastfeeding.
Finding the best way to feed your baby can sometimes be difficult or stressful. Don’t be afraid to ask for help if you need it, because it’s important that you’re happy about how you’re feeding your baby.
Your health visitor is there to help you find the best option for you and your baby.
Can I use tampons after giving birth?
You should not use a tampon (or menstrual cup) until you’ve had your 6-week postnatal check. This is because you still have a wound where the placenta joined with the wall of your womb. Using internal sanitary products before the wound has healed could increase your chance of infection.
After giving birth, most people have some vaginal bleeding known as ‘lochia’. It’s like a first period after birth, but can last from 2 to 6 weeks. It can be heavy at first but usually gets lighter over time.
It’s best to use maternity pads or sanitary towels during this time. Make sure to change the pads or towels regularly.
What will my first period after birth be like?
You periods after the lochia bleeding may be different from how your period was before. Some women and birthing people report noticing changes in their periods after having a baby. You may have:
- irregular periods (especially if your period returns while you're breastfeeding)
- cramping (this may be better or worse than before)
- heavier periods
- small blood clots in your periods.
If you have large blood clots in your period or have much heavier blood loss than you have had before, you should speak to your midwife, health visitor or GP.
There are other things that can affect when your periods start again including:
- stress
- perimenopause
- sudden weight loss
- doing too much exercise
- taking the contraceptive pill
- breastfeeding.
Talk to your health visitor or GP if you have any concerns about your menstrual cycle or what you periods are like.
Sex after having a baby
Having sex may be the last thing on your mind after having a baby. But it can be an important part of your wellbeing and your relationship with a partner, if you have one. Some people find it hard to talk about sex, but you can talk to your health visitor about any questions or concerns you have.
Find out more about sex after pregnancy.
When can I start having sex again after giving birth?
There’s no set rule about when you can have sex after giving birth. Everyone is different and it will depend on what kind of birth you had and how you are recovering.
After giving birth you will likely be tired and you might feel sore. You will also have vaginal bleeding for around 6 weeks after giving birth and you may have other symptoms such as incontinence. These might put you off having sex and it’s important to give your body time to repair itself.
If you have a partner, you both also need to feel emotionally ready to have sex. It might be some time before you want to have sex and do not have sex before you feel physically and emotionally ready.
Will the type of birth I had affect when I can have sex?
If you’ve had a caesarean section, you can start having sex again as soon as you feel recovered. This will be different for everyone. It’s a good idea to do gentle activities such as walking when you are recovering from a caesarean, as this can help reduce the risk of blood clots.
However, it may take some time before you feel ready to do activities such as driving, exercising, and having sex. This could take up to 6 weeks or so.
Find out more about recovering from a c-section.
If you had a vaginal birth, your vagina and surrounding area might feel sore. If you had stitches after tearing or an episiotomy (where the doctor or midwife makes a cut to make the opening of the vagina a bit wider), pain during sex is very common in the first few months.
Whatever type of birth you had, make sure you only start having sex when you feel ready to do so.
Will sex after birth be painful?
It’s common to experience some pain when you start having sex after giving birth. This might be because you are sore. Hormonal changes after birth can also make your vagina feel drier than usual, which can make sex painful.
Over time, it should become less painful. When you are looking to start having sex again, here are some tips that might help:
- Take it gently and don’t rush it. If sex is painful, it won’t be pleasurable.
- If penetration hurts, say so. There are other ways to give each other pleasure or be close without penetration, for example, mutual masturbation. Make time to relax with your partner, if you have one, to try this.
- You could try using a water-based lubricant to help with the pain.
- Talk with your partner about any worries and how you feel about having sex.
- Tell your GP or health visitor if you are experiencing ongoing pain.
Fertility after having a baby
You may be able to get pregnant as little as 3 weeks after the birth of your baby, even if you are breastfeeding or your periods haven't started again yet.
Some women and birthing people feel that they won’t need contraception so soon after having a baby, especially if they have found it difficult to get pregnant before. But your body goes through lots of changes during pregnancy and fertility is complex and hard to fully predict.
Even if you had your baby by IVF it is important to think about which contraception you’d like to use.
If you do not want to get pregnant, you will need to use contraception every time you have sex .
What kind of contraception should I use after pregnancy?
There are lots of different types of contraception to choose from. The kind of contraception you should use after pregnancy will depend on several factors, including if you:
- are hoping to have another baby and when
- are breastfeeding
- know that you do not want any more children
- are comfortable remembering to take something at the same time every day
- have any medical conditions.
You can talk about your options at any time with your health visitor, GP or a doctor or nurse at a contraception or sexual health clinic.
