Regaining intimacy after childbirth

Lilian was feeling awful. During her pregnancy and after delivery, she had hoped to maintain intimacy with her husband.

The last thing she had anticipated was that John would feel rejected. But as fate would have it, that is exactly how John was feeling three months after the delivery.

“Sincerely it is now more than double the time the doctor gave for abstinence,” John lamented, “she keeps pushing me away and I feel that the baby is now more important to her than I am.”

“But I have no sexual feelings and I fear it will be painful,” Lilian explained, “it is not in bad faith, I just do not know what to do.”

The couple, in their late twenties, had been married for two years. All was well in the relationship until after Lilian delivered. John wanted to resume sex as quickly as possible but the doctor told them to wait for six weeks. Time passed and three months later, sex had not resumed. John felt rejected and dejected. A conflict developed. They came to the Sexology clinic “to get medicine to bring back Lilian’s libido”!

I explained to the couple that resuming sex after delivery can be challenging. Whether the delivery is by Caesarean-section or vaginally, some tissue damage happens and requires time to heal before sex can resume. The uterus also continues to bleed for a while, a sign that the wound left inside after delivery is yet to heal. On average, most women will heal by the sixth week after delivery.

Some, however, heal faster while others require a longer time.  “Really doctor, I think we need to be fair to each other here,” John interrupted, “this lady is healed, she is going around her house chores as usual, I think there is more than meets the eye.”

I noticed that Lilian’s eyes were welling up with tears. She was getting distressed. I asked John to be patient as I explained.

MAINTAIN THE WARMTH

Hormonal changes in the body following delivery are bad for sex. First, prolactin levels rise. Prolactin is the hormone that causes the mother’s milk to flow. High prolactin levels totally knock out the desire for sex. In fact, affected women fail to get aroused. The situation is further complicated by low oestrogen levels that occur at this time. Low oestrogen results in poor lubrication and makes the vagina less elastic. What this means is that even when the bruises and cuts of delivery have healed, the vagina can be dry and inelastic during sex after delivery and this can cause severe pain.

But let us not forget that most women are exhausted during this time. Irregular sleeping hours, caring for the baby and still maintaining the wife’s role can be daunting. You do not expect an exhausted person to have sexual feelings.

“So it appears there will never be sex after all,” John asked.

Well, there are answers to these problems. First, open discussion is important. Empathy between spouses is also crucial. The couple did well to seek professional opinion when communication between them broke down.

Second, it is important to maintain intimacy even if penetrative sex is not possible. Cuddling, kissing and other forms of foreplay help maintain the warmth. This can start even from the day of delivery. Surprisingly, Lilian and John had been sleeping on different beds after  delivery because Lilian wanted to give the baby attention and not interfere with John’s sleep. It is understandable that John had to continue going to work after his two weeks of paternity leave but separating beds was bad for intimacy. I advised that they move back to their marital bed and keep the baby in the cot.

“But that means the baby will cry so much!” Lilian exclaimed frowning.

“Well, babies cry and soon learn that they have to sleep alone because mummy and daddy have other serious businesses to transact,” I replied to which John nodded vigorously.

When you keep close, touch, cuddle, massage and do whatever foreplay you want, things get easier and you are soon back on course with your sex lives.

But remember hormones may still lead to dryness and pain even when you are psychologically set to make a go. Using a lubricant for a start can be of great relief. In fact you may want to continue with the lube for a while till the body picks up naturally.

And always remember that ovulation happens any time from the sixth week after delivery. Even if your periods have not resumed, you need to start on a contraception. There are women who have delivered and before their periods resumed they conceived again.

Lillian and John promised to try these tips. Two weeks later, John called to say things had happened. He had put the phone on speaker and Lillian was laughing throughout.

“Great!” I shouted back, “So Lilian just do Kegel exercises to tighten your pelvic muscles so that you have maximum pleasure.” They both laughed in unison, a reassurance that the couple was fully back on course.