57442178Resuming your love life

Preparing for the arrival of your new baby is a busy time, but it gets even busier once your baby has arrived! Given the need to physically recover from pregnancy and the birth, ‘round the clock’ baby care and the associated sleepless nights, it’s not surprising that sex is often the very last thing on many new parents’ minds. When couples choose to resume sexual intercourse is a very individual decision; studies have shown that there doesn’t seem to be much difference whether your baby is born vaginally or by caesarean section. Historically, women have been advised not to have sex until after their six week postnatal check, as this examination makes sure that everything has healed properly and returned to normal – the uterus (womb) takes around six weeks to return to its pre-pregnancy size. However, some couples may resume sexual activity sooner than this, while others may prefer to wait several months or even a year. If your baby was born with the help of forceps or ventouse (vacuum extraction), it can sometimes take longer for the bruising to disappear and healing to take place. In these circumstances, you may find that it delays your resuming sexual intercourse; however, the area around the vagina and perineum (the area of skin between your vagina and anus) has a very rich blood supply, so heals quickly.

On average, most couples will have resumed sexual intercourse by seven or eight weeks following their baby’s birth – you and your partner will know when it feels the right time for you. However, if your partner feels more ready to resume sexual activity than you do, it’s important to talk honestly about how you are feeling. This might include discussing any physical discomforts or concerns about your post birth body image – women often say that they don’t feel sexy anymore. Keeping the lines of communication open is very important; not being interested in sex doesn’t mean that you are ‘rejecting’ your partner; however they may feel that this is the case. Where this is so, it is even more important to find other ways of expressing your feelings for each other and being intimate – for example, through kissing, cuddling, caressing, enjoying a shared bath/shower, or massaging each other.

 

Touched out

For many mums a lack of interest in sex is simply down to feeling totally exhausted. Giving birth is rather like running a marathon with the baby being pushed down the birth canal through a lot of maternal effort; this naturally leaves the soft tissues feeling strained, bruised, sore and swollen. This is particularly the case where mums have torn or needed an episiotomy and stitches (also called ‘sutures’). If breastfeeding, nipples can feel sore and sensitised, and the breasts full and tender in the early days. Frequent feeds (breast or bottle), carrying, cradling and lulling baby to sleep can leave mums feeling that their body no longer belongs to themselves. In these circumstances, physical caresses from their partner might be viewed as just another additional demand on their already over-tired body and it’s not uncommon for women to feel ‘touched out’.

 

Breastfeeding and sex

If you are breastfeeding, the influence of the hormones that support your body’s production of breast milk, can also affect how you feel about sex. While you are breastfeeding there is less oestrogen circulating around your body. You may feel less interested in, and get less satisfaction from, sexual intercourse because it can diminish your libido (sex drive) and can also cause vaginal dryness. However, every mum is different and some women find that breastfeeding doesn’t affect their desire for sexual intimacy; in fact, many women report feeling sexier and very positive about their body image. Nursing mothers may find that they leak milk while aroused; this isn’t a concern, however, if you and your partner find it off-putting you can always breastfeed your baby before intercourse so that your breasts are as empty as they can be. If you develop breastfeeding problems such as cracked or bleeding nipples, mastitis or a breast abscess, you should seek advice from your health professional immediately and ask your partner to leave well alone until you’re more comfortable!

 

Mood changes and sex

Sex can also be affected by specific problems with mood swings after the birth; childbirth involves significant hormonal changes which may take the form of the third day ‘baby blues’ and/or postnatal depression. Similarly, if you had a less than optimal birth experience (a long or difficult labour and/or birth), or there have been concerns about your or your baby’s health, these experiences can leave you feeling anxious, disappointed or vulnerable. Very few mums feel sexy and in the mood for love-making until a long time after the birth.

 

Sex and violence

Research shows that physical violence can begin during pregnancy and/or after childbirth, and if a woman is already a victim of violence, it can become worse. Women being abused can also be at risk of sexual violence and/or forced sex. It is important that you speak to your health professional if you are a victim of domestic violence and/or are concerned for your and your baby’s safety.

 

Will it be the same?

Childbirth definitely affects a couples’ sex life and both partners need to appreciate that it may not go brilliantly well in the first six months following their baby’s birth. Having gone through pregnancy and childbirth, it can take women some time to get used to being touched in a sexual/sensual way again. The important thing is to take things slowly and to only try full penetrative intercourse when both you and your partner feel completely ready.

Tell your partner if you are worried about having sex again. Loving words and caresses can be extremely pleasurable; you could perhaps just focus on foreplay to help you relax, feel aroused and fulfilled. However, performing oral sex on the new mum should be avoided for the first few months post birth. This is because it can introduce infection into the mother’s vagina and uterus; also, possibly air – this air can easily enter the mother’s bloodstream and result in a fatal condition called an ‘air embolism’.

