Thursday, December 13, 2007

Getting in the SAC ( Sex After Childbirth)

I've had this blog for a while and posted nothing up... so.. here is a work in progress - after all - thats what this spot was meant to be....

The wisdom and experiences collected here were sourced from friends, family and work colleagues through a written survey emailed around the globe and two in person workshops. The discussions I held were in wonderful open and sharing spaces, around tables with cuppas in hand. The women who contributed are from a range of ages, backgrounds, nationalities and birthing experiences. Their insights and wisdom follow. In no way are their insights or experiences representative of everyone, however they can be viewed as representative of the thoughts, beliefs and feelings of a large proportion of women who are willing to speak about sex after birth.

Sex Postpartum – sounds so clinical doesn’t it? Sadly it’s treated as such by healthcare professionals. It is a subject held taboo even amongst the closest of girlfriends. Men and women have different worries and reactions when it comes to sex; before adding the often complicating aspects of childbirth, coupled with the reshaping and search for meaning and identity as a new parent. Even the most revered texts – “The Joy of Sex”, “Dr Ruth’s Guide to Sex” and “Couple Sexual Awareness”, only briefly touch on the subject of sex after birth. The general consensus and advice to couples is to ‘get back into it’ as soon as they can. One book goes as far as suggesting that if one partner seems to have lost their desire, then counselling is required immediately.

The Magic Six Week Marker

Most of my friends, family members and work colleagues, who assisted with this article, were told by their midwives or health care professionals to abstain from sex after the birth of a child for six weeks. At this time most of them had a full medical check to ensure everything was back to “working order”. What very few women understand is that it takes approximately six weeks for the uterus to return to "normal" size after birthing – which is where the magical six comes into the equation. Despite anatomically (give or take a few love handles) coming back to ‘normal’ within six weeks, many women feel a complete lack of desire for sex for several months after that. This is likely to be due to a number of reasons such as exhaustion, breastfeeding, hormone changes, lack of proper nutrition or nurturing, stress, anxiety, depression …. the list goes on.

The Sexual Pause

Especially with first babies, women can have a tendency to make their baby the centre of their universe. This often leaves little time to focus on or be with their partner. This drought in every day intimacy and attention flows on to a coital hiatus. Nature, it seems, planned on this to ensure that babies are well looked after and future pregnancies are spaced out.

Of the women who shared their experiences with me, around half of them felt that their partners had a reluctance to have sex again with them, even when the six week mark had arrived. Of these women, the majority felt that this reluctance stemmed from their partners’ distaste of their more “bootylicious” body shape. Some from both sides noted disgust or embarrassment from their partners when they leaked (or spurted) milk during sex. Those women, whose partners were not reluctant to engage in sex, had some reservations on what positions they could use. Only a small number of the women felt that sex within the first two to three months was exactly like it had been before birthing.

When asked if they missed sex in the time that lapsed between birthing and having sex for the first time post partum, the majority of women said that they didn’t miss the sex. What they did miss and long for was affection and closeness. A small number of women said that they had strong desire for sex immediately, whereas the larger percentage of women the desire for sex, was not felt for months (or some years) afterwards. One friend believed that the sexless period and just not enjoying sex after birth, was normal. Many other women however women felt guilty that they just didn’t feel like it or want it. Many believed they are depriving their partners and often submitted to painful or lack luster sex out of guilt or pity. A large number of women also noted that their partners were fearful of hurting them and were not sure how to initiate sex again.

When I asked at what stage did they feel they were ‘back to normal”, the vast majority indicated that it was well over 18 months, assuming there were no further pregnancies during this time. One friend’s advice was, “to be patient and everything you thought you'd lost will come back after 2 years..... It’s like someone switched a light”. The sudden return to sexual desire seemed to be a common theme among the women who shared with me.

The advice the women wished to share was to return to sexual intimacy in your own good time and not to rush it. The also advised to make space and time, to care and nurture yourself. Lastly, they unanimously agreed in the important of including and communicating with your partner.

Mum Dad Baby and Sex
Of interest to me, was the link between a partner’s involvement in caring for the baby and mother, and the lapse of time in returning to sexual intimacy. Couples where the father became involved with every aspect of looking after the baby returned to sex earlier. Women whose partners were absent, either emotionally or physically, were unresponsive to the needs of both baby and mother or only half heartedly attempted to assist experienced either a total or dramatic decrease in the desire for sex for months, or even years after birthing. I believe the disparity of these experiences, illustrates the differences between a family unit functioning as a whole, as compared to isolated individuals under the one roof just getting by. This again highlights the importance of a supportive partner – be it the father or another person, as an essential element in the wellbeing of the mother.

Care providers, post natal care and sex
The women I spoke with felt that their doctor or midwife should have discussed the post birth healing process with them, and that this was both an appropriate and essential part of follow up care for both the mother and the baby. They were especially concerned that the physical dimensions of healing were not discussed in relation to conditions specific to their particular birth experience. For most of the women this key aspect of post natal care was either missing entirely or brushed over quickly by their care provider. Physical healing is the one topic that the women felt most reluctant to ask advice on or to talk about with family or partners. They agreed that is it a topic not discussed in any depth, even with closest of girlfriends.

I Believe Sex after Birth is …

I asked my women friends, family members and colleagues to finish the statement – “I believe Sex after Birth is” ….
· a new journey
· important in re-establishing your relationship with your partner.
· reclaiming your femininity
· not as important as spending time and skin-to-skin contact with the ones you love.
· establishing your space again in the relationship.

For my friends, family and work colleagues fatigue from birthing, pain from perineal tearing or stitches, lack of sleep, the tearing around on the hor­monal and emotional rollercoaster, and concern over physical appearance impacted greatly on their sexual desire. From sharing in their wisdom, I can see that there is no right time to restart your sex life. While sex may not be necessary, just lying together, cuddling and spending time in each other’s company is important. It strengthens your relationship and gives you the space and time to be comfortable with your body again.

“If you have stitches or a tear (which can actually be worse) you are going to have to be careful. The scar tissue will be stretched during intercourse and the rearranged nerve endings might protest too. At best it will probably feel weird and different and at worst it's going to hurt. You need to be able to trust your partner completely and tell him that you may have to stop at any time. Better still, be in a position where you are in charge of controlling penetration, and tell him to be sure not to get too enthusiastic and to leave it all up to you. Also use a good quality lubricant to prevent any dragging of the tissues.”

“This first post-partum romp isn't going to be passion central believe me, but it puts you back on the road towards a fulfilling sex life.”

“Especially if you've just been through a traumatic birth experience, there is the fear (or is that blind terror?) of getting pregnant again. The pain hasn't faded from your brain yet (isn't it such a clever little trick that Mother Nature plays on us?)”

“Getting through the birth was one thing – but I was quite unprepared for the changes that this new little bundle brought our lives, and particularly in all aspects of our relationship.”

“Birthing can bring up so many of our buried demons. In the weeks and months afterwards, if you aren’t careful, you will start to act on your learned and observed behaviors, bringing your parents beliefs and opinions into play into your life – without you even knowing that you have invited them in. Be aware of your actions, your communication and don’t lose yourself in amongst it all.”

· Be appreciative and understanding as a couple. You are both undergoing big changes – let things go to a natural rhythm.

· It depends on how you were brought up on your beliefs and stuff. But you can make your own choices. Do it your way and have sex when it’s right for your body.

In preparing to write this article, I found that the women who became involved were desperate to share. They found it heartening that there were stories of beauty and passion, when such a plethora of horror stories and grim tales bandied about that would dishearten the most desirous Venus in us. I’d like to thank those wonderful women who contributed their thoughts, experiences, wisdom and advice for this piece. I appreciate your honesty and thank you for the clarity I gained through talking with you.