If you have had a baby recently, and have lost all interest in sex, you are not alone. A 2015 study found that 50% of Australian women had still not regained their interest in sex, even 12 months after the delivery. Disturbingly, 30% of these women were experiencing pain with sex.
The responsibility of looking after a new life can bring feelings of anxiety and worry or depression. Having had a traumatic delivery experience will make those feelings stronger. It can feel like the first postpartum year is about survival, and nothing else.
The Physical Barriers to Intimacy
Of course, nobody feels like sex when they are sleep deprived and experiencing bone-aching fatigue. Or backache, or pelvic pain. Vaginal dryness occurs in close to 50% of women. Sometimes this is from the low oestrogen and high prolactin/low testosterone state that occurs when breastfeeding. Tight and protective pelvic floor muscles are likely to occur in 40% of women, but there might also be a feeling that your vagina is loose and your insides are going to fall out. You could still have a sore perineum from stitches, episiotomy, or the vacuum or the forceps.
You might feel turned off by the appearance of your bits down-under, or afraid your partner will be turned off. You might be dealing with weight gain, saggy skin, sore or dripping breasts, and altered body image in general. And nobody feels sexy if they have wet or soiled themselves, or have a fear of this happening.
The Emotional Barriers to Intimacy
Your role within the relationship will have changed. It can be difficult to switch from mother to lover in an instant.
You will have had to re-negotiate practical responsibilities and you may feel resentful that you aren’t getting the help you need.
You no longer have the freedom to do what you want to do when you want to do it. It will be hard to get out of the house to do the things that used to boost your mental health, like exercising or meeting your friends, and it is almost impossible to do anything on your own.
You may not be receiving the level of emotional support that you need.
All these things can be barriers to emotional intimacy, which is a necessary precursor to enjoyable sex.
Look for Opportunities to Connect Emotionally
If you can allow yourself to experience emotional intimacy with your partner, your body is likely to become receptive to the idea of sexual activity, and arousal and then desire are likely to follow. It is important to note that, for most women, desire comes last, AFTER the experience of emotional intimacy, and even after some arousal has been felt. In contrast, men are more likely to use physical intimacy as a starting point, with emotional closeness the endpoint.
No wonder there is room for misunderstanding and miscommunication!
Emotional intimacy is achieved by having trust in each other and showing respect for each other. Small things that will rebuild emotional intimacy include accepting your partner’s help, saying please and thank you, having common experiences that aren’t shared with others, accepting or giving your partner a compliment, and initiating or allowing non-sexual physical touch, such as accepting or initiating a hug, a shoulder squeeze, or holding hands.
If pain or fear of pain is a barrier to intimacy for you, your pelvic health physiotherapist can help. If you suspect relationship issues, see your GP for referral to a couple’s counsellor. If you suspect you have anxiety or depression, reach out to Perinatal Anxiety and Depression Australia via their website or on 1300 726 306. You might find the Centre of Perinatal Excellence resources useful.
Returning to sex after birth is different for everyone. Our women’s health physiotherapists can help support and guide you toward a speedy recovery. Book with us today and we’ll get you started.
1. Exploring the Complexities of Postpartum Sexual Health Deirdre O’Malley, Agnes Higgins, Valerie Smith. Current Sexual Health Reports (2021) 13:128–135 https://doi.org/10.1007/s11930-021-00315-6
M2. McDonald E, Woolhouse H, Brown S. Consultation about sexual health issues in the year after childbirth: a cohort study. Birth. 2015;42(4):354–61. 24.