Guest Post: Sex After Giving Birth

Peri-Natal Psychiatry
sex?? I just had a baby...Photo attribution:

Written by:  Dr. Ditza Katz, PT, PhD, Women’s Therapy Center, Plainview NY

Sex? Really? I just had a baby… I am so tired… My body is still sore… I don’t feel sexy… The baby needs me 24/7… I am leaking urine and it will turn him off…

Sounds familiar?

Historically referred to as postpartum, it has now been coined The Fourth Trimester, promoting a comprehensive understanding and management of the postpartum process.  The Fourth Trimester is defined as the time between giving birth and the 12th week after giving birth during which the woman’s uterus shrinks, vaginal bleeding ceases, tears or episiotomy heal, energy is restored, emotional state stabilizes, family dynamics are realigned as the woman adjusts to her new life.  Of note, postpartum recognition is found in most cultures and religions, albeit with difference practices.

Barring medical instructions to the contrary, a woman can become sexually active at the 6th week postpartum when her body has restored itself, yet many women are still hesitant or don’t feel ‘ready’ to resume sexual intimacy.  Why?  Common causes include

  • Fatigue, sleeplessness;
  • Anxiety, especially first-time mothers who are more vulnerable to this new experience of motherhood;
  • Painful healing episiotomy, C-section scar, hemorrhoids;
  • A dry vagina? Insufficient lubrication?
  • Embarrassment about leaking urine;
  • Will intercourse be painful? Can the vagina handle the penis’ thrusting?  Will it tear the episiotomy?
  • Vaginismus considerations: did having a baby vaginally cure it? Can the penis fit? Why am I afraid to even try penetrations?
  • Not feeling ‘sexy’ with new body, leaking breasts, recovering vagina…
  • Overwhelmed with the new life and responsibilities? 
  • Struggling with balancing life and baby? 
  • Relationship breakdowns; 
  • Is the partner/husband putting forth demands, with the typical, “You love the baby more than me… You do not pay attention to me as much as to baby”?  
  • Panic/anxiety/OCD conditions are present?
  • Postpartum depression? Note: history of anxiety or depression increases the likelihood of postpartum depression;
  • Is life too busy – work, multiple kids, etc. – to be able to find a time to shut down her racing mind and dive into the physical nice of sexual intimacy?  

The female sexual template is largely controlled by her mind, with the clitoris being her sexual organ of arousal.  It is very easy for a woman to ‘kill’ sexual interest with the slightest worry or negative thought.  In other words, because sexual interest is a mind issue, is there a wonder why sex after giving birth is such a complicated matter?

Sexual intimacy is a normal bodily function that is vital for maintaining a healthy relationship with the partner, but more importantly with oneself and one own’s body.  So, ask yourself: are you ready to resume sexual intimacy? Do you relate to any of the abovementioned stop signs and need intervention?  For a woman to engage sexually, she must have her body and mind working together in the positive. 

A woman’s emotional well-being is just as important as her physical, especially when it comes to sexual activity. Healthy restoration of sexual intimacy postpartum calls for sorting out the cause(s) behind avoiding it.   Resources include your maternity provider, a mental health clinician, a sex therapist, a pelvic floor physical therapist.

Take your time to explore and experiment. There are solutions available to any of the above causes of refrain from sex after giving birth and you need not suffer, feel that you are alone, or that there is no hope.  The value of sexual intimacy goes a long way in promoting relationship and emotional health.

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