Sex: Prenatal And Postpartum
This is a continuation of the previous blog post titled “What They Don’t Teach You in Parenting Class”. This post was written from a heteronormative, monogamous, able-bodied, female-identifying angle with a planned and wanted pregnancy and therefore does not entirely take into account the perspective of LGTBQ+ or disabled experiences with regards to sex after having a baby.
Though there are exceptions to the rule, most modern day romantic relationships include sex in some way, shape, or form. Throughout the course of a relationship, sexual activities and interests change. The following blog post breaks down the act of sex, emotional feelings, and physical sensations associated with it into three different time frames: (i) pre-pregnancy, (ii) pregnancy, and (iii) postpartum.
When first meeting a partner, boyfriend, girlfriend, or significant other, sex may not even be involved in your relationship; you might choose to “take things slow” and gradually work your way up to engaging in sexual activity. Through first dates and time spent together getting to know one another sexual tension may build. When engaging in sexual intercourse with a partner eventually occurs, a wide variety of emotions are typically experienced ranging from passion and excitement to nervousness or even awkwardness. In the beginning, sex may be uncomfortable. Your partner could be clueless as to what feels best for you or the ways that you like to be touched. Over time as the relationship strengthens or as an individual becomes more confident in the bedroom, some may choose to voice and express their sexual preferences thereby making the act more enjoyable.
Months or even a couple of years into a romantic relationship may be considered the “Golden Age” of sex. You now understand your partner and their sexual predilections, and they understand yours hopefully enabling each other’s sexual wants and needs to be continuously met. There can be a sense of relief felt by all parties knowing that there is another person with whom you can connect on a social, emotional, and now fully intimate level.
Fast forwarding many years into a long-term relationship or even marriage, sex can begin to feel repetitive and stale if you do not incorporate variety into your sexual engagements. Couples might discover a mismatch in the sex drive between one another leaving some dissatisfied with the frequency, intensity, or duration of the act. Sexual activity might begin to feel like a chore or rather routine for some because it’s “just something you have to do” in relationships. Some couples may resort to the introduction of toys, roleplay, or pornography to ignite a dimmed flame. Couples who engage in consensual nonmonogamy may choose to invite new partners into the mix to spice things up. Other couples may come to the point in their relationship in which they make the decision to use sex for a purpose other than pleasure, rather to become pregnant. It can initially feel stimulating and exhilarating as you and your significant other embark on this potentially life changing journey; however, for couples who face infertility issues sex may start to feel stressful and calculated as it becomes more strategic rather than gratifying in an effort to achieve the intended goal.
Sex during the first trimester might not actually occur for some couples due to the severity of symptoms being experienced at the time. It is no secret that nausea, fatigue, and constipation that accompany the first trimester of pregnancy are certainly not the most appealing turn-on. Jumping ahead to the second trimester, libido for many tends to increase as first trimester symptoms subside. Though this may be true, sex might not be quite the same as it was pre-pregnancy. Your body may have difficulty achieving the different positions that you once preferred as your physical flexibility and bodily capability change entirely. There is also the possibility of experiencing a lack of confidence as you begin to notice the transformation of your body.
In your third trimester, you may make efforts to more frequently engage in intercourse with your partner as you are reminded of the quickly approaching lack of privacy you will have once a baby is welcomed into your home. Though you want to make the most out of the time you and your partner have as just the two of you, sex may be a challenge. When simply sitting down on the couch leaves you instantly breathless and when you look down in the shower and can’t even see your own vagina because it is blocked by this bulbous belly containing your offspring, imagine the difficulty of sex. Your partner might even turn into Seth Rogen’s character from “Knocked Up” in which fears arise that he is hurting the baby with his penis while having sex with you. Sex is also said to induce labor. Therefore, in the weeks or days leading up to your due date sex may be a choice as a method to speed up the process to bring you to the eventual alleviation of your condition.
Doctors recommend no sexual or physical activity for at least six weeks postpartum. Even when you are cleared to resume normal activity, your body might not truly feel ready. What once was a fun, exciting, passionate, intimate, and pleasurable activity, shared between you and your partner, can now be uncomfortable, tender, and potentially worrisome. In terms of having sex after a baby, you may fear that the stitches you had received to mend your torn vagina from childbirth might be tearing open as that is quite possibly what it may feel like for you. One might assume that this discomfort may only occur for those who have given birth vaginally, but that is far from the case. Just prior to birth and afterward, as your body has begun and continued to produce breastmilk, it has simultaneously decreased the amount of estrogen it normally creates. As a result, the natural lubrication your body used to generate to make sex more comfortable and pleasurable is no longer present or, at least, has significantly declined. Doctors explain that this occurrence is completely normal though will most likely continue until you stop breastfeeding. If you want to continue to have sex postpartum despite the pain, then the advice here, bluntly put, is to use artificial lubrication and push through while biting the bullet.
Not only can sex after having a baby be physically uncomfortable or even painful, but it can be more emotional as well. Imagine trying to set the mood with a crying, screaming, or even cooing baby in the room next door. It may be incredibly challenging to stay mindful and in the moment, especially when your mind is on whether or not your baby is sleeping, breathing, or comfortable. Lack of self-esteem or confidence with your new, postpartum body that was previously inhabited by your new infant may make feeling sexy or seductive increasingly difficult. Those sensations and types of touch that formerly felt gratifying and titillating may no longer send that spark throughout your body, leaving you with a mystery and need for discovery of what feels good currently.
Returning to sex for some also means the return to the use of contraception. There are many different forms of contraception that you can discuss with your doctor, but depending on your timeline for family planning, the recommendation for types of birth control may vary. Intrauterine devices (a.k.a. IUDs) can be excruciatingly painful to insert and remove. If you want your babies spaced about two years apart, then considering the potentially short amount of time that you would be using the IUD, it may not be worth the pain. The problem with the pill, on the other hand, is that it must be taken exactly at the same time each day in order for it to be the most effective in preventing pregnancy. When you are not getting enough sleep and find it challenging even to make time to shower, think about the difficulty of taking your birth control pill on time every day. Given the recent Supreme Court ruling overturning Roe v Wade that restricts and bans safe abortion access to many across the country, the use of and ability to obtain contraception is crucial. Though your normal menstruation cycle might not return until several months post-childbirth, spontaneous ovulation can occur leading to the possibility of pregnancy if choosing to engage in sexual intercourse. Should this be the case, your body could potentially face serious health risks as it might not be able to appropriately foster another pregnancy so close to your previous pregnancy. Alternatively, you may not wish to become pregnant so soon while having to concurrently care for your newborn.
Just as everything else in life, things change over time, particularly sex and sexual preferences during pregnancy and postpartum. At various points in a relationship, your sense of comfort with your partner and yourself both physically and emotionally will transform. Two crucial and consistent factors throughout these stages that can make sex more attractive or appealing are communication and vulnerability. At any point in a sexual relationship, communication is key to convey what you are comfortable with, what you want to try that is new, or what is most definitely off limits for you. Communication during sex can lead to a more gratifying experience for both you and your partner as it allows for more understanding in the bedroom, therefore, enabling the ability to let loose and be free. The ability to openly communicate with your sexual counterpart is a vulnerable act in and of itself. Vulnerability is essential to a sexual encounter due to the sheer nature of the act. Being vulnerable with a sexual partner typically allows for the increase of trust, intimacy, and appreciation especially if the vulnerability flows both ways.
Article by Jillian Ross, LCSW