Sex C
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Sex C
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Brian Levine, MD, MS, FACOG, is board-certified in obstetrics-gynecology, as well as reproductive endocrinology and infertility (REI). He is the director and founding partner of CCRM New York and was named a rising star by Super Doctors from 2017 to 2019.
When can you have sex after a C-section? Usually, at about six weeks postpartum. 1 The timeline is the same as if you had a vaginal birth. It's a common misunderstanding that giving birth by cesarean section means you can have sex right away. That's not the case, because your body needs time to recover.
After a C-section , it's usually safe to have sex once your incision is healing well and your postpartum bleeding has stopped. This is typically about six weeks after delivery. Many people will have a check-up with their healthcare provider at this time; it's a good opportunity to discuss how you are feeling and whether it's OK to have sex again.
Some people believe that if they have a surgical birth, they won't have postpartum vaginal bleeding. However, postpartum bleeding comes from inside the uterus, at the site where the placenta was located. It's not caused by delivering vaginally. So everyone has postpartum bleeding, regardless of how they gave birth.
It takes about six weeks for the inside of the uterus to heal and for the cervix to fully close, regardless of type of delivery. This is why it's important to avoid intercourse and tampons during this time. 1
Even once you get the go-ahead for sex from your doctor or midwife, you may not always feel ready. Take your time, and take steps to make sex a more comfortable experience for your post-C-section, postpartum body.
Partner-on-top positions like the missionary position may put too much pressure on your incision, especially if it's still tender. You may wish to use a position where you are on top, or a side or rear entry position, to avoid direct contact with your incision.
While the incision should heal around the six-week mark in most people, it may still be sensitive to pressure. You may also feel some numbness or tingling around the incision site. This is normal. However, report pain (especially if it is new or severe) to your practitioner immediately.
You may find that vaginal lubricants help make post-cesarean sex more pleasant. Most people have some issues with lubrication after giving birth, particularly if they are breastfeeding or taking hormonal birth control. This happens regardless of how you gave birth.
In addition to store-bought lubrication, remember that foreplay can help increase the amount of lubrication that your body naturally makes. Incorporate lots of hugging, kissing, massage, and more.
While time is a precious commodity when you have a new baby, encourage intimacy with your partner throughout the day. This can include holding hands when you take a walk, playing footsies at dinner, or snuggling on the couch while you feed the baby and watch television.
These small acts of affection help boost feelings of love and support, They can also help increase lubrication and make sex more appealing and comfortable.
If you are breastfeeding , your breasts may also leak during foreplay and sex. This is normal and will not affect your milk supply. It's just a normal thing that happens.
Some people prefer to wear a bra and breast pads if they tend to leak a lot. This can also happen if you are not breastfeeding but is more common in people who are actively nursing a baby.
Having a baby does not protect you from getting pregnant. This is still true if you have a c-section. Even if you haven't yet had your period, you can still ovulate. This is why birth control is very important.
At your postpartum visit, talk to your practitioner about the best form of birth control. Even if you want another child again soon, it's safest to wait six to 18 months between pregnancies. 2
Remember that time and patience are great cures for sexual discomfort post-cesarean and post-baby. You might have a few awkward encounters, but a sense of humor will really help with most of what you experience. If you have issues that seem to be beyond the typical time frame, or pain or bleeding that doesn't seem normal, be sure to see your doctor or midwife for advice.
Alum AC, Kizza IB, Osingada CP, Katende G, Kaye DK. Factors associated with early resumption of sexual intercourse among postnatal women in Uganda . Reprod Health . 2015;12:107. doi:10.1186/s12978-015-0089-5
Obstetric Care Consensus No. 8: Interpregnancy care . Obstet Gynecol . 2019;133(1):e51-e72. doi:10.1097/AOG.0000000000003025
Amiri FN, Omidvar S, Bakhtiari A, Hajiahmadi M. Female sexual outcomes in primiparous women after vaginal delivery and cesarean section . Afr Health Sci . 2017;17(3):623-631. doi:10.4314/ahs.v17i3.4
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While the risk of transmitting the hepatitis C virus through sex is low, some sexual activities do increase the risk. Here's what to know to stay safe.