You can also visit Contraception Choices or sexual health charity Brook. Both websites have information designed to help people decide which method of contraception may suit them best.
Remember that condoms are the only contraception that prevent sexually transmitted infections.
Not all methods of contraception are safe for all women and birthing people. For example, you should not use some methods if you have certain medical conditions.
Your doctor or midwife should advise you if there are any types of contraception that you can’t use. However, if you are worried or have any questions, ask your health visitor or GP.
What if I don’t want to or can’t use hormonal contraceptives?
Some contraceptives work by using hormones that are similar to the hormones women and birthing people produce naturally. These hormones are oestrogen and progestogen.
Contraceptives that contain these hormones aren't suitable for some people. For example, contraceptives that contain oestrogen (such as the combined pill, contraceptive patch, and vaginal ring) may not be suitable for people who are over 35 and who smoke, or are obese.
The combined pill containing oestrogen may also not be suitable for you if you have ever had:
- a blood clot or a family member who had a blood clot under the age of 45
- narrowed or blocked arteries, or a previous stroke
- a heart problem, heart disease, or high blood pressure
- breast cancer
- gallbladder or bile duct problems
- liver cancer or severe cirrhosis
- complications due to diabetes
- migraines with aura.
Not all contraceptive methods use hormones. Some work in other ways, including:
- intrauterine device (IUD)
- male condoms or female condoms
- diaphragm or cap.
Can I start any type of contraception straight away?
Once you have given birth, there are some contraceptives you can start straight away and others that you need to wait to use.
Immediately after birth
As long as you have no medical risks, you can have:
- a contraceptive implant
- a contraceptive injection
- the progestogen-only pill
- male or female condoms
- an IUD (intrauterine device, often called the ‘coil’) or an IUS (intrauterine system, often called ‘hormonal coil’)
An IUD or IUS should be fitted within 48 hours of the birth. If you chose not to, you’ll usually be advised to wait until 4 weeks after the birth.
You can start these above types of contraception straight after the birth, including if you’re breastfeeding.
3 weeks after birth
If you're not breastfeeding and you have no medical risk factors for a blood clot in a vein, you can start to use the:
- combined pill
- vaginal ring
- contraceptive patch.
If you're breastfeeding you'll usually be advised to delay using the combined pill, ring or patch until at least 6 weeks after the birth.
4 weeks after birth
If you did not have an IUD or IUS inserted within 48 hours of the birth, you can have one inserted now.
6 weeks after birth
If you're breastfeeding, you can start using the combined pill, vaginal ring, or patch 6 weeks after giving birth.
You can usually start using a diaphragm or cap around 6 weeks after giving birth.
If you used a diaphragm or cap before becoming pregnant, see a GP or a doctor or nurse at a contraception clinic after the birth to make sure it still fits correctly. This is because childbirth and other factors, such as gaining or losing weight, means you might need a different size.
Will contraception affect my breastmilk?
If you’re breastfeeding, it’s generally advised that you wait for 6 weeks after birth before starting some hormonal methods of contraception, like the combined pill. (You can take the progesterone only pill sooner.) This is to reduce risk of blood clots.
There’s also a chance that taking hormonal contraception could affect your milk supply, although there isn’t much evidence to support this. Your doctor will be able to advise you on your best contraception options.
Can I use emergency contraception after having a baby?
If it’s been 21 days or more since the birth, you can use emergency contraception. It’s possible to get pregnant 21 days (3 weeks) after giving birth.
The emergency pill (morning after pill)
You can use the emergency pill from 21 days after giving birth. There are two types: pills with levonorgestrel (brands include Levonelle) and pills with ulipristal acetate (brands include ellaOne).
Levonelle is safe to take while breastfeeding. Although small amounts of the hormones in the pill may pass into your breastmilk, it's not thought to be harmful to your baby.
The safety of ellaOne during breastfeeding isn't confirmed, so levonorgestrel or a copper intrauterine device will likely be offered to you instead of ellaOne. Evidence shows small amounts of the ellaOne pill may get into breastmilk but side effects would not be expected for your baby. As a precaution, the manufacturer recommends that you don't breastfeed for 1 week after taking it. Try to express and throw away your breast milk during that week so you don’t interrupt your flow.
The intrauterine device (IUD or coil)
You can use the IUD as emergency contraception. This can be fitted from 28 days after giving birth, unless it was fitted within 48 hours of birth. The intrauterine device (IUD) is a small, T-shaped plastic and copper device that's put into your womb (uterus) by a doctor or nurse. It releases copper to stop the egg implanting in your womb or being fertilised.
