Postpartum Sexuality

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Many individuals or couples have questions or concerns about postpartum sexuality. Resuming sexual relations takes time and patience. During the first 6-weeks postpartum, the birth parent’s body is in recovery mode – much more than simply a return to the non-pregnant state!  Almost every culture advocates 6 weeks of abstinence for medical or spiritual reasons. 

After giving birth, some people have no change in libido and a rare few experience an increased drive.  However the majority notice lessening or lack of sexual desire; it’s a normal result of the physical and hormonal changes that accompany birth and post-partum. Most researchers report a return to pre-pregnancy levels of sexual desire, enjoyment, and frequency within a year. The hormones of breastfeeding often lead to suppression of sexual desire. Other factors that play into the temporary decrease in sexual feelings include:

  • Lifestyle changes
  • Exhaustion or fatigue
  • Feeling “touched out” due to constant contact with infant
  • Time constrains with duration of sex due to infant needs
  • Loss of privacy as a couple
  • Individuals in a partnership dealing with new pressures such as how to be a devoted parent or deal with increased financial responsibility
  • Many birth-mothers find themselves feeling dependent on their partner partner in new ways – a major mental and emotional adjustment
  • Self-image – postpartum people may feel self-conscious of their body and it’s workings
  • Relationship satisfaction, which is a predictor of postpartum sexual desire and frequency of intercourse
  • Baby blues or postpartum depression

Did you Know?

  • It takes 6 weeks for the placenta attachment site to heal. During that time there’s actually an open wound in the uterus, at risk for infection or injury.
  • The perineum can take 4-8 weeks to heal after incisions or stitches.
  • Vaginal secretions are decreased due to postpartum hormone levels.
  • Either or both partners may feel shy.
  • Jealousy of baby, mother-baby relationship, or partner’s perceived freedom is normal.
  • Nipples may be sore or tender. Breasts may leak breast-milk with sexual stimulation.
  • Some people feel sexually aroused when their milk lets down.
  • It is not normal to have pain with intercourse or using the toilet after 8 weeks postpartum.

The top concerns by both genders at 4 months postpartum include when to resume sexual penetration, birth control, recovery from delivery, and postpartum body image. Have open discussions as a couple.

When to Begin Again…

  • To prevent infection or discomfort, wait until whichever is LATEST:
    • Postpartum bleeding has fully stopped
    • Perineal tears, injuries, sutures heal
    • 6 weeks
    • **Everyone involved is ready physically, mentally, emotionally**
  • Start slowly,  especially in cases of traumatic birth
  • Stop in case of pain or discomfort
  • Patience may be required during the time-period before resuming sexual relations. Try:
    • Mutual caring and love
    • Cuddling, hugging
    • Kissing
    • Other sensual, nonsexual contact such as massage

Challenges to Sexuality

  • Relationship as both parents transition to parenthood
  • Perceived or actual inadequate support and presence of partner
  • No time for intimacy, especially if in survival mode
  • Difficult or traumatic birth, including Caesarean, can have physical and emotional lingering effects
  • Trauma to perineum during birth process
  • Religious or cultural beliefs

Other Strategies

  • Postpartum support to ensure rest and recovery from pregnancy and birth
  • Daily connection and even romance
  • If partners find each other attractive or beautiful then tell them, or find something to compliment
  • Set aside time for sex when neither of you are tired or anxious e.g. weekly date (day or evening) when someone takes baby for a couple of hours, or a weekly rendezvous while baby sleeps
  • Use a lubricant, as it’s normal to be dry or drier than usual, especially if breastfeeding
    • Water-soluble are “healthiest” and help with irritation or sensitivity
    • Silicone-based last longer and are more slippery than water-soluble
    • Avoid petroleum products (Vaseline, baby oil, or mineral oil) as they’re toxic and can dissolve latex condoms or barriers
  • Don’t take it personally if if your partner isn’t interested in resuming sexual relations; this will improve with time as hormones and schedules normalize.

Contact Health Care Provider, such as Pelvic Floor Physiotherapist in Case of…

  • Pain with penetration or using the toilet beyond 8 weeks that isn’t lessening each week.
  • Any questions or concerns regarding sexuality postpartum.

Pelvic Floor Physiotherapy

  • Specialists in female pelvic floor care and recovery after birth; also help with prenatal pelvic floor health.

Other Practitioners who can Help

  • Painful penetration may be referred to a pelvic floor physiotherapy specialist or gynaecologist.
  • Sex therapist in case of non-physical or unidentified origin.
  • Couples counselling if relationship is strained.

References

Association of Reproductive Health Professionals. (2006, Sep). Postpartum Counseling – Sexuality and Contraception. Retrieved Sep 2011, from Association of Reproductive Health Professionals: http://www.arhp.org/publications-and-resources/quick-reference-guide-for-clinicians/postpartum-counseling/contraception

Calgary Health Region. (2007). From Here Through Maternity. Calgary: Alberta Health Services.

Davis, E. (1997). Heart & Hands (3rd ed.). Berkeley, CA: Celestial Arts.

Lim, R. (2001). After the Baby’s Birth – A Complete Guide for Postpartum Women (Revised ed.). Toronto: Celestial Arts.

McCabe, M. A. (2002). Psychological Factors and the Sexuality of Pregnant and Postpartum Women. The Journal of Sex Research , 39 (2), 94-103.

Pastore, L. P., Annette Owens MD, P., & Raymond, C. ,. (2007). Postpartum Sexuality Concerns Among First-Time Parents from One U.S. Academic Hospital. The Journal of Sexual Medicine , 4 (1), 115-123.