If you or your partner has been diagnosed with hepatitis C , you don’t have to swear off sex. Hepatitis C is spread through blood-to-blood contact, and although certain sexual behaviors may increase the risk of hepatitis C, the virus is only rarely spread through sexual transmission.
That doesn’t mean you should throw caution to the wind: Although treatable, hepatitis C is a serious illness that can harm the liver and lead to cirrhosis , liver failure, liver cancer, and other health complications. What’s more, it usually doesn’t cause symptoms and can go undetected for years — even decades.
“The risk [of transmission] comes down to whether sex results in mucosal tears in body tissues, such as to the vagina or the rectum,” says Andrew H. Talal, MD, MPH , a hepatologist and professor in the department of medicine at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences, part of The State University of New York.
Even the smallest tear in the skin or tissue gives the hepatitis C virus a way to travel from one body and enter the other. “You need to always think about blood being exchanged; that’s where you need to be careful,” Dr. Talal adds.
It’s rare for the hepatitis C virus to be transmitted through vaginal intercourse. Unless the vagina isn’t lubricated or intercourse is very rough and leads to tears in the vaginal walls, there’s no opportunity for blood to be exchanged. The risk of transmission with vaginal intercourse is about 1 in 190,000, according to research published in the journal Hepatology .
The U.S. Department of Veteran Affairs , which is the largest care provider for people with hepatitis C , says if one partner in a monogamous, heterosexual relationship has hepatitis C, the risk of transmission is very low, but they do recommend that the other partner get tested. Concerned couples can also discuss using a condom to lower the already very low risk of spreading the virus, says Talal.
Just how safe sex is when a partner has hepatitis C hinges on other factors as well. For example, it’s important to use a new condom with each sexual act that has the potential to expose the uninfected partner to the infected person’s blood, even if you’re in a committed relationship, says the Centers for Disease Control and Prevention (CDC). Some of these situations include sex when one partner:
Keep in mind that if you have more than one sex partner, the CDC recommends always using a male latex condom. (This is especially true if you’ve been diagnosed with HIV .) If you have multiple partners, the odds increase that you’ll either infect others or become infected yourself.
Oral sex does not pose an increased risk of transmitting the hepatitis C virus unless there are open sores or cuts in the mouth, according to the American Liver Foundation . To be safe, though, the CDC recommends using a latex (or, if you’re allergic to latex, polyurethane) condom whenever you have oral sex to reduce the risk of transmitting hepatitis and STIs.
Anal sex is high risk, because rectal tissue is fragile and can easily tear when manipulated or pushed to expand. If the tissue tears and bleeds, there’s a chance for blood-to-blood contact. For this reason, it’s best to always use a condom during anal sex. It’s also important to liberally apply water- or silicone-based lubricant to keep anal tissue and condoms from tearing.
If you use sex toys, it may be safest to avoid sharing them. If you’re engaging in rough sex that results in skin tears, even tiny traces of infected blood that remain on a toy can pass through openings in the skin, although the risk of spreading bloodborne diseases remains very low. What’s more, the human papilloma virus ( HPV ) has been transmitted via sex toys , even after cleaning.
If you have chronic hepatitis C, you can lower your odds of spreading the virus by seeking medical treatment . Direct-acting antiviral medications can cure more than 90 percent of hepatitis C cases with eight to 12 weeks of treatment, according to the CDC . These newer hepatitis C treatments are not only effective but also generally have fewer, much less severe side effects than previous drugs.
Just be aware that during treatment, transmission can still occur. And a cure doesn’t grant you protection against the virus for life. “If you continue to engage in high-risk behavior, you can get reinfected,” warns Kenneth Sherman, MD, PhD , a professor of medicine and the director of the division of digestive diseases at the University of Cincinnati College of Medicine.
