Sex after baby arrives: challenges and what matters

            You’ve spent nine months waiting for your little miracle, getting ready to have another being in your home, and planning how best to adapt to all the changes a baby brings. Pregnancy isn’t usually easy and often connecting sexually with your partner is one of the last things on your mind. By the third trimester, about 75% of people report a loss of sexual desire, while between 83 and 100% report less frequent sexual activity (De Judicibus & McCabe, 2002). So you’ve probably already had less sex with your partner by the time baby arrives. Now what? Should you just get right back to how sex was before pregnancy? What’s normal? What makes sex so challenging after childbirth? How about the role of post-partum depression? And what can you do to get back to your normal? This blog post will answer these questions to help you understand sexuality after childbirth and how to meet those challenges.
When can we have Sex Again?
             There’s lots to worry about when you bring baby home – feedings, changing diapers, sleeping, playing, and keeping baby safe. It’s easy to lose sight of the union that created the baby – you and your partner. Should you have sex right away? Is it normal to not want it? First of all, it’s recommended that you wait about two weeks after delivery before having intercourse because there is some risk of infection or hemorrhage (Hyde & Delamater, 2011). That doesn’t mean you can’t do other sexual activities, but you may not want to.
What’s Normal?
            In the month after birth, only about 17% of couples have intercourse, while by the fourth month, 90% of couples have resumed intercourse (Hyde & Delamater, 2011). Couples start enjoying intercourse gradually after birth, with a small amount enjoying it after two weeks, while 67-80% enjoy it at around twelve weeks after birth (De Judicibus & McCabe, 2002). So, if you’re not having intercourse right away, you’re in the majority, and you may not start wanting it or enjoying it until 3-4 months after delivery. That’s totally normal. It might actually be a time that you can try other sexual activities that don’t involve intercourse. More on that later. But what factors cause some couples to re-engage quicker than others?
What Makes Sex Challenging?
            There are at least six factors studied by researchers that are related to less sexual desire after childbirth (De Judicibus & McCabe, 2002). It can be difficult to adjust to the role of being a mother, marital satisfaction can change, while fatigue, physical changes, breast-feeding, and mood are also issues. If you are having issues adjusting to parenthood, you’re not alone. It limits your social life and sleep, while also making it difficult to take care of yourself. There’s also a lot of research that shows how difficult a baby can be on a relationship (De Judicibus & McCabe, 2002). Add those stresses to overall fatigue, soreness due to limited lubrication, and evidence that breastfeeding reduces sexual desire, and you have a recipe for limited sexual desire and frequency. So, it’s pretty normal to not want much sex after birth, and there are lots of good reasons for that. There’s one last big factor that deserves special attention – mood.
Post-Partum Depression – Is it Affecting you?
            About 35-40% of women experience some depressive symptoms after childbirth, while it is estimated that around 10% of women suffer from more severe symptoms and have post-partum depression (De Judicibus & McCabe, 2002). There can be a loss of identity and personal space, as well as feelings of not fulfilling expectations in addition to the normal challenges of adapting to a baby (Edhborg et. al., 2005). How do you know if you have post-partum depression and not just the fairly typical less severe form of depression? Symptoms of sadness, anxiety, low energy, reduced sexual desire, irritability, crying episodes, and changes in sleeping and eating patterns would need to be present for at least two weeks to meet the criteria. In extreme cases, thoughts of homicide or suicide can also be present. Talk to your doctor if you’re not sure if you need medical attention, but a good rule of thumb is that if you have these symptoms for most days out of two weeks, then you should see your physician or psychologist to talk. Some research has found that maintaining a healthy marital relationship where parenting is shared helps with post-partum depression, while other research says that it’s important to challenge perfectionist expectations of motherhood and talk about feelings (Edhborg et. al., 2005). That’s a couple of specific things related to depression, but what else can you do to manage less sex?
What Can You Do About It?
            We’ve talked about the challenges, but what you really want to know is what can you do about it? The first thing is to recognize that you are completely normal if you aren’t having sex right away after childbirth, and it’s also normal if you just don’t want to or don’t enjoy it. It doesn’t mean there’s anything wrong with you. If intercourse isn’t enjoyable, think about using more lube or focusing on all the different things you can do sexually. It doesn’t have to include intercourse or vaginal contact, and it might not include as much nipple play either if you’re breastfeeding. Find other things you enjoy, like massages, hugging, or kissing if you can’t or don’t want to do your normal sexual activities (Hyde & DeLamater, 2011). In most cases, it will take until the fourth month after childbirth to get back to your old activities, and sometimes it takes longer (De Judicibus & McCabe, 2002). You may also have some sadness and relationship changes. Make sure you find time to nurture your marital relationship and talk to your doctor if your sadness makes life difficult for more than two weeks.
Take Home Messages
            It’s normal to have less sex and desire for sex after childbirth. Though it can be the most special time in your life, it can also be difficult to adjust to the role of being a mother (or father), marital satisfaction can change, while fatigue, physical changes, breast-feeding, and mood are also issues (De Judicibus & McCabe, 2002). Be especially careful about your mood since post-partum depression may affect around 10% of women while less severe sadness affects almost half of women (Edhborg et. al., 2005). Make sure you talk to your doctor if you think your depression has lasted for more than two weeks. However, difficulties with sexuality are pretty normal, and it doesn’t mean there’s anything wrong with you. Pay attention to your relationships, your self-care, your expectations, your sleep, and take action to prevent less sex from overwhelming you. Do other things with your partner to connect, share your experiences together, and keep an eye on each other. You can get through this – together. And if you’re partner isn’t around, make sure to get support from family and friends. It’s hard to do this on your own.      
References
De Judicibus, M. A. & McCabe, M. P. (2002). Psychological factors and the sexuality of
            pregnant and postpartum women. Journal of Sex Research, 39(2), 94-103.
Edhborg, M., Friberg, M., Lunch, W., & Widstrom, A. (2005). “Struggling with life”:  
            Narratives from women with signs of postpartum depression. Scandinavian
            Journal of Public Health, 33, 261-267.
Hyde, J. S. & Delamater, J. D. (2011) Understanding Human Sexuality (11th ed.). New York:
            McGraw-Hill.