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What No One Tells You About Sex After Pregnancy

From major physical changes to emotional ups and downs, it’s no wonder a new mom’s libido often goes MIA after giving birth. Here’s what to expect and how to get your groove back.

| March 18th, 2014
What No One Tells You About Sex After Pregnancy

For many couples, the months following a new baby’s arrival are a sexual desert—as they battle with sleepless nights and as new moms recover and regroup from the myriad changes their body has gone through during pregnancy and labor.

After delivery, obstetricians see patients at the six-week mark, which is usually their final post-partum checkup. So long as the new mother has healed properly, women are usually told that they can resume sexual activity at this point. For many, however, sex could not be further from their minds.

Vaginal dryness, incontinence, pain during intercourse and a general lack of libido can impact a new mom’s interest in slipping between the sheets, not to mention the fatigue, stress and the emotional rollercoaster ride that many experience adjusting to life with baby. For better or worse, these symptoms are all normal during the first six months following delivery. In a survey of nearly 500 women published in the journal BJOG, 83 percent of women reported sexual problems in the three months following their child’s birth. At six months, that number had dropped to a still-high 64 percent, compared to pre-pregnancy levels of 38 percent.

Despite all this, few doctors broach the subject of postpartum intimacy issues with their patients—and few women ask. In the BJOG study, only 15 percent said they sought medical help or input about their sexual problems following delivery. “Everyone focuses on birth plans, but labor is only 12 hours of your life,” says Lauren Streicher, M.D., an associate professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine and author of “Love Sex Again.” “But no one is talking about postpartum, which goes on for months and is incredibly difficult for women.”

Physical Changes Behind the Loss of Libido
The issues that cause a new mom’s libido to take a nosedive are numerous and can take her and her partner by surprise. For starters, after delivery, women experience a drastic drop in estrogen, to the point that their vaginas function as if they were post-menopausal. The tissue becomes very thin, taut and dry, which can make sex painful even when lubrication is used. This issue often persists until breast-feeding stops. “The vaginal dryness problem is huge,” Dr. Streicher says. “Lots of doctors don’t mention this to women, and they wind up being blindsided by that.”

Caro Reyes, 28, can relate: “The first time I had sex after my daughter was born, it felt like I was a virgin again—it was so tight,” says the mother of two from San Diego, who waited about three months to have sex again after her first delivery. “The only position I felt comfortable in was him on top in missionary. I couldn’t be on top of him because penetration would be painful. Any other position was too tender.”

During vaginal delivery, the vagina experiences trauma as its delicate tissues are stretched, bruised or torn. Depending on the severity, this trauma plays a major role in when a woman is physically ready to have sex again. Although the BJOG study found that dyspareunia—pain during sex—was significantly correlated with vaginal deliveries, having a C-section does not necessarily preclude a woman from experiencing dyspareunia. The estrogen drop is still very much at play, in addition to the residual pain at the incision site.

Michelle Langford, 29, a mother of two from Atlanta, delivered both of her children via C-section, but still found sex afterwards to be painful. Rebecca Green*, 41, had a similar experience: “I assumed that since I had a C-section, our sex life would pick up right where we’d left off. I was mistaken. Penetration was surprisingly painful at first, even with lubrication, and no one had warned me about that. It took a couple of weeks of trying before sex became more comfortable and then things got better and better.”

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