If you aren’t sure whether you have hepatitis C, get tested . Testing is especially important if you are having sex with more than one person or if you have other risk factors for hepatitis C , including having had a blood transfusion prior to 1992 or injecting drugs (even if you’ve only done it once).
Talk to your partner about getting tested as well, for hepatitis C and other STIs, so you know the risks before having sex. “People who are at risk for hepatitis C are also at risk for HIV and other STIs,” notes Talal.
Rule number one for a healthy sexual relationship: Be open and honest. “I believe in transparency,” says Talal. This conversation can be difficult, but it’s important to have. Part of discussing your status is talking about what exposure you may have had to hepatitis C, even in the distant past.
It’s a good opportunity for you to share both your sexual history and your past experiences with other ways the virus can be transmitted, such as injecting drugs or being exposed to items that may have infected blood on them, including needles, razors, and toothbrushes.
Dr. Sherman explains that even if you consistently use condoms during sex, other activities, such as sharing needles or straws to inject or snort drugs, increase your risk of spreading (or getting) hepatitis C. “People do not want to hear about this,” he says. “It’s difficult to get the word out about risk.”
If you and your partner find that hepatitis C is disrupting your relationship or sex life, you might also want to consider working with a marriage and family therapist or sex therapist .
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Chromosome Analysis . This can be done on fetal cells obtained by amniocentesis or chorionic villus sampling , on lymphocytes from a blood sample, on skin cells from a biopsy, or on cells from products of conception such as an aborted fetus. The cells are then cultured in the laboratory until they divide. Cell division is arrested in mid-metaphase by the drug Colcemid. The chromosomes can be stained by one of several techniques that produce a distinct pattern of light and dark bands along the chromosomes, and each chromosome can be recognized by its size and banding pattern. The chromosomal characteristics of an individual are referred to as the karyotype . It is also possible to make a photomicrograph of a cell nucleus, cut it apart, and rearrange it so that the individual chromosomes are in order and labeled. The autosomes are numbered 1–22, roughly in order of decreasing length. The sex chromosomes are labeled X and Y. Karyotyping is useful in determining the presence of chromosome defects. Before the chromosomes could be precisely identified they were placed in seven groups: A (chromosomes 1–3), B (4–5), C (6–12 and X), D (13–15), E (16–18), F (19–20), and G (21–22 and Y).
Chromosomal Abnormalities . The prevalence of chromosomal disorders cannot be fully and accurately determined because many of these disorders do not permit full embryonic and fetal development and therefore end in spontaneous abortion. About one in every 100 newborn infants do, however, have a gross demonstrable chromosomal abnormality. A large majority of cytogenetic abnormalities can be identified by cytogenetic analysis either before birth, by means of chorionic villus sampling or amniocentesis , or after birth. Cytogenetic disorders with visible chromosomal abnormalities are evidenced by either an abnormal number of chromosomes or some alteration in the structure of one or more chromosomes. In the language of the geneticist, trisomy refers to the presence of an additional chromosome that is homologous with one of the existing pairs so that that particular chromosome is present in triplicate. An example of this type of disorder is a form of down syndrome ( trisomy 21 ). Another example is patau's syndrome ( trisomy 13 ), which produces severe anatomical malformations and profound mental retardation. The term monosomy refers to the absence of one of a pair of homologous chromosomes. Monosomy involving an autosome usually results in the loss of too much genetic information to permit sufficient fetal development for a live birth. Either trisomy or monosomy involving the sex chromosomes yields relatively mild abnormalities. A condition known as mosaicism results from an error in the distribution of chromosomes between daughter cells during an early embryonic cell division, producing two and sometimes three populations of cells with different chromosome numbers in the same individual. Mosaicism involving the sex chromosomes is not uncommon. Other abnormal structural changes in the chromosome are consequences of some kind of chromosomal breakage, with either the loss or rearrangement of genetic material. translocation involves the transfer of a segment of one chromosome to another. inversion refers to a change in the sequence of genes along the chromosome, which occurs when there are two breaks in a chro
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