Pregnancy loss is one of the most emotional and physical ordeals that a woman can endure. “The psychological impact of a miscarriage can be detrimental for some people. It can have a mental and emotional impact, varying in duration from one person to the next,” Dr. Janette Nesheiwat, a family and emergency doctor and the medical director at CityMD, tells Scary Mommy. “It can cause anxiety and depression, which needs to be addressed. That’s why it’s important to have a primary care doctor to help you through the process.”
It’s also why it’s not uncommon that sex is a touchy subject for women who have gone through miscarriage or a dilation and curettage (D&C). Some women might question their fertility after such an experience while others might be scared of having sex because it could lead to another loss, while others might be wondering when, or if, it will be safe to be intimate with their partners again. It’s a loaded subject with tons of questions. If you’ve recently suffered a miscarriage and have questions about sex, you can learn more from our expert, ahead.
What is a miscarriage? What is a D&C?
“Miscarriage occurs when there’s a loss of pregnancy, usually before 20 [to] 24 weeks of pregnancy,” says Nesheiwat. “Sometimes there can be abdominal pain; Usually, vaginal bleeding occurs. Also, low blood pressure from bleeding can occur, which can be the result of genetics, chromosomal factors, or an ectopic pregnancy.” Miscarriages are common. According to Nesheiwat, about 30 percent of all pregnancies end up in miscarriage, and there is vaginal bleeding associated with it. “Medical or surgical intervention is sometimes needed when the pregnancy is no longer viable.”
A D&C, says Nesheiwat, stands for “dilation and curettage to remove any placenta remnants or fetal tissue out of the uterus after a miscarriage.”
When can you have sex after a miscarriage and D&C?
Sex after miscarriage depends on the individual as well as the couple, and there are both physical and emotional factors to consider.
Physically speaking, Nesheiwat says that “after bleeding resolves and the miscarriage is completed, which is usually about two weeks, it’s safe to engage in sexual activity.” According to the International Society of Sexual Medicine (ISSM), after a miscarriage, the uterus and cervix stay partially dilated, which makes these organs more prone to infection until they completely heal. Which is why women are advised not to insert anything into their vaginas, including tampons, until they have completely healed, and all fetal tissue has been removed. The ISSM also advises for a woman to have a thorough pelvic exam before having sex again.
Dealing with the emotional side-affects of pregnancy loss are not as black and white, so sex after a miscarriage is dependent on the woman and couple. It’s normal for grief, depression, and anxiety to set in for either or both partners, which might result in a low sex drive and arousal. The ISSM recommends keeping the lines of communication open between you and your partner; support is key. Counseling might be another option.
Can you have unprotected sex after a miscarriage?
It depends on your situation. If you’re not looking to get pregnant or if you’re not in a monogamous relationship, you should definitely be on some type of birth control and practice safe sex to avoid STDs, says Nesheiwat. “STDs such as chlamydia and gonorrhea can cause scarring of the fallopian tubes and may result in complications with future pregnancies.”
If you’re in a relationship and hoping to conceive, Nesheiwat says fertility should not be affected after a miscarriage. According to the Mayo Clinic, if you’ve had one miscarriage, there might not be any need to wait to conceive and that most women who miscarry go on to have healthy pregnancies after miscarriage. So, basically, you can definitely get pregnant again if you have unprotected sex after a miscarriage.
However, says Nesheiwat, “if surgical intervention is required due to heavy bleeding such as a D&C, or if too much of the uterine tissue was removed, it can potentially make it more difficult to become pregnant.” Speak to your OB-GYN about any questions or concerns you might have specific to your health.
How soon can you get pregnant after a miscarriage?
According to Healthline, ovulation can happen as early as two weeks after the loss of a pregnancy with most women returning to their normal menstrual cycles four to six weeks following a miscarriage. If your health is in check and you’re emotionally ready for it, then it’s likely you can get pregnant any time after a miscarriage. While there’s been some back and forth within the medical community about when is the best time to conceive after miscarriage (the WHO recommends six months while the American College of Obstetrics and Gynecology doesn’t recommend waiting), its said that waiting at least one full menstrual cycle is advisable.
Does sex hurt after a miscarriage?
The short answer is: No. “Sexual activity after a miscarriage should not be painful,” says Nesheiwat. “If surgical intervention is required, your surgeon may want you to abstain from sexual activity for longer than 2 to 3 weeks, depending on the type of miscarriage and the gestational period of when the miscarriage occurred.” If you are experiencing pain after sex, then it’s wise to see your local health practitioner.
No matter when you decide to have sex after miscarriage, Nesheiwat says it’s crucial to make your health a top priority. “It is very important to have routine physicals,” she says. “Make sure you’re up-to-date with your Pap smears, which checks for cervical cancer, and to practice safe sex when applicable.”
But most importantly, go at your own pace and listen to your body at every step of the way.