The IUD can be inserted up to 5 days after unprotected sex, or up to 5 days after the earliest time you could have ovulated (released an egg), to prevent pregnancy.
What if I don’t want any more children?
The above kinds of contraception are a reliable way of avoiding unplanned pregnancy, if you use them correctly.
Sterilisation is another option if you are sure that you don’t want any more children.
Female sterilisation involves surgery to block or seal the fallopian tubes to prevent the eggs reaching the sperm and becoming fertilised. Male sterilisation (known as vasectomy) involves surgery to cut or seal the tubes that carry a man’s sperm.
Both female and male sterilisation is more than 99% effective at preventing pregnancy permanently and are available on the NHS. Once you're sterilised it's very difficult to reverse it, so it’s really important to consider your options before making your decision. Sterilisation reversal is not usually available on the NHS.
What if I want to get pregnant again?
You can stop taking or have any kind of contraception taken out at any time you want and your normal fertility (ability to get pregnant) should return.
However, if you use the contraceptive injection, your fertility may not return for up to a year.
Generally, you are advised to wait at least 18 months after giving birth before getting pregnant again. This can help you have a healthier pregnancy and birth, and can also reduce the risk of complications such as an early birth or a very small baby.
Of course, pregnancy isn’t always planned. Or you may want to get pregnant sooner for your own reasons. If you do get pregnant earlier, don’t worry, just make your booking appointment with a midwife as soon as you can. Your midwife will always make sure that you get the best care possible however quickly you get pregnant after giving birth.
World Health Organization (2023) Infant and young child feeding. Available at: https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding
NHS (2022) Missed or late periods. Available at: https://www.nhs.uk/conditions/missed-or-late-periods/ (Accessed 12 December 2024) (Page last reviewed: 05/08/2022. Next review due: 05/08/2025)
NHS (2023) Your post-pregnancy body. Available at: https://www.nhs.uk/conditions/baby/support-and-services/your-post-pregnancy-body/ (Accessed 12 December 2024) (Page last reviewed: 17/01/2023. Next review due: 17/01/2026)
NICE guidelines (2024) Caesarean birth [ng192]. Available at: https://www.nice.org.uk/guidance/ng192/resources/caesarean-birth-pdf-66142078788805
NHS (2023) Recovery - Caesarean section. Available at: https://www.nhs.uk/conditions/caesarean-section/recovery/ (Accessed 12 December 2024) (Page last reviewed: 04/01/2023. Next review due: 04/01/2026)
NHS (2023) Episiotomy and perineal tears. Available at: https://www.nhs.uk/pregnancy/labour-and-birth/what-happens/episiotomy-and-perineal-tears/ (Accessed 12 December 2024) (Page last reviewed: 09/06/2023. Next review due: 06/09/2026
NHS (2024) Who can take the combined pill? Available at: https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/who-can-take-it/ (Accessed 27 March 2024) (Page last reviewed: 15/02/2024. Next review due: 15/02/2027)
Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Contraceptives, Oral, Combined. [Updated 2024 Sep 15]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501295/
NHS (2022) Early days. Available at: https://www.nhs.uk/pregnancy/labour-and-birth/after-the-birth/early-days/ (Accessed 27 March 2024) (Page last reviewed: 08/07/2022. Next review due: 08/07/2025)
Shaaban, OM. et al (2018) ‘Levonorgestrel emergency contraceptive pills use during breastfeeding; effects on infants’ health and development’ J Matern Fetal Neonatal Med, 32(15)
NHS Inform (2022) Emergency contraception. Available at: https://www.nhsinform.scot/healthy-living/contraception/emergency-contraception/ (Accessed 27 March 2024) (Page last reviewed: 30/12/2022
NHS (2024) Female sterilisation. Available at: https://www.nhs.uk/conditions/contraception/female-sterilisation/ (Accessed 27 March 2024) (Page last reviewed: 14/02/2024. Next review due: 14/02/2027)
NHS (2024) Vasectomy. Available at: https://www.nhs.uk/contraception/methods-of-contraception/vasectomy-male-sterilisation/what-is-it/ (Accessed 27 March 2024) (Page last reviewed: 28/02/2024. Next review due: 28/02/2027)
NHS (2024) What is the contraceptive injection? Available at: https://www.nhs.uk/contraception/methods-of-contraception/contraceptive-injection/what-is-it/. (Accessed 12 December 2024). Page last reviewed 8 February 2024. Next review due 8 February 2027.
NHS Inform (2023) Having another baby. Available at: https://www.nhsinform.scot/ready-steady-baby/early-parenthood/your-growing-family/having-another-baby/ (Accessed 27 March 2024) (Page last reviewed: 15/12/2020)