New mums who have had vaginal tears or episiotomy and sutures can experience tenderness or irritation (itching) along the scar line when they have intercourse. Things might feel tighter or looser than before, but this shouldn’t be permanent and you should loosen up/tighten as your sex life gets back on track; using a vaginal lubricant can also help. If there is a particularly tender/sensitised area, you and your partner could try different positions for intercourse that lessen the pressure on that area. If the woman is on top, she is better able to control the depth and rate of penetration; lying side-by-side, facing each other can also be more comfortable. Ensure that you are both feeling relaxed and won’t be interrupted (make love when baby’s sleeping!), take things slowly, and, above all, be patient.

 

Looking after your pelvic floor

Giving birth to your baby vaginally, naturally stretches the soft tissues of the vagina and the perineum, so some muscle tone is often lost. However, if you start doing pelvic floor exercises as soon as possible post birth, you will start to regain your muscle tone. These exercises are also extremely important to strengthen the muscles so that you don’t leak urine when coughing or sneezing (called stress incontinence) and have control when passing wind (flatus) or having your bowels open (a poo). Your midwife, health visitor or GP can give you information about doing pelvic floor and other postnatal exercises.

 

From lovers to mum & dad

Going from being lovers to becoming ‘mum’ and ‘dad’ is a huge period of transition; losing interest in sex after you’ve had your baby is neither abnormal nor permanent. You have nurtured and nourished your baby inside you for the past nine months; giving your body and emotions time to recuperate is important too. Difficulties with sex are not uncommon, so keep talking as a couple. However, if you’re disinterest in sex persists and is a concern for either of you, consider speaking with your health professional. They will have offered help and advice to other couples in your situation and will be sensitive, understanding and discreet.

Remember: If you are not exclusively breastfeeding, you will need to start using some form of contraception before, or by, 21 days following the birth of your baby; this is the timescale for when ovulation can resume and you can become pregnant again.

 

Abdool Z, Thakar R, Sultan AH (2009). Postpartum female sexual function. European Journal of Obstetrics and Gynecology and Reproductive Biology 145(2):133-137.

Barrett G, Pendry E, Peacock J et al (2000). Women’s sexual health after childbirth. BJOG: An International Journal of Obstetrics and Gynaecology 107(2):186-195.

Barrett G, Pendry E, Peacock J et al (1999). Women’s sexuality after childbirth: a pilot study. Archives of Sexual Behavior 28(2):179-191.

Bick D (2009). Postpartum management of the perineum. British Journal of Midwifery 17(9):571-577.

Bick D, MacArthur C, Winter H (2009). Postnatal care. Evidence and guidelines for management. 2nd ed. Edinburgh: Churchill Livingstone. 256 pages.

Brown S (2012). Sex after childbirth. O & G 14(4):22-23.

DeJudicibus MA, McCabe MP (2002). Psychological factors and the sexuality of pregnant and postpartum women. Journal of Sex Research 39(2):94-103.

Ejegard H, Ryding EL, Sjogren B (2008). Sexuality after delivery with episiotomy: a long-term follow-up. Gynecologic and Obstetric Investigation 66(1):1-7.

Elliott SA, Watson JP (1985). Sex during pregnancy and the first postnatal year. Journal of Psychosomatic Research 29(5):541-548.

Fischman SH, Rankin EA, Soeken KL et al (1 986). Changes in sexual relationships in postpartum couples. Journal of Obstetric, Gynecologic, and Neonatal Nursing 15(1):58-63.

Grudzinskas JG, Atkinson L (1984). Sexual function during the puerperium. Archives of Sexual Behavior 13(1):85-91.

Hughes H (2008). Management of postpartum loss of libido. Journal of Family Health Care 18(4):123-125.

Kettle C, Ismail K, O’Mahony F (2005). Dyspareunia following childbirth. Obstetrician and Gynaecologist 7(4):245-249.

Lal M, Pattison HM, Allan TF et al (2011). Does post-caesarean dyspareunia reflect sexual malfunction, pelvic floor and perineal dysfunction? Journal of Obstetrics and Gynaecology 31(7):617-630.

O’Malley D, Smith V (2013). Altered sexual health after childbirth: part 1. The Practising Midwife 16(1):30-32.

O’Malley D, Smith V (2013). Altered sexual health after childbirth: part 2. The Practising Midwife 16(2):27-29.

Rathfisch G, Dikencik BK, Beji NK et al (2010). Effects of perineal trauma on postpartum sexual function. Journal of Advanced Nursing 66(12):2640-2649.

Riley AJ (1989). Sex after childbirth. British Journal of Sexual medicine 16(5):185, 187.

Smith J (1996). Sexuality and sexual problems after childbirth. Modern Midwife 6(10):16-19.

von Sydow K (2002). Sexual enjoyment and orgasm postpartum: sex differences and perceptual accuracy concerning partners’ sexual experience. Journal of Psychosomatic Obstetrics and Gynecology 23(3):147-155.

Williams A, Heron-Marx S, Hicks C et al (2007). The prevalence of enduring postnatal perineal morbidity and its relationship to type of birth and birth risk factors. Midwifery 23(4):392-